The larynx and vocal folds age along with the rest of the body. The muscles of the vocal fold lose bulk (atrophy) as a result of aging, as do other muscles of the body. In addition, much like tissue elsewhere in the body, the vocal folds lose their flexibility and become stiffer and less pliable over time.
Voice therapy is the most appropriate initial treatment of age-related voice changes. Voice therapy is aimed at correcting behaviors that cause vocal fold irritation, such as habitual loud-talking or throat clearing. Often, mild hoarseness may be overcome with improved voicing techniques.
If the results of voice therapy prove unsatisfactory, injection of the vocal folds, with substances such as collagen or fat, may be considered to increase the bulkiness of the vocal folds. This intervention can improve the steadiness, strength, and endurance of the voice. However, most substances injected into the vocal folds are slowly absorbed and the results are temporary. Therefore, injections are needed periodically to maintain the quality of the voice.
The above changes may result in loss of projection and resonance of voice which is perceived as sounding “old.”