Prebyphonia is due to mechanical alteration of the vocal cords due to age and may require, if the social and psychological consequence is important, speech therapy treatment and at times phonosurgery or even the lifting of the vocal cords.

However, one should not forget that the ear and hearing influence the voice and therefore the first therapeutic action should be a hearing test to determine whether hearing aids are necessary. The symptoms of prebyphonia occur in 3 forms:
• Vocal fatigue
• Voice that rise on high notes at the end of speech
• Hoarse voice as years advance.

There may be vocal cord atrophy, an alteration of the vibration of the vocal mucosa, and finally, a decrease of lubrication with laryngeal dryness that is very common during menopause. In these cases medical intervention is essential. It often requires pharyngolaryngeal reflux treatment, allergic rhinitis treatment due to secondary pollutants of our cities and not least an intake of multivitamin and mineral supplements. In order to avoid voice masculinization and premature prebyphonia, hormone replacement treatment is often necessary.

In humans, the injection of testosterone has permitted excellent results without surgery, but there remains a distinctive indication which needs a precise prostate balance in patients in their seventies. In case of the failure of speech therapy and / or medical treatments and persistence of vocal cord atrophy, an endoscopic injection of inert substances can produce excellent results. This type of intervention is performed orally under general anesthesia. It is not invasive and is performed by videosurgery using a microscope. Although many have proposed the injection of autologous fat, inert substances, which are currently the most appropriate, are the injection of collagen, hydroxyapatite and hyaluronic acid. Results on the voice are very satisfactory, allowing for a significant extension of the maximum phonation time and an effective vibration of the vocal fold mucosa without the falling of high notes. In approximately 30% of the cases a second injection is required over a period of 1 to 3 years. These patients can now rediscover the world of discussion with others, regain their social life and the pleasure of a spoken and sung voice.