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001), benign vocal cord lesions ( .001), or muscle tension dysphonia ( .001). Overall, 139 patients had surgery, 251 received medical therapy, and 156 underwent voice therapy. The ≥65 cohort demonstrated improvement in Voice Handicap Index scores after surgery ( = .001) and voice therapy ( = .034), as did the 65 cohort (surgery, .001; voice therapy, = .015). Adult surgical patients 65 reported greater improvements than patients ≥65 ( = .021). There are notable differences in the pathophysiology of dysphonia betwee