Currently, Thai society has entered an aging society, resulting in an increase in diseases caused by degeneration or diseases of the elderly, such as decreased hearing quality, osteoarthritis causing pain, or even problems that many overlook, such as changes in voice pronunciation because they think it is normal or something that cannot be fixed. Medically, vocal fold atrophy or age-related voice changes can be treated.
What causes vocal fold atrophy?
In cases where the patient has no other pathological problems, vocal fold atrophy usually occurs due to
- Not using or not speaking for a long period
- Side effects following respiratory tract infections
- Head and neck injuries causing voice changes
What are the characteristics of vocal fold atrophy?
When “vocal fold atrophy” occurs, the vocal folds that normally close tightly will not close completely, or in some cases, one or both vocal folds may move less, causing the voice to become lower than usual, feeling tired when speaking for a long time, difficulty reaching high notes, and followed by frequent choking when swallowing water or food. Generally, these problems can initially be improved by frequent speech exercises to strengthen the vocal fold muscles. However, if the patient has both voice problems and frequent choking, urgent treatment by surgery may be necessary.
Surgical techniques for vocal fold adjustment from vocal fold atrophy
1. Tightening or pulling the vocal folds to increase tension, focusing on allowing the vocal folds to close normally (Voice Lift, Vocal Fold Medialization)
2. Endoscopic surgery involves treatment using fillers commonly used in cosmetic surgery, injected into the area of the vocal folds that are sagging or lax to tighten the vocal folds. Other substances from the patient’s own body, such as abdominal fat, can also be injected as a substitute.
3. Vocal fold augmentation surgery (Thyroplasty Type I or Medialization of True Vocal Fold) is usually performed in cases of severe vocal fold atrophy causing voice problems and often severe choking. This surgery involves an incision in the neck to insert material to support the vocal folds, allowing them to close tightly and permanently. This surgery can be done under general anesthesia or local anesthesia, but requires a one-night hospital stay.
Vocal fold surgery helps improve voice changes caused by vocal fold atrophy and reduces frequent choking. It is advisable to consult a doctor rather than leaving it untreated because frequent choking on water or food is more dangerous than we think.
