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I couldn't find anything on here for a good discussion of aging of the vocal cords as we get older, and ain't nobody got time for aging around here.

I'd imagine HGH can help, but I was curious what people would advise to keep the voice in good shape.

I'd imagine HGH helps, but want to discuss lower-maintenance solutions (such as exercises) too. How early would one need to start?

Any singers, medical professionals, other experts want to share their knowledge?

This link is a good starting point: http://www.enttoday.org/details/article/...Voice.html

Quote:

Aging patients themselves may also not recognize the help available for them to improve voice impairments, and thereby often unnecessarily live with a diminished ability to communicate that leads to loss of confidence, credibility, and quality of life that accompanies such impairment.

CHANGES IN THE OLDER VOICE-KNOW THE CAUSE

For many elderly patients who present with voice problems, presbyphonia, or aging of the larynx, accounts for a number of voice alterations, including poor vocal projection, shorter phonation duration, and changes in pitch and tone. For many of these people, the main culprit is glottic insufficiency, or the failure of the vocal folds to close solidly. However, because aging affects the whole body system, other changes that may alter breath support or pulmonary capacity, or induce neurologic deficits and tremor, may also be affecting an older person's voice and indicate an underlying medical condition that needs correction.

Voice therapy is noninvasive, but it can require time and practice, and the patient must be motivated and able to perform the necessary exercises.

The really important thing to remember is that there are multiple factors that impact the quality of voice in seniors, said Michael S. Benninger, MD, Chairman of the Head and Neck Institute at the Cleveland Clinic. It is not uncommon that seniors present to us where their primary initial complaint for progressive neurologic disease are voice-related.

Other medical conditions commonly found in older persons and that can affect the voice include hormonal changes, tumors, viruses, allergies, and gastroesophageal reflux disease (GERD).

Accurate diagnosis of the cause of vocal problems in the elderly is therefore the first critical step. Along with a thorough medical history, which includes medications and environmental factors (e.g., tobacco smoke) that can affect the voice, examination of the larynx to look at the vocal cords and to determine the degree of glottal incompetence is critical.

If an underlying medical condition is found, treatment of the condition is the next step. Simple measures such as better hydration or controlling the inflammatory changes associated with GERD or persistent posterior nasal drainage may be of help to many elderly patients with vocal changes, according to Dr. Shapshay.

For patients whose vocal changes are identified as presbyphonia, different therapeutic options are available, depending on the degree of vocal fold changes as well as the needs of the patient.

TREATMENT OPTIONS FOR PRESBYPHONIA
Voice Therapy
The first and, for most patients, the only treatment needed for voice alterations due to the aging larynx will be voice therapy. Voice therapy is a common first treatment, said Nadine P. Connor, PhD, a speech pathologist and Assistant Professor at the University of Wisconsin in the Departments of Communicative Disorders and Surgery. The pro of voice therapy is that it is noninvasive; the con is that it can take time and home practice and the patient has to be cognitively able and motivated to perform the exercises.

As the third step in what Dr. Sataloff has termed voice lift therapy (the first two steps being a comprehensive evaluation and treatment of any identified medical condition), voice therapy includes techniques and exercises to restrengthen the power source of the voice, which includes medically supervised aerobic retraining of the respiratory, abdominal, and back muscle systems. In Dr. Sataloff's practice, along with a speech pathologist, most patients also see a singing voice specialist even if they are not singers, and some eventually also see an acting voice specialist as well. Using singing training for a speaker is like using jogging or running for someone who wants to walk better, he said. It gives them training beyond anything they'll need for daily speech, so even when they are talking in public they are nowhere near the limits of their ability.

According to Dr. Benninger, although compliance can be low, as it is for therapy for any chronic medical condition, he emphasized that for people who really need their voices, compliance is fairly good. In general, most people can be helped in six to eight sessions, but they may have to continue exercises on their own to maintain vocal quality. Although factors that influence compliance or adherence to treatment have not been well studied for voice therapy, said Dr. Connor, studies are currently under way to examine these factors and their contribution to the success of voice therapy.

Voice therapy usually is sufficient to improve glottic insufficiency for most patients; however, some people may need more invasive help to close a particularly large gap in the vocal folds or because of the failure of voice therapy to provide adequate improvement to meet the needs of the patient.

Surgery
The fourth and final step in the voice lift therapy process, according to Dr. Sataloff's schema, is surgery. There are several approaches to surgery, but the basic principle of all of them is to bring the vocal folds closer together, so that when people exert minimal effort, instead of having a gap and flabby partial closure, they have good, firm, redundant closure for a little effort, said Dr. Sataloff.

Two main surgical approaches are used to bring the vocal folds together: injection laryngoplasty or thyroplasty. The most common first approach used is injection therapy, in which filler such as collagen, fat, or hydroxyapatite is injected into the larynx to bulk up the vocal folds. Thyroplasty is often used to correct large vocal fold gaps, and consists of an implant placed through a small incision in the neck to compress the laryngeal tissues. According to Dr. Sataloff, it takes a great deal of skill and experience to determine when to use which approach.

If someone has vocal folds that are almost completely closed and just a little gap and flabbiness and a lack of resistance, then often injecting a little filler to bulk up the vocal folds is the ideal methodology, he said. Although, he said, a disadvantage of this approach is the frequent need to repeat the procedure several times to obtain permanent closure, he also emphasized the need at times to intentionally use only temporary fillers.

If you're not sure how a filler will work or if the patient is not certain he or she wants it done, there are temporary substances that we can inject that are gone in anywhere from five weeks to six months, depending on what we choose to inject, he said, adding that temporary fillers are also good for patients with temporary vocal fold paralysis who cannot wait for their voice to recover on its own, such as radio announcers.

Thyroplasty, or external implants, he observed, is often reserved for people with large vocal fold gaps, although this approach too has complications, including shifting implants and, more rarely, infection or rejection.

This mainly discusses voice aging in women, but is also relevant:
http://www.dailymail.co.uk/femail/articl...years.html

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But it’s not just our vocal folds that age our voice. Rubin’s colleague, Dr Ruth Epstein, explains: ‘We’re up against a lack of elasticity throughout our bodies as we age. Our lung capacity diminishes dramatically, dropping by 50 per cent between the ages of 20 and 80, which naturally affects the power of the voice.’

The number of glands in our body decreases with age, including those around the larynx and vocal folds. Glands are where mucus is produced; when it decreases, this impacts on the voice and can make it sound crackly.

The larynx drops significantly with age, too, extending the length of the vocal tract and changing the sound we make. Dr Epstein adds. ‘Male and female voices lower with age, and from about 65, the cartilage in the male larynx gets very thin and male voices become higher, reedy and tremulous. Women don’t suffer in this way — our voices just get deeper.’

Diets high in acid are very bad for the vocal cords because it irritates them, so spicy foods, white wine and citrus should be avoided, as should eating late at night.’

To improve vocal fitness, I am instructed to do breathing exercises to improve lung function, to sing scales whenever I have a spare moment and read out passages from poetry books to project my voice.

‘Sing karaoke, meet friends and take physical exercise as this will improve the voice by working all the vital muscles, and tone up your stomach to improve your breathing,’ says Dr Epstein. ‘You will notice a difference in a few weeks.’

If you follow a strict regime for vocal health, including vocal function exercises, and still have problems, you may be offered fat implantation into the vocal folds.

Known in America as a ‘voicelift’, fat is taken from the stomach and grafted on to the vocal folds to plump them up and enhance voice performance. In the U.S., it’s commonly used for ‘cosmetic’ purposes and can cost up to $25,000,