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Diabetes affects the body with changes in the neurological, muscular and vascular systems. It is therefore conceivable that the larynx, which is a musculoskeletal organ, can be adversely affected by type 2 diabetes mellitus. To explore this possibility, 174 Caucasian subjects were included in this study and their laryngeal functions were assessed with stroboscopic fibroptic laryngoscopy. The video recordings were analysed independently by two experienced otorhinolaryngologists. They looked for bowing, prominence of the vocal process in abduction and spindle shaped glottal gap as signs of ‘presbylaryx’. In the 174 patients, 77 had presbylarynx (41%). Twenty six of these patients (15%) had type 2 diabetes mellitus and, in this subgroup, 20 patients (77%) showed endoscopically identifiable presbylarnx. The study also revealed that patients with type 2 diabetes mellitus were eight times more likely to have presbylarynx as compared with those without this condition. Patients with presbylarynx had a higher incidence of diabetes than those without. There were no gender differences. Changes induced by diabetes resulting in an early ‘presbylaryx’ are postulated as loss of muscle mass leading to sacropenia and neuropathy, the latter caused by loss of myelinated and unmyelinated fibres. This process is accelerated by diabetes. Despite some limitations, such as more women than men in the study population and lack of pathological details of diabetes, the study is a novel one and suggests diabetes as an important risk factor which results in faster ageing of the larynx.

Presbylarynx: Is diabetes mellitus a risk factor for vocal atrophy? A positive case controlled study.
Santos M, Machado A, Vaz Freitas S, et al.
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Madhup K Chaurasia

Mid and South Essex NHS Foundation Trust, UK.

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