Correlation Between Presbylarynx and Laryngeal EMG

BACKGROUND: The normal aging process affects many human functions profoundly. The voice is no exception, and some aging effects on the voice are obvious including vocal fold atrophy, bowing, stiffness, more prominent vocal fold processes, and glottic insufficiency. The study\u27s primary aim was to determine the correlation between presbylarynx and laryngeal electromyography (LEMG) results and to compare these electromyography (EMG) results with young and old voice patients without evidence of presbylarynx changes on strobovideolaryngoscopy. METHODS: Medical records for voice patients seen in the senior author\u27s (RTS) practice between 2015 and 2019 were reviewed retrospectively. Patients with presbylarynx confirmed by strobovideolaryngoscopy were identified and compared to two control groups. The first control group included patients with ages and American Society of Anesthesiologists scores similar to the experimental group but no presbylarynx. The second control group included younger patients (ages ranging between 18 and 35 years with mean age of 24.57 years) with vocal fold paresis. All groups had undergone LEMG because of suspected paresis clinically. Social and medical factors reviewed and compared between groups included smoking history, alcohol consumption, occupation (voice demanding versus not voice demanding occupation), Voice Handicap Index score at the initial office visit, medical comorbidities, medications, and LEMG results. RESULTS: There was no significant difference in the recruitment results for three pairs of muscles (cricothyroid, thyroarytenoid and posterior cricoarytenoid) between the presbylarynx group and both control groups. Rate of asthma was higher in presbylarynx group compared with the first control group. Rates of corticosteroid inhaler use, thyroid medications, smoking, and Voice Handicap Index score were higher in presbylarynx group compared with the second control group. There was no significant difference in occupation type and alcohol consumption between groups. CONCLUSION: There was no significant difference found in the neuromuscular function based on laryngeal EMG between presbylarynx patients and both old and young patients with vocal fold paresis but without presbylarynx. Corticosteroid inhaler is associated with atrophic changes seen in presbylarynx. There still could be differences in the neuromuscular function which weren\u27t detected. More research is needed to confirm or refute these findings