Matthias Echternach1, Fabian Burk1, Michael Burdumy2, Christian T Herbst3, Marie Köberlein1, Michael Döllinger4, Bernhard Richter1. 1. Institute of Musicians' Medicine, Freiburg University Medical Center, Freiburg, Germany. 2. Division of Radiology, Department of Medical Physics, Freiburg University Medical Center, Freiburg, Germany. 3. Laboratory of Bio-Acoustics, Department of Cognitive Biology, University of Vienna, Vienna, Austria. 4. Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology-Head & Neck Surgery, University Hospital Erlangen Medical School, Erlangen, Germany.
Abstract
OBJECTIVES/HYPOTHESIS: In professional classical singing, an even voice quality throughout the entire singing voice range is essential. Transitions between vocal registers (passaggio) are the technically most challenging aspects in classical singing. It is hypothesized that they are most affected by vocal fold mass lesions (VFML). STUDY DESIGN: Cohort study. METHODS: In this study, the effect of VFML on vocal fold vibration in the passaggio regions was analyzed in four female and three male singers suffering from organic dysphonia. The singers were asked to sing an ascending glissando through the passaggio regions, before and after treatment. The vocal fold vibration was documented with transnasal endoscopic high-speed imaging recordings at 20,000 frames per second, supplemented by synchronized acoustic and electroglottographic recordings. RESULTS: Major irregularities were found in the passaggio region of four singers before treatment, whereas the respective phonations below the passaggio were almost regular. In two female singers only the upper, but not the lower passaggio was affected. In all four of these participants, the passaggio region was more regular after treatment. In the remaining three participants, the VFML showed no effect on the passaggio region. However, the singers' ability to reach higher pitches was impaired, but was resolved after treatment. CONCLUSIONS: The data in this case study strongly suggest that the passaggio region could be affected by VFML, even if phonation outside the passaggio regions is unimpaired. When planning surgical procedures for professional singers, clinical examination protocols should therefore include phonatory tests across the passaggio regions. LEVEL OF EVIDENCE: 4 Laryngoscope, 127:1392-1401, 2017.
OBJECTIVES/HYPOTHESIS: In professional classical singing, an even voice quality throughout the entire singing voice range is essential. Transitions between vocal registers (passaggio) are the technically most challenging aspects in classical singing. It is hypothesized that they are most affected by vocal fold mass lesions (VFML). STUDY DESIGN: Cohort study. METHODS: In this study, the effect of VFML on vocal fold vibration in the passaggio regions was analyzed in four female and three male singers suffering from organic dysphonia. The singers were asked to sing an ascending glissando through the passaggio regions, before and after treatment. The vocal fold vibration was documented with transnasal endoscopic high-speed imaging recordings at 20,000 frames per second, supplemented by synchronized acoustic and electroglottographic recordings. RESULTS: Major irregularities were found in the passaggio region of four singers before treatment, whereas the respective phonations below the passaggio were almost regular. In two female singers only the upper, but not the lower passaggio was affected. In all four of these participants, the passaggio region was more regular after treatment. In the remaining three participants, the VFML showed no effect on the passaggio region. However, the singers' ability to reach higher pitches was impaired, but was resolved after treatment. CONCLUSIONS: The data in this case study strongly suggest that the passaggio region could be affected by VFML, even if phonation outside the passaggio regions is unimpaired. When planning surgical procedures for professional singers, clinical examination protocols should therefore include phonatory tests across the passaggio regions. LEVEL OF EVIDENCE: 4 Laryngoscope, 127:1392-1401, 2017.
Authors: Johannes Fischer; Ali Caglar Özen; Serhat Ilbey; Louisa Traser; Matthias Echternach; Bernhard Richter; Michael Bock Journal: MAGMA Date: 2021-09-20 Impact factor: 2.310