From: john schweinfurth
To: VOCALIST <vocalist>
Subject: Re: MED: Geriatric voice
Send reply to: VOCALIST <vocalist>

On Mon, 13 Dec 1999 12:43:30 -0500, VOCALIST wrote:

> Hello Listers:
>
> My aunt is 93 years old and still going strong. Her doctors
> also told her that she was experiencing some arthritis in the larynx,
> and that she may lose her voice permanently. she told
> me she now has trouble projecting across the dining table to her
> friends. Could she be experiencing some bowing of the vocal folds from
lack of use?
>
> Any suggestions, illumination, explanations will be most welcomed!

> MaryBeth D. Smith


My hat goes off to anyone over 90 (I don't really wear a hat) who's still
going strong. You are more likely to be correct than her doctors.
Arthritis of the larynx is an extremely rare condition (but treatable!) and
only occurs with certain types of arthritis; certainly not with
osteoarthritis which is the 'arthritis' of the elderly. Bowing of the vocal
folds, or presbylarynx, is probably the most common benign dysphonia of the
elderly. As you age, all muscle groups atrophy and all joints become more
lax. Your skin sags, your nose hangs further down on your face, etc. The
mucosa of the vocal folds thins out and closure beomes a problem (hence, the
inability to raise her voice). This is not a usage problem. Your vocal
cords get exercise every time you breathe, cough, or swallow; they don't
exactly consider talking running laps.

This condition is treatable with speech therapy but is more likely to
respond to surgery to 'fatten' up the vocal folds and bring them closer
together so that they close stronger.

Hope this helps.

John M. Schweinfurth, MD
Laryngology and Professional Voice Care
Assistant Professor
Vanderbilt University
Nashville, TN
(615) 322-6180





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