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Clinical Challenges in Otolaryngology
September 2004

Commentary on the Changing Voice

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2004;130(9):1118. doi:10.1001/archotol.130.9.1118

I enjoyed Steven Bielamowicz's discussion of the multifarious etiologies of dysphonia in the aging larynx. The best part of the article is the presentation of the myriad ways, medical and surgical, we now have to improve aging dysphonia. I have been particularly enthusiastic about fat injection thyroplasty, calcium hydroxyapatite microsphere injection thyroplasty, and mini-fenestra Gore-Tex thyroplasty. I prefer fat injection thyroplasty in prepubertal patients, as a safe way to ameliorate the incompetent larynx with a living material that may grow at the same rate as the child.

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