Voice and Respiratory Characteristics of Men and Women Seeking Treatment for Presbyphonia

Abstract

Impaired respiratory function could potentially explain why some older speakers experience voice-related handicap whereas others do not, despite presenting with similar age-related laryngeal characteristics. The objectives of this study were therefore to (1) describe voice and respiratory function across men and women in a sample of treatment-seeking patients with presbyphonia; (2) assess how respiratory function differed from the general elderly population, based on normative data; and 3)discuss how respiratory function may play a role in the development of voice symptoms across men and women. Twenty one participants with presbyphonia underwent respiratory assessments (spirometry and respiratory muscle strength testing) in addition to standard of care voice assessments. Respiratory variables included forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP). Voice features were consistent with the diagnosis of presbyphonia and values did not different significantly between males and females, although some trends were noted. Regarding respiratory variables, one-third of the participants (n=7) presented with FVC and FEV1 less than 80% of predicted, and 57% (n=12) were <90% of predicted. Nine percent of the males (n=1) and none of the females had a MIP below the lower limit of normal (LLN) expected for their age, sex, and weight. Eighteen percent of the males (n=2) and 20% of the females (n=2) fell below the LLN for MEP. Our sample of participants with presbyphonia included a non-negligible proportion of patients with decreased percent predicted values of FVC and FEV1, and with respiratory muscle strength (MEP) below the LLN. Standardized values of pulmonary function were not different across sexes, indicative of a similar respiratory health. However, a lower raw pulmonary function and respiratory muscle strength in women may compound laryngeal changes and have an impact on perceived voice-related handicap. Together, findings warrant further studies to explore the impact of decreased respiratory function on voice and, ultimately, on the response to voice therapy in patients with presbyphonia.