J R Lechien1, A Schindler2, C Robotti3, L Lejeune4, C Finck5. 1. Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, School of Medicine, Brussels, Belgium; Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of International Federation of Oto-rhino-laryngological Societies, Paris, France. Electronic address: Jerome.Lechien@umons.ac.be. 2. Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of International Federation of Oto-rhino-laryngological Societies, Paris, France; Department of Biomedical and Clinical Sciences, Phoniatric Unit, L. Sacco Hospital, University of Milan, Milan, Italy. 3. Department of Biomedical and Clinical Sciences, Phoniatric Unit, L. Sacco Hospital, University of Milan, Milan, Italy. 4. Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Liège, Faculty of Medicine, University of Liège, Liège, Belgium. 5. Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology, University of Mons (UMons), Mons, Belgium; Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of International Federation of Oto-rhino-laryngological Societies, Paris, France; Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Liège, Faculty of Medicine, University of Liège, Liège, Belgium.
Abstract
PURPOSE OF REVIEW: Laryngopharyngeal reflux (LPR) is an inflammatory disease associated with the development of voice disorder and vocal fold lesions. The occurrence of LPR in professional voice users as singers can have a dramatic impact of daily life. The aims of this paper is to review the current literature about the pathophysiological mechanisms underlying the development of voice disorder, especially in singers, and to propose a new patient-reported outcome instrument to assess complaints of these patients. RECENT FINDINGS: Many clinical and experimental studies reported that LPR leads to the development of significant macroscopic and microscopic histological changes in the mucosa of the vibratory margin of the vocal folds. Epithelial cell dehiscence, microtraumas, Reinke's space modifications, inflammatory infiltrates, mucosal drying, and epithelial thickening are associated with LPR. These histological changes may modify the biomechanical properties of the vocal fold tissue leading to hoarseness. In practice, singers with LPR may have normal or discretely pathological speaking voice but impaired singing voice (vocal fatigue, hoarseness, and loss of range). To date, the literature about the specific LPR signs and symptoms in singers is almost non-existent. However, singers are at high risk to present LPR because of necessary air support involving higher intra-abdominal pressure, increased stress due to career management and uncomfortable schedules, late meals just before sleep, bad nutrition habits like increased intake of citrus products, fats foods and spicy foods. PERSPECTIVES: The lack of clinical singer-reported outcome instrument may decrease the management of LPR in singers. In this context, the LPR Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) developed a new instrument to precisely assess symptoms related to LPR in singing voice. This instrument will be validated and could be used in clinical practice in voice centers.
PURPOSE OF REVIEW: Laryngopharyngeal reflux (LPR) is an inflammatory disease associated with the development of voice disorder and vocal fold lesions. The occurrence of LPR in professional voice users as singers can have a dramatic impact of daily life. The aims of this paper is to review the current literature about the pathophysiological mechanisms underlying the development of voice disorder, especially in singers, and to propose a new patient-reported outcome instrument to assess complaints of these patients. RECENT FINDINGS: Many clinical and experimental studies reported that LPR leads to the development of significant macroscopic and microscopic histological changes in the mucosa of the vibratory margin of the vocal folds. Epithelial cell dehiscence, microtraumas, Reinke's space modifications, inflammatory infiltrates, mucosal drying, and epithelial thickening are associated with LPR. These histological changes may modify the biomechanical properties of the vocal fold tissue leading to hoarseness. In practice, singers with LPR may have normal or discretely pathological speaking voice but impaired singing voice (vocal fatigue, hoarseness, and loss of range). To date, the literature about the specific LPR signs and symptoms in singers is almost non-existent. However, singers are at high risk to present LPR because of necessary air support involving higher intra-abdominal pressure, increased stress due to career management and uncomfortable schedules, late meals just before sleep, bad nutrition habits like increased intake of citrus products, fats foods and spicy foods. PERSPECTIVES: The lack of clinical singer-reported outcome instrument may decrease the management of LPR in singers. In this context, the LPR Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) developed a new instrument to precisely assess symptoms related to LPR in singing voice. This instrument will be validated and could be used in clinical practice in voice centers.