What is a “weak voice” or presbyphonia?

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A weak voice is a fairly frequent patient complaint. People tell us they have trouble being heard if they are not in the same room with a listener. They also talk about having trouble projecting their voice. We have had patients who were very concerned about people talking over them in business meeting and a female judge-patient who felt it was hard to control her courtroom because she did not have a commanding voice.

Sometimes, this happens because of vocal fold motion impairment (see link), but sometimes the vocal folds move normally. Instead of being firm and tight, however, they can become bowed (like bowed legs) and this means that air can escape through them when they close and make the voice weak.

Voice therapy can be helpful to build up these muscles. For some patients injecting the vocal cords with fillers to plump them up is an option. In some cases, placing permanent implants behind the vocal muscles to help bulk them up is the best way to solve this problem.

To make sure this condition isn’t part of something neurological, we may have our neurologists see the patient as part of the team evaluation.