title: Managing dysphonia in occupational voice users.
abstract: OBJECTIVE
  Recent advances with regard to occupational voice disorders are highlighted with emphasis on issues warranting consideration when assessing, training, and treating professional voice users.
  
  
  RESULTS
  Findings include the many particularities between the various categories of professional voice users, the concept that the environment plays a major role in occupational voice disorders, and that biopsychosocial influences should be analyzed on an individual basis. Assessment via self-evaluation protocols to quantify the impact of these disorders is mandatory as a component of an evaluation and to document treatment outcomes. Discomfort or odynophonia has evolved as a critical symptom in this population. Clinical trials are limited and the complexity of the environment may be a limitation in experiment design.
  
  
  CONCLUSIONS
  This review reinforced the need for large population studies of professional voice users; new data highlighted important factors specific to each group of voice users. Interventions directed at student teachers are necessities to not only improving the quality of future professionals, but also to avoid the frustration and limitations associated with chronic voice problems. The causative relationship between the work environment and voice disorders has not yet been established. Randomized controlled trials are lacking and must be a focus to enhance treatment paradigms for this population.
authors.affiliation: aCentro de Estudos da Voz - CEV bUniversidade Federal de São Paulo - UNIFESP cSindicato dos Professores de São Paulo - SINPRO, São Paulo, Brazil.
authors.forename: Mara
authors.initials: M
authors.lastname: Behlau
authors.forename: Fabiana
authors.initials: F
authors.lastname: Zambon
authors.forename: Glaucya
authors.initials: G
authors.lastname: Madazio
mesh_terms: D000328:Adult; D055154:Dysphonia / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D014834:Voice Training