Presbyphonia: A Scoping Review for a Comprehensive Assessment of Aging Voice

BACKGROUND: Presbylarynx refers to age-related changes in the larynx that can manifest clinically as presbyphonia. Several underlying mechanisms remain unclear. OBJECTIVES: Perform a scoping review of the published literature on the mechanisms of presbyphonia in order to provide an adequate, comprehensive assessment of aging voice. METHODS AND RESULTS: A scoping review on Medline, Cochrane, and Scopus included 188 published articles. Laryngeal aging results in calcifications of the hyaline cartilages, decreased vocal folds lubrication, decreased neuromotor transmission, decreased hyaluronic acid, increased lamina propria stiffness, and changes in the thyroarytenoid muscles. Concomitant aging of the respiratory system, collateral effects of age-related hormonal changes, concomitant presbycusis, and medical comorbidities interact with the presbylarynx to induce clinically detectable voice aging changes (a weak, breathy, or hoarse voice). Based on the results of our study, we proposed a comprehensive assessment of the aging voice, including all the factors involved. CONCLUSION: This scoping review proposes a comprehensive assessment of presbyphonia based on the available data. We believe that this assessment will allow a more personalized approach to treatment.