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Management of presbyphonia: A systematic review of the efficacy of surgical intervention.
Am J Otolaryngol. 2020 Jul - Aug; 41(4):102532.AJ

Abstract

OBJECTIVE

The aging larynx undergoes structural changes that have functional consequences for voice production known as presbyphonia. Treatment of presbyphonia includes voice therapy and surgery. This review seeks to examine voice outcomes after surgery for presbyphonia.

DATA SOURCES

Three electronic databases (PreMed, ScienceDirect, Embase) were reviewed for articles published between 1 January 1900 and 1 June 2019.

REVIEW METHODS

Original English-language studies examining surgical treatment of presbyphonia in elderly patients (≥65 years) were included according to PRISMA. Two researchers independently analyzed articles. Outcome measures were extracted from and qualitatively compared across studies.

RESULTS

Of the 118 articles identified, five satisfied eligibility criteria. In all studies, diagnosis of presbyphonia was based on videostroboscopy. 85 patients (61M, 21F) were evaluated. 37.6% underwent implantation thyroplasty (IT), 48.2% underwent injection augmentation (IA), 7.1% underwent both, and 7.1% underwent basic-fibroblastic growth factor (b-FGF) injection. Average patient age was 71.3 years. Average follow-up time was 5.4 months. Three months post-intervention, IT patients self-reported greater improvement in quality of life (QoL) metrics compared to IA patients. Aerodynamic measures, like mean phonation time, were significantly improved in IT and IA, but not b-FGF-injected patients. All patients experienced improvements in the auditory perception of voice three months post-intervention.

CONCLUSION

Surgical modalities currently utilized for presbyphonia include IT and IA, with bFGF-injection being trialed abroad. IT patients reported enhanced QoL relative to IA and bFGF-injected patients. Overall there is a paucity of high-power, prospective studies that explore the efficacy of these modalities. Moreover, wide variability exists in reported outcomes among published studies.

Authors+Show Affiliations

Rush Medical College, Chicago, IL, United States of America.Chicago Medical School, Rosalind Franklin University, Chicago, IL, United States of America.Department of Otorhinolaryngology - Head and Neck Surgery, Rush University Medical Center, Chicago, IL, United States of America. Electronic address: Inna_Husain@rush.edu.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32409162

Citation

Brown, Hannah J., et al. "Management of Presbyphonia: a Systematic Review of the Efficacy of Surgical Intervention." American Journal of Otolaryngology, vol. 41, no. 4, 2020, p. 102532.
Brown HJ, Zhou D, Husain IA. Management of presbyphonia: A systematic review of the efficacy of surgical intervention. Am J Otolaryngol. 2020;41(4):102532.
Brown, H. J., Zhou, D., & Husain, I. A. (2020). Management of presbyphonia: A systematic review of the efficacy of surgical intervention. American Journal of Otolaryngology, 41(4), 102532. https://doi.org/10.1016/j.amjoto.2020.102532
Brown HJ, Zhou D, Husain IA. Management of Presbyphonia: a Systematic Review of the Efficacy of Surgical Intervention. Am J Otolaryngol. 2020 Jul - Aug;41(4):102532. PubMed PMID: 32409162.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of presbyphonia: A systematic review of the efficacy of surgical intervention. AU - Brown,Hannah J, AU - Zhou,Dimin, AU - Husain,Inna A, Y1 - 2020/05/05/ PY - 2020/03/25/received PY - 2020/04/29/accepted PY - 2020/5/16/pubmed PY - 2020/5/16/medline PY - 2020/5/16/entrez KW - Aging larynx KW - Laryngoplasty KW - Presbyphonia KW - Surgical management KW - Thyroplasty SP - 102532 EP - 102532 JF - American journal of otolaryngology JO - Am J Otolaryngol VL - 41 IS - 4 N2 - OBJECTIVE: The aging larynx undergoes structural changes that have functional consequences for voice production known as presbyphonia. Treatment of presbyphonia includes voice therapy and surgery. This review seeks to examine voice outcomes after surgery for presbyphonia. DATA SOURCES: Three electronic databases (PreMed, ScienceDirect, Embase) were reviewed for articles published between 1 January 1900 and 1 June 2019. REVIEW METHODS: Original English-language studies examining surgical treatment of presbyphonia in elderly patients (≥65 years) were included according to PRISMA. Two researchers independently analyzed articles. Outcome measures were extracted from and qualitatively compared across studies. RESULTS: Of the 118 articles identified, five satisfied eligibility criteria. In all studies, diagnosis of presbyphonia was based on videostroboscopy. 85 patients (61M, 21F) were evaluated. 37.6% underwent implantation thyroplasty (IT), 48.2% underwent injection augmentation (IA), 7.1% underwent both, and 7.1% underwent basic-fibroblastic growth factor (b-FGF) injection. Average patient age was 71.3 years. Average follow-up time was 5.4 months. Three months post-intervention, IT patients self-reported greater improvement in quality of life (QoL) metrics compared to IA patients. Aerodynamic measures, like mean phonation time, were significantly improved in IT and IA, but not b-FGF-injected patients. All patients experienced improvements in the auditory perception of voice three months post-intervention. CONCLUSION: Surgical modalities currently utilized for presbyphonia include IT and IA, with bFGF-injection being trialed abroad. IT patients reported enhanced QoL relative to IA and bFGF-injected patients. Overall there is a paucity of high-power, prospective studies that explore the efficacy of these modalities. Moreover, wide variability exists in reported outcomes among published studies. SN - 1532-818X UR - https://www.unboundmedicine.com/medline/citation/32409162/Management_of_presbyphonia:_A_systematic_review_of_the_efficacy_of_surgical_intervention L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-0709(20)30223-4 DB - PRIME DP - Unbound Medicine ER -
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