A comparison of radiation-induced and presbylaryngeal dysphonia

Objective: The goal of this study was to assess voice after radiotherapy compared with patients with presbylaryngeal dysphonia. Study Design and Setting: Prospective assessment of 20 patients aged 60+ years who remained free of disease longer than 1 year after radiotherapy for T1 squamous cell carcinoma and retrospective review of 46 patients aged 60+ with presbylaryngeal dysphonia, conducted at a tertiary care, academic hospital. Assessment data included videostroboscopy, spectrography, voice range profile, and Voice Handicap Index. Results: Eighty percent of the radiotherapy patients reported a voice disorder. Acoustic data and functional measures reflected similar limitations and abnormalities for both groups. A high incidence of glottal gap in all patients may have been associated with increased mucosal stiffness in the radiotherapy group and vocal fold atrophy in the presbylaryngeal group. Conclusion: Patient perception and functional outcome of voice were similar for both groups, despite differences in etiology of abnormal vocal fold vibratory behavior. Significance: Radiotherapy in older individuals may yield dysphonia that is no greater than that caused by normal aging. (Otolaryngol Head Neck Surg 2001;125:193-200.)