Joel Guss1, Babak Sadoughi2, Brian Benson3, Lucian Sulica4. 1. Department of Head and Neck Surgery, Kaiser Permanente Medical Center, Walnut Creek, California. 2. Department of Otolaryngology-Head and Neck Surgery, Beth Israel Medical Center, New York, New York. 3. Voice Center, Hackensack University Medical Center, Hackensack, New Jersey. 4. Sean Parker Institute for Voice Disorders, Department of Otolaryngology, Weill Cornell Medical College, New York, New York. Electronic address: lus2005@med.cornell.edu.
Abstract
OBJECTIVES: To identify causes of dysphonia in performers and compare causes and aspects of treatment of dysphonia in performers and nonperformers. STUDY DESIGN: Case-control study. METHODS: A chart review of all new patients presenting with a chief complaint of dysphonia over a 1-year period was performed. The prevalence of laryngeal disorders was reviewed and differences between performers and nonperformers were analyzed. The odds ratio of the prevalence of each disorder was computed against performer status as a risk factor. RESULTS: Four hundred seventy-six new patients complaining of dysphonia presented over 12 months; 74 were vocal performers. The median duration of symptoms in performers was 90 days. Phonotraumatic lesions were significantly more prevalent in performers (63.5% vs. 28.6%, P < 0.001), particularly bilateral mid-fold swelling (4-fold increase in performers), pseudocysts (3-fold increase), and vocal fold hemorrhage/ectasia. Neurologic disorders (vocal fold paralysis and spasmodic dysphonia), neoplastic pathologies, and age-related phenomena (atrophy/presbyphonia) were significantly more common in nonperformers. Overall and diagnosis-specific rates of surgical intervention were equal between the two groups. CONCLUSIONS: Phonotraumatic injury is responsible for the majority of dysphonia in vocal performers, to a significantly greater extent than in nonperformers and requires the implementation of standard therapeutic strategies. Awareness of the specific risks and management needs of the performer is of paramount importance to the practice of laryngology of the performing voice.
OBJECTIVES: To identify causes of dysphonia in performers and compare causes and aspects of treatment of dysphonia in performers and nonperformers. STUDY DESIGN: Case-control study. METHODS: A chart review of all new patients presenting with a chief complaint of dysphonia over a 1-year period was performed. The prevalence of laryngeal disorders was reviewed and differences between performers and nonperformers were analyzed. The odds ratio of the prevalence of each disorder was computed against performer status as a risk factor. RESULTS: Four hundred seventy-six new patients complaining of dysphonia presented over 12 months; 74 were vocal performers. The median duration of symptoms in performers was 90 days. Phonotraumatic lesions were significantly more prevalent in performers (63.5% vs. 28.6%, P < 0.001), particularly bilateral mid-fold swelling (4-fold increase in performers), pseudocysts (3-fold increase), and vocal fold hemorrhage/ectasia. Neurologic disorders (vocal fold paralysis and spasmodic dysphonia), neoplastic pathologies, and age-related phenomena (atrophy/presbyphonia) were significantly more common in nonperformers. Overall and diagnosis-specific rates of surgical intervention were equal between the two groups. CONCLUSIONS:Phonotraumatic injury is responsible for the majority of dysphonia in vocal performers, to a significantly greater extent than in nonperformers and requires the implementation of standard therapeutic strategies. Awareness of the specific risks and management needs of the performer is of paramount importance to the practice of laryngology of the performing voice.
Authors: Laura E Toles; Nelson Roy; Stephanie Sogg; Katherine L Marks; Andrew J Ortiz; Annie B Fox; Daryush D Mehta; Robert E Hillman Journal: J Speech Lang Hear Res Date: 2021-11-03 Impact factor: 2.674