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The ageing process affects hearing and production of voice. It is not unknown that impairment of these faculties can affect quality of life and also cause depression. The authors have presented an array of actual anatomical and functional changes that occur with age in vocalisation (presbylarynx) and hearing (presbyacusis) and then correlated these with Voice Handicap Index (VHI) and Geriatric Depression Scores (GDS). The study was carried out in 209 consecutive subjects. Presbylarynx was diagnosed by videolaryngoscopic images to pick up vocal fold bowing, prominent vocal fold on abduction and spindle-shaped gap. Presbyacusis was assessed by pure tone audiometry, tympanometry and speech reception threshold. It was noted that age affected both VHI and GDS adversely. The VHI index was higher in patients with presbylarynx, especially with a spindle shaped gap. Presbyacusis had lower incidence in females but, in both genders, was associated with higher GDS. The average PTA and SRT did not correlate with higher VHI but did so statistically with GDS. VHI was higher in patients having both presbyacusis and presbylarynx. The study also shows cumulative effect of presbyacusis and prebylarynx on the presence of depressive symptoms. The main limitation of this study is the exclusion of confounding factors such as social status, educational levels, voice demands and general health but does provide interesting reading.

How do presbylarynx and presbyacusis affect Voice Handicap Index and the emotional status of the elderly? A prospective case-control study.
Rodrigues Dias D, Santos M, Sousa F, et al.
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Madhup K Chaurasia

Mid and South Essex NHS Foundation Trust, UK.

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