title: Multidimensional Analysis on the Effect of Vocal Function Exercises on Aged Vocal Fold Atrophy.
abstract: OBJECTIVE
  Age-related voice change is characterized as weak, harsh, and breathy. These changes are caused by histologic alteration of the lamina propria of the vocal fold mucosa as well as atrophy of the thyroarytenoid muscle. Several therapeutic strategies involving laryngeal framework surgery and injection laryngoplasty have been tried, but effects have been limited. Vocal function exercises (VFE) have been used to treat age-related vocal fold atrophy although the effectiveness has been shown with limited analysis. The present study aims to determine the effectiveness of VFE for the treatment of aged atrophy using multidimensional analysis.
  
  
  METHODS
  This is a retrospective study.
  
  
  METHODS
  Sixteen patients with vocal fold atrophy aged 65-81 years underwent voice therapy using VFE. Six patients with vocal fold atrophy aged 65-85 years were involved as a historical control group. The grade, roughness, breathiness, asthenia, strain (GRBAS) scale, stroboscopic examinations, aerodynamic assessment, acoustic analysis, and Voice Handicap Index-10 (VHI-10) were performed before and after VFE. Normalized mucosal wave amplitude (NMWA), normalized glottal gap (NGG), and bowing index (BI) were measured by image analysis during stroboscopic examinations.
  
  
  RESULTS
  After VFE, significant improvements were shown in GRBAS, maximum phonation time, jitter, NMWA, NGG, and VHI-10 although BI has not changed significantly. There were no significant improvements in the historical control.
  
  
  CONCLUSIONS
  The data suggest that VFE produces significant improvement in subjective, objective, and patient self-evaluation and deserves further attention as a treatment for aged atrophy of the vocal fold. It was also suggested that VFE does not improve the vocal fold bowing but may improve muscular function during voicing.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Mami
authors.initials: M
authors.lastname: Kaneko
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. Electronic address: hirano@ent.kuhp.kyoto-u.ac.jp.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Hirano
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tateya
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Yo
authors.initials: Y
authors.lastname: Kishimoto
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Nao
authors.initials: N
authors.lastname: Hiwatashi
authors.affiliation: Department of Eating Disorder and Dysphagia, the University of Niigata Rehabilitation Graduate School, Niigata, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Fujiu-Kurachi
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Juichi
authors.initials: J
authors.lastname: Ito
mesh_terms: D000162:Acoustics; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology; D001284:Atrophy; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007828:Laryngoscopy; D008297:Male; D020127:Recovery of Function; D012189:Retrospective Studies; D013068:Speech Production Measurement; D049489:Stroboscopy; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014827:Vocal Cords / Q000473:pathology / Q000503:physiopathology*; D014832:Voice Disorders / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D014833:Voice Quality; D014834:Voice Training
keywords: Aged vocal fold atrophy; Multidimensional analysis; Vocal function exercises; Voice therapy