The aging voice (presbyphonia) is thought to be a condition resulting from anatomical and physiological changes associated with aging. While extensive work has demonstrated age-related changes in the histoarchitecture of the larynx, the extent to which paresis might play a role in the dysphonia is not clear. Some observers believe that paresis is underdiagnosed, and suggest that it is an underlying etiological factor in dysphonias caused by secondary benign vocal fold lesions such as polyps and nodular lesions often associated with presbyphonia. It is possible that paresis plays a role in the aged voice, although it is likely that anatomical laryngeal changes (presbylaryngis) as well as underlying systemic neurological degenerative changes (such as tremor) are also factors. More rigorous clinical studies using laryngeal electromyogram are required to resolve this question.