Geriatric Dysphonia: Etiological Analysis in a Rural Hospital in India

Abstract

To establish the prevalence of etiological factors for dysphonia in elderly individuals in rural India. Hundred adults aged ≥ 65 years, who presented with dysphonia for ≥ 4 weeks and underwent detailed clinical evaluation including videolaryngoscopic assessment and other appropriate investigations/evaluation, were included in a retrospective cohort clinical study. Patients were classified into eight groups for further descriptive statistical analysis based on standard diagnostic criteria/guidelines i.e. benign vocal cord lesions, inflammatory disorders of the larynx, laryngeal and hypopharyngeal neoplasms, isolated vocal cord palsy/paresis, presbylaryngis, central neurological disorders affecting laryngeal function, impaired pulmonary function and non specific dysphonia. Mean age was 70.73 ± 4.29 years. 58% were aged between 65 and 69 years. Overall, the common causes for dysphonia were laryngopharyngeal reflux disease (23%), carcinoma larynx (12%) and presbylaryngis (8%). Inflammatory disorders of the larynx, benign vocal cord lesions and laryngeal/hypopharyngeal malignancies were the commonest causes for dysphonia in individuals aged between 65 and 74 years. Presbylaryngis and systemic causes were the commonest among individuals aged 75–89 years. 63 males and 37 females met the inclusion criteria. The most common cause for dysphonia among females was laryngopharyngeal reflux disease (17%), followed by vocal palsy (5%) and spasmodic dysphonia (4%). Carcinoma larynx (12%) was the most common cause for dysphonia among males, followed by laryngopharyngeal reflux (6%) and presbylaryngis (6%). Geriatric dysphonia is an often overlooked symptom of greater underlying disease as evidenced in this study. With its impact on the quality of life in this age group and life expectancy in the rural population, dysphonia requires early detection, prompt evaluation and appropriate management.