Evidence map›Paper›PMID 41862710›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

Patient-reported handicap, perceptual grade, and presbylarynx type drive subjective therapeutic choice in presbyphonia.

Ralph Haddad, Stephane Gargula, Dario Ebode, Alexia Mattei, Estelle Bogdanski, Justin Michel, Antoine Giovanni

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Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Ralph HaddadDepartment of Oto-Rhino-Laryngology and Head and Neck Surgery, AP-HM, La Conception University Hospital, Aix-Marseille University, 147 Boulevard Baille, 13385 CEDEX 5, Marseille, France. ralph.haddad@ap-hm.fr.ORCID http://orcid.org/0000-0002-1388-3848
Stephane GargulaDepartment of Oto-Rhino-Laryngology and Head and Neck Surgery, AP-HM, La Conception University Hospital, Aix-Marseille University, 147 Boulevard Baille, 13385 CEDEX 5, Marseille, France.
Dario EbodeDepartment of Oto-Rhino-Laryngology and Head and Neck Surgery, AP-HM, La Conception University Hospital, Aix-Marseille University, 147 Boulevard Baille, 13385 CEDEX 5, Marseille, France.
Alexia MatteiDepartment of Oto-Rhino-Laryngology and Head and Neck Surgery, AP-HM, La Conception University Hospital, Aix-Marseille University, 147 Boulevard Baille, 13385 CEDEX 5, Marseille, France.
Estelle BogdanskiDepartment of Oto-Rhino-Laryngology and Head and Neck Surgery, AP-HM, La Conception University Hospital, Aix-Marseille University, 147 Boulevard Baille, 13385 CEDEX 5, Marseille, France.
Justin MichelDepartment of Oto-Rhino-Laryngology and Head and Neck Surgery, AP-HM, La Conception University Hospital, Aix-Marseille University, 147 Boulevard Baille, 13385 CEDEX 5, Marseille, France.
Antoine GiovanniDepartment of Oto-Rhino-Laryngology and Head and Neck Surgery, AP-HM, La Conception University Hospital, Aix-Marseille University, 147 Boulevard Baille, 13385 CEDEX 5, Marseille, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aimed to identify the most useful clinical parameters to inform the physician-patient therapeutic discussion and determine which parameters predict therapeutic choice in presbyphonia. We studied the vocal parameters of a cohort of patients diagnosed with presbyphonia with endoscopic signs of presbylarynx, analyzing several voice parameters by age subgroups and by presbylarynx type according to the Santos classification.

methodsA retrospective analysis was conducted on 88 patients (51 women, 37 men; mean age 74.16 ± 6.87 years) with presbyphonia and presenting a type 1 or 2 presbylarynx. Patients underwent a comprehensive voice assessment, including acoustic (F0, voice intensity, Jitter, and HNR), aerodynamic (MPT, oral airflow (OAF), and estimated subglottic pressure (ESGP)), and perceptual assessment (GRB scale of Hirano), as well as a voice self-assessment score. We used multinomial logistic regression to assess the association between different parameters and treatment choice (monitoring, speech therapy, or injection).

resultsPerceptual parameters were significantly associated with age, with overall grade (G) and roughness (R) scores progressively worsening. Patients who received vocal fold injections presented with a significantly higher self-assessment score (p = 0.0148). Patients who received speech therapy had a significantly lower overall dysphonia grade (G) score (p = 0.0281) compared to those monitored. Notably, a significant association was observed between Santos presbylarynx type and treatment choice (χ2 = 34.64, p < 0.001), with type 1 patients primarily receiving voice therapy and type 2 patients receiving injections. Acoustic and aerodynamic parameters showed limited significant associations with treatment decisions.

conclusionThe most clinically useful parameters to guide treatment decisions in presbyphonia appear to be perceptual voice analysis, patient self-assessment, and presbylarynx type. Objective acoustic and aerodynamic measures demonstrated non-significant changes within this cohort and were of limited utility in this setting. These findings highlight the importance of a multidimensional assessment integrating subjective (patient self-assessment) and perceptual data (G score) with anatomical findings (presbylarynx type). These factors serve as essential measurable inputs to inform a therapeutic decision that remains ultimately subjective, shared, and centered on patient demand.

Indexed as

DysphoniaVoice QualityAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesSpeech TherapyPresbylarynxPresbyphoniaVocal assessment

Identifiers

PMID41862710

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.