الفهرس 
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Abstract
During the aging process, natural modifications occur in the larynx and the structures involved in phonation which explain the specific characteristics found in the voices of elderly persons. When, at any moment, a voice fails and there is interference with communication, a voice disorder has occurred. This can generate disadvantages in communicative efficiency and have a negative impact on quality of life, compromising mechanisms of socialization, the maintenance of autonomy, and the sense of well-being. Nevertheless, there appears to be little clarity about which factors are associated with voice disorders in this population, especially from an epidemiological perspective.
The aim of this work is to investigate the performance of elderly diagnosed as dysphonia (whatever the cause), compare them with non-symptomatic elderly, correlate between the V-RQOL score and perceptual analysis (APA) and correlate between the V-RQOL outcome and different diagnostic categories of voice disorders.
This study was conducted on 80 elderly persons. The participants were divided into two groups, (group A): 40 dysphonic elderly, (they were selected from the out-patient clinic, Phoniatric unit of Beni Suef University hospital with variable social class) and (group B): 40 non-dysphonic elderly subjects.
All participants were above 65 year of age of both sexes. All patients were subjected to history taking, full phoniatric examination including Flexible nasofibrolaryngoscopy.
All participants completed the V-RQOL Questionnaire. It includes ten different items, the individual answered it all based upon what about his voice had been like in the last two weeks. Considering how severe the problem was when he gets it, and how frequently it happens, each item was rated on how bad it is by (1-5) rating scale. The total score was calculated for all test persons according to the original test instructions. Then, all individuals self-rated their voice quality as poor, fair, good, very good, or excellent.
We found that the complaint in the case group is the change of voice in 40 patients (100%) and the most frequent symptoms by the patient history is chronic cough in 14 patients (35%).
The most common diagnosis of the studied cases were MAP lesions which were responsible of 32.5% of cases, followed by neoplastic lesions which were found in 11 out of 40 patients (27.5 %).
We found a significant difference in the total score results of V-RQOL Questionnaire between cases and controls, the total score results were significantly higher in cases with dysphonic symptoms, the mean scores was (30.95 ±7.5 vs. 12.65 ±2.4) in cases and controls respectively; with a significant (P-value 0.001*).
We found that the total score of the Voice Related Quality of Life (V-RQOL) Questionnaire is higher in patient with neoplastic lesions in the supra-glottis area in comparison to other diagnoses with significant difference (P-value 0.004*).
We found that there was a statistical significant positive moderate correlation (r=0.390) between the self perception and APA (Dysphonia Grade) (P=0.019).
We found a significant positive correlation between Dysphonia Grade and Voice Related Quality of Life (V-RQOL) total score in elderly.
We found a statistically significant relation between the categories of (V-RQOL) score and the diagnosis as all neoplastic cases and most of post radio glottis trauma were associated more with poor score but the patients with MAP lesions had a better score.
Finally we concluded that dysphonia significantly affects quality of life in elderly with a significant positive correlation between Dysphonia Grade and Voice Related Quality of Life (V-RQOL) total score.