Literally, “old age larynx.” The term presbylarynx is used to signify vocal cord changes (and, by extension, vocal limitations) that accompany aging. Also referred to as presbyphonia (presby- “old age” phonia- “voice”), which does not describe precisely the voice’s capabilities, limitations, and aberrations as well as the term presbylarynx.

See also: Presbyphagia

Causes and Symptoms

Typically, these vocal cord changes include bowing of the cords, atrophy, flaccidity, and sometimes reduced wetness and lubrication of the vocal cords. The symptoms of these changes include foggy or weak voice quality, difficulty being heard in noisy places, and decreased vocal endurance.

Such findings are by no means universal in older individuals, however, and some of these changes may be resisted with vocal conditioning exercises. Moreover, some “presbylarynx” changes can be seen in individuals who are only 40 or 50, due to disuse of the voice or familial predisposition. For these reasons, presbylarynx does not seem to be a very useful term; instead, a precise description of the patient’s vocal cords seems to be more useful (e.g. vocal cord bowing, flaccid vocal cords).

Vocal Cord Bowing

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Wide lateral excursions (1 of 4)

Open phase vibration, strobe light. Notice the large amplitude of vibration. The wide lateral excursions suggest flaccidity, especially when this is seen in middle voice.

Anterior cords are more flaccid (2 of 4)

Partially closed phase. Notice that the anterior cords (arrows) are more flaccid, with delayed return to midline contact. When this is seen, that anterior segment may vibrate independently and cause a rough, gravelly voice quality. The capillary ectasia, left vocal cord (right of image), is an incidental finding and not related to the patient’s rough voice quality.

Vocal cord bowing (3 of 4)

Coming to closed phase, but with the persistent anterior open segment.

Vocal cord bowing (4 of 4)

Closed phase of vibration.

Flaccid Vocal Cords

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Flaccid vocal cords (1 of 3)

Open phase of vibration showing large amplitude in middle voice.

Flaccid vocal cords (2 of 3)

Maximum closed phase, but with persistent open area anteriorly (at arrow) If this area of exaggerated flaccidity oscillates independently, a rough quality is added to the voice.

Flaccid vocal cords (3 of 3)

Between open and closed phase, showing vibratory contact is aberrant.