Vocal Fold Atrophy in a Japanese Tertiary Medical Institute: Status Quo of the Most Aged Country

Objective. Voice problems in the geriatric population are increasing worldwide. Since the demographic research of geriatric voice patients in Japan, the country of the most advanced Aging Society, is missing, the authors assessed the current trend of geriatric voice patients, especially patients with presbylarynx at a tertiary medical institute of Japan. Study Design. Retrospective study. Methods. From a review of the medical records of newly referred patients, patients aged 65 years and older and patients with vocal fold atrophy were selected, and demographic data, questionnaires, and parameters of aerodynamic and acoustic study, and videostroboscopy were analyzed in terms of age and gender. Subsequently, the difference between patients with presbylarynx and 20 vocally healthy elderly subjects were assessed with multivariate analysis. Results. Of 1157 newly referred patients seen at the Voice Outpatient Clinic between 2006 and 2012, patients aged 65 years and older accounted for 37% (428 patients): there was 7% increase during the past 7 years and the prevalence was considerably higher than any other previous reports. Vocal fold atrophy accounted for 11% (128 patients) of all patients: dysphonia in patients with vocal fold atrophy aggravated as age advanced; there was a gender difference; and multivariate analysis revealed that reflux laryngitis, chronic medical condition, and vocal abuse were risk factors of presbylarynx. Conclusion. In Japan, elderly dysphonic patients were prevalent and rapidly increasing in recent years. Age-and gender-related differences should receive attention. Preventive approach on risk factors such as reflux laryngitis, chronic medical condition, and vocal abuse should be considered in the management of presbylarynx.