Atrophic Laryngitis

With age, minor salivary gland tissue is lost, and moisture in the larynx decreases. Muscle atrophies, vibratory mass decreases, fibrous tissue support is lost, and squamous metaplasia develops. These changes may cause a chronic tickle in the throat with a constant urge to clear it. In elderly men, a high, trembling, weakened voice may be the first sign of age's effects on the larynx. Voice quality diminishes because the vocal cords bow (due to decreased elasticity and muscle mass), allowing more air to escape with phonation, or because pulmonary volume and expiratory effort decrease.

For chronic tickle, treatment is symptomatic. Lozenges, sugar-free citrus hard candies, or chewing gum can stimulate salivary flow. Patients with a weak voice can be instructed to take a deep breath before they speak; doing so corrects the condition momentarily and confirms the diagnosis. Speech therapy may help. Occasionally, surgical procedures such as injection of collagen preparations into the vocal cords or thyroplasty (insertion of polymeric silicone forms to move the vocal cords toward the midline [medialize]) are performed.