Causes of dysphonia in patients above 60 years of age

Yıl 2003, Cilt: 11 Sayı: 5, 139 - 143, 13.10.2003

Tolga Kandoğan Levent Olgun Gürol Gültekin

Öz

Objectives: We evaluated the causes of hoarse- ness in patients above 60 years of age.Patients and Methods: The study included 98 patients 40 females, 58 males; mean age 64 years; range 60 to 77 years who presented with hoarse- ness. Ali the patients were examined by videolaryngoscopy. Temporary hoarseness secondary to respiratory tract infections was excluded.Results: The most common cause of hoarseness was benign vocal fold lesions 28.6% followed by malignant lesions 27.6% , vocal fold paralysis 25.5% , functional dysphonia 10.2% , and presby- phonia 8.2% . Laryngopharyngeal reflux was found in 13 patients 13.3% . Fourteen male and 11 female patients had paralysis of the recurrent laryngeal nerve. Malignancies that caused hoarseness without paralyzing the vocal folds were larynx carcinoma n=18 , hypopharynx carcinoma n=8 , and multiple malignancy n=1 .Conclusion: Our data show that dysphonia develops due to disease processes associated with aging rather than to physiologic aging alone. Considering adverse influences of dysphonia on the quality of life of elderly population, efforts should be directed to elucidation of the cause and to performing appropriate treatment.

Anahtar Kelimeler

Aged, aging/physiology, laryngeal diseases, laryngeal neoplasms, guality of life, vocal cord paralysis/diagnosis, vocal cords/physiopathology, voice/physiology, voice disorders/etiology/diagnosis/physiopathology, voice guality

Altmış yaş üzerindeki kişilerde ses bozukluğu nedenleri

Öz

Amaç: Altmıfl yafl ve üzerindeki kiflilerde ses bozukluğu nedenleri arafltırıldı.Hastalar ve Yöntemler: Çalıflmaya ses bozukluğuile baflvuran 98 hasta alındı. Tüm hastalar videolarengoskopi ile incelendi. Solunum yolu enfeksiyonlarınabağlı olarak ses bozuklukları geliflen olgular çalıflmaya alınmadı. Bulgular: Ses bozukluğuna en sık ses tellerinin benign %28.6 ve malign lezyonlarının %27.6 nedenolduğu görüldü. Bunları sırasıyla ses teli paralizileri %25.5 , fonksiyonel disfoniler %10.2 ve presbifoni %8.2 izlemekteydi. Larengofarenjeal reflüye 13hastada %13.3 rastlandı. On dört erkek, 11 kadınhastada reküren larenjeal sinir paralizisi saptandı.Ses tellerinde paraliziye yol açmadan ses bozukluğuna neden olan malign hastalıklar, larenks kanseri n=18 , hipofarenks kanseri n=8 ve multipl malignensi n=1 olarak belirlendi.Sonuç: Bulgularımız, ses bozukluğunun fizyolojikyafllanmadan çok, yafllanma sürecinde geliflen hastalıklara bağlı olarak gelifltiğini gösterdi. Yafllı kiflilerdeki ses bozukluklarının hastanın yaflam kalitesiüzerindeki olumsuz etkilerini de göz önüne alarak,nedenin ortaya çıkarılması ve uygun tedavinin uygulanması önem taflımaktadır

Anahtar Kelimeler

Yafllılık, yafllanma/fizyoloji, larenjealhastalıklar, larenjeal neoplaziler, yaflam kalitesi, vokal kordparalizisi/tanı, vokal kord/fizyopatoloji, ses/fizyoloji, ses hastalıkları/etyoloji/tanı/fizyopatoloji, ses kalitesi

Kaynakça

• Hagen P, Lyons GD, Nuss DW. Dysphonia in the elder- ly: diagnosis and management of age-related voice changes. South Med J 1996;89:204-7.
• Jiang J, Lin E, Hanson DG. Vocal fold physiology. Otolaryngol Clin North Am 2000;33:699-718.
• Woo P, Casper J, Colton R, Brewer D. Dysphonia in the aging: physiology versus disease. Laryngoscope 1992;102:139-44.
• Segre R. Senescence of the voice. Eye Ear Nose Throat Mon 1971;50:223-7.
• Endres W, Bambach W, Flosser G. Voice spectrograms as a function of age, voice disguise, and voice imita- tion. J Acoust Soc Am 1971;49:1842-8.
• Hollien H, Shipp T. Speaking fundamental frequency and chronologic age in males. J Speech Hear Res 1972; 15:155-9.
• Wilcox KA, Horii Y. Age and changes in vocal jitter. J Gerontol 1980;35:194-8.
• Ramig LA, Ringel RL. Effects of physiological aging on selected acoustic characteristics of voice. J Speech Hear Res 1983;26:22-30.
• Lundy DS, Silva C, Casiano RR, Lu FL, Xue JW. Cause of hoarseness in elderly patients. Otolaryngol Head Neck S u rg 1998;11 8 : 4 8 1 - 5.
• Mueller PB. The aging voice. Semin Speech Lang 1997; 18:159-68;quiz 168-9.
• Morrison MD, Gore-Hickman P. Voice disorders in the elderly. J Otolaryngol 1986;15:231-4.
• Yonekawa H. A clinical study of Reinke's edema. Auris Nasus Larynx 1988;15:57-78.
• Ormseth EJ, Wong RK. Reflux laryngitis: pathophysiolo- g y, diagnosis, and management. Am J Gastro e n t e ro l 1 9 9 9 ; 9 4 : 2 8 1 2 - 7 .
• Olson NR. Laryngopharyngeal manifestations of gas- t roesophageal reflux disease. Otolaryngol Clin North Am 1991;24:1201-13.
• Grontved AM, West F. pH monitoring in patients with benign voice disorders. Acta Otolaryngol Suppl 2000; 543:229-31.
• Koufman JA, Amin MR, Panetti M. Prevalence of reflux in 113 consecutive patients with laryngeal and voice disorders. Otolaryngol Head Neck Surg 2000;123:385-8.
• Ahuja V, Yencha MW, Lassen LF. Head and neck man- ifestations of gastroesophageal reflux disease. Am Fam Physician 1999;60:873-80, 885-6.
• Aronson AE. Organic voice disorders, neurologic dis- ease. In: Clinical voice disorders: an interdisciplinary approach. 1st ed. New York: Georg Thieme Publishers; 1980. p. 77-123.
• Gauri LA, Agrawal NK, Banerjee S, Misra SN. N e u rological manifestations associated with bro n- chogenic carcinoma. J Indian Med Assoc 1990;88:224-6.
• Tachimori Y, Kato H, Watanabe H, Ishikawa T, Yamaguchi H. Vocal cord paralysis in patients with tho- racic esophageal carcinoma. J Surg Oncol 1995;59:230-2.
• Arnold W, Ganzer U, editors. Schilddru s e n m a l i g n o m e . In: Checkliste Hals-Nasen-Ohren-Heilkunde. 3rd ed. Stuttgart: Georg Thieme Verlag; 1999. p. 449-52.
• Sama A, Carding PN, Price S, Kelly P, Wilson JA. The clinical features of functional dysphonia. Laryngoscope 2 0 0 1 ; 111 : 4 5 8 - 6 3 .
• Koufman JA, Blalock PD. Functional voice disorders. Otolaryngol Clin North Am 1991;24:1059-73.
• Morrison MD, Rammage LA, Belisle GM, Pullan CB, Nichol H. Muscular tension dysphonia. J Otolaryngol 1983;12:302-6.
• Monday LA. Clinical evaluation of functional dyspho- nia. J Otolaryngol 1983;12:307-10.
• Sapienza CM, Dutka J. Glottal airflow characteristics of women’s voice production along an aging continu- um. J Speech Hear Res 1996;39:322-8.
• Ramig LO, Gray S, Baker K, Corbin-Lewis K, Buder E, Luschei E, et al. The aging voice: a re v i e w, treatment data and familial and genetic perspectives. Folia Phoniatr Logop 2001;53:252-65.
• Murty GE, Carding PN, Kelly PJ. Combined glotto- graphic changes in the elderly. Clin Otolaryngol 1991; 16:532-4.