Summary
Objective
Professional singers are more likely to develop laryngeal pathologies and symptoms
associated with misuse and overuse of the voice. However, different studies have shown
conflicting evidence. We aim to perform a systematic review and quantitative meta-analysis
to determine the prevalence and risk of laryngeal pathologies and symptoms among professional
singers.
Methods
Four electronic databases (MEDLINE, PubMed, EMBASE, and CINAHL) were searched, with
no language restrictions. From 3368 potential studies, a total of 21 studies met our
inclusion criteria. A systematic review of the literature was conducted according
to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)
guidelines. All cohort, case-control, or cross-sectional studies that reported the
risk of laryngeal pathologies in singers were included. Data were pooled by a random
effects model and the pooled odds ratios (ORs) and 95% confidence intervals (CIs)
were calculated.
Results
There was a positive relationship between singing and laryngeal pathologies. There
was an increased risk of hoarseness (OR: 2.00, 95% CI: 1.61–2.49), gastroesophageal
reflux disease (GERD) (OR: 1.45, 95% CI: 1.19–1.77), Reinke edema (OR: 2.15, 95% CI:
1.08–4.30), and polyps (OR: 2.10, 95% CI: 1.06–4.14) in professional singers.
Conclusion
Professional singers are at an increased risk of laryngeal pathologies and symptoms
associated with vocal misuse and overuse, particularly hoarseness, GERD, edema, and
polyps.
Key Words
Level of Evidence
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References
- Perspectives on the impact on vocal function of heavy vocal load among working professional music theater performers.J Voice. 2013; 27 (e31-9): 390
- Care of the Professional Voice: A Guide to Voice Management for Singers, Actors, and Professional Voice Users.2 ed. Butterworth Heinemann, London2004
- Popular music and the music theatre.in: Care of the Professional Voice: A Guide to Voice Management for Singers, Actors, and Professional Voice Users. 2 ed. Butterworth Heinemann, London2004: 61-71
- Anxiety, artistic temperament, and the voice.in: Care of the Professional Voice. Butterworth Heinemann, London, United Kingdom2004: 51-60
- Travel and the vocal performer.in: Care of the Professional Voice. Butterworth Heinemann, London, United Kingdom2004: 73-77
- Medications and the professional voice.in: Care of the Professional Voice. Butterworth Heinemann, London, United Kingdom2004: 78-87
- Artistic vocal styles and technique.in: Benninger M.S. Murry T. The Performer's Voice. Plural Publishing, Abingdon, Oxfordshire, United Kingdom2006: 51-59
- The Performer's Voice.Plural Publishing, Abingdon, Oxfordshire, United Kingdom2006
- Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.Ann Intern Med. 2009; 151: 264-269
- Meta-analysis in clinical trials.Control Clin Trials. 1986; 7: 177-188
- Measuring inconsistency in meta-analyses.BMJ. 2003; 327: 557-560
- Bias in meta-analysis detected by a simple, graphical test.Br Med J. 1997; 315: 629-634
- A fail-safe N for effect size in meta-analysis.J Educ Stat. 1983; 8: 157-159
- Voice overuse and abuse among professional voice.Bahrain Med Bull. 2001; 23: 12-18
- Clinical voice analysis of carnatic singers.J Voice. 2013; 28: 128.e121-128.e129
- Reflux symptoms in professional opera choristers.Gastroenterology. 2007; 132: 890-898
- Reduction of risk factors in patients with behavioural dysphonia after vocal group therapy.J Voice. 2017; 31: 123.e15-123.e19
- Profile of voice professionals seen in a tertiary health centre.Braz J Otorhinolaryngol. 2007; 73: 27-31
- The vocal load of reform Jewish Cantors in the USA.J Voice. 2012; 26: 201-204
- Strobovideolaryngoscopic findings in singing.J Voice. 2002; 16: 81-86
- Prevalence and risk factors for voice problems in priests.Wien Klin Wochenschr. 2009; 121: 276-281
- Is an occupation with vocal load a risk factor for laryngopharyngeal reflux: a prospective, multicentre, multivariate comparative study.Clin Otolaryngol. 2012; 37: 362-368
- Vocal fold paresis.Otolaryngol Head Neck Surg. 2000; 122: 537-541
- Type and severity of pain during phonation in professional voice users and nonvocal professionals.J Voice. 2012; 26: 671.e619-671.e623
- Incidence of abnormal laryngeal findings in asymptomatic singing students.Otolaryngol Head Neck Surg. 1999; 121: 69-77
- Frequency and risk factors for voice problems in teachers of singing and control subjects.J Voice. 1995; 9: 348-362
- 24 hours prior to curtain.J Voice. 2000; 14: 92-98
- Prevalence and voice characteristics of laryneal pathology in an Italian voice therapy-seeking population.J Voice. 2016; 30 (e13-21): 774
- Voice Handicap Index in singers.J Voice. 2000; 14: 330-377
- A comparison of initial and subsequent follow-up strobovideolaryngoscopic examinations in singers.J Voice. 2016; 30: 472-477
- Vocal attrition in voice students: survey findings.J Voice. 1993; 7: 69-74
- A pilot survey of vocal health in young singers.J Voice. 2002; 16: 244-250
- Prevalence of abnormal laryngeal findings in healthy singing teachers.J Voice. 2012; 26: 577-583
- Interdisciplinary voice examination (screening) for (choir) singers at the ‘Salzburger Sanger Service-Tag 2003’.Logop Phoniatr Vocol. 2004; 29: 92-96
- Gastroesophageal reflux disease: work-related disease?.Digest Dis. 2009; 27: 38-44
- Evaluation of dysphoia in a children's choir.Folia Phoniatr Logop. 1994; 46: 27-34
- Self-reported voice problems among three groups of professional singers.J Voice. 1999; 13: 602-611
- Popular music and the musical theatre.in: Care of the Professional Voice. Butterworth Heinemann, London, United Kingdom2004
- Acoustical analysis of the underlying voice differences between two groups of professional singers: opera and country and western.Laryngoscope. 1986; 96: 549-554
- Development of the larynx and the voice.in: Care of the Professional Voice. Butterworth Heinemann, London, United Kingdom2004
Article info
Publication history
Published online: March 06, 2018
Accepted:
September 6,
2017
Identification
Copyright
Crown Copyright © 2019 Published by Elsevier Inc. on behalf of The Voice Foundation. All rights reserved.
