The Impact of Respiratory Function on Voice in Patients with Presbyphonia

Maude Desjardins; Lucinda Halstead; Annie Simpson; Patrick Flume; Heather Shaw Bonilha

doi:10.1016/j.jvoice.2020.05.027

The Impact of Respiratory Function on Voice in Patients with Presbyphonia

J Voice. 2022 Mar;36(2):256-271. doi: 10.1016/j.jvoice.2020.05.027. Epub 2020 Jul 5.

Authors

Maude Desjardins¹, Lucinda Halstead², Annie Simpson³, Patrick Flume⁴, Heather Shaw Bonilha⁵

Affiliations

¹ Department of Communication Sciences and Disorders, University of Delaware, Newark, Delaware. Electronic address: maude@udel.edu.
² Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.
³ Department of Health Sciences and Research, Medical University of South Carolina, Charleston, South Carolina.
⁴ Pulmonary and Critical Care Division, Medical University of Soutch Carolina, Charleston, South Carolina.
⁵ Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina; Department of Health Sciences and Research, Medical University of South Carolina, Charleston, South Carolina.

PMID: 32641221
DOI: 10.1016/j.jvoice.2020.05.027

Abstract

Background and objective: Presbyphonia is an age-related voice disorder characterized by vocal fold atrophy and incomplete glottal closure during phonation. The extent to which the effects of presbyphonia may be compounded by age-related declines in the respiratory system and further impact communication and quality of life remains unknown. Therefore, the objective of this study was to determine how variations in respiratory function impacts voice measures in a sample of participants with presbyphonia.

Methods: In this pilot study, 21 participants with presbyphonia underwent respiratory assessments (spirometry and respiratory muscle strength testing) and voice assessments (videostroboscopy, acoustic analysis, auditory-perceptual ratings, aerodynamic assessment, and self-assessments). Factor and cluster analyses were conducted to extract voice and respiratory constructs and to identify groups of participants with similar profiles. Correlations and regression analyses were conducted to better describe the relationships between voice and respiratory function.

Results: Respiratory function was found to impact voice via two main pathways: through its physiological effect on voice and through its impact on general health and impairment. A lower respiratory function was associated with a lower vocal fold pliability and regularity of vibration and with an elevated aerodynamic resistance accompanied by laryngeal hyperfunction. Standardized measures of respiratory function were associated with perceived voice-related handicap. Respiratory function did not associate with voice quality, which was mostly influenced by the severity of vocal fold atrophy.

Conclusion: Poor respiratory health exacerbates the burden of vocal fold atrophy and, therefore, implementation of respiratory screening prior to starting voice therapy may significantly affect the treatment plan and consequently the outcomes of voice therapy in this patient population.

Keywords: Respiration—Voice—Presbyphonia—Spirometry—Breathing—Atrophy.

MeSH terms

Humans
Phonation / physiology
Pilot Projects
Quality of Life
Vocal Cords
Voice Disorders* / diagnosis
Voice Disorders* / etiology
Voice Quality*