Singing voice handicap and videostrobolaryngoscopy in healthy professional singers.
OBJECTIVE
This study correlates the Singing Voice Handicap Index (SVHI) scores with videostrobolaryngoscopy in healthy professional singers as a measure of self-perceived vocal health versus actual pathology seen on examination. The objective was to measure the strength of self-assessment among professional singers and determine if there is a benefit of combining SVHI and videostrobolaryngoscopy for routine assessment of singers without an obvious singing voice problem.


METHODS
Prospective cross-sectional study.


METHODS
Forty-seven singers were included in the study. Singers produced spoken and sung pitches during videostrobolaryngoscopy. Examinations were blindly rated by two independent fellowship-trained laryngologists who assessed vocal fold appearance and function. The correlation between SVHI scores and total pathologic findings seen on videostrobolaryngoscopy was analyzed using linear regression and serial t tests.


RESULTS
SVHI scores (mean of 22.45/144) were as expected for healthy singers. However, although all singers self-identified as healthy, laryngeal abnormalities were relatively common. The interrater reliability of total pathologic findings between two laryngologists was 71% (P = 0.006). Linear regression found no significant correlation (P = 0.9602) between SVHI scores and videostrobolaryngoscopy findings.


CONCLUSIONS
Greater than expected laryngeal pathology was seen in these professional singers, who identified themselves as healthy, which possibly indicates a minimal impact on their singing voice and/or perception of vocal health. These findings demonstrate that laryngeal appearance alone does not dictate nor fully explain the sound or apparent health of a professional singer. Sustaining good vocal health is complex, and even experienced singers may not reliably assess the presence of pathology.
Boston University School of Medicine, Boston, Massachusetts.
Liliana
L
Castelblanco
Department of Cell and Neurobiology, University of Southern California, Los Angeles, California.
Michael
M
Habib
Boston University School of Medicine, Boston, Massachusetts.
Daniel J
DJ
Stein
Department of Music Education, Boston University School of Music, Boston, Massachusetts.
André
A
de Quadros
Department of Otolaryngology-Head and Neck Surgery, Duke University School of Medicine, Durham, North Carolina.
Seth M
SM
Cohen
Department of Otolaryngology-Head and Neck Surgery, Boston University School of Medicine, Boston, Massachusetts. Electronic address: noordzij@bu.edu.
Jacob Pieter
JP
Noordzij
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007828:Laryngoscopy / Q000379:methods*; D007830:Larynx; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results; D012647:Self-Assessment; D012720:Severity of Illness Index; D063346:Singing / Q000502:physiology*; D049489:Stroboscopy / Q000379:methods*; D011795:Surveys and Questionnaires; D014741:Video Recording; D014827:Vocal Cords / Q000503:physiopathology*; D014832:Voice Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000534:rehabilitation; D014833:Voice Quality / Q000502:physiology*; D055815:Young Adult
Laryngoscopy; Professional singers; Singing; Videostrobolaryngoscopy; Vocal health; Voice; Voice handicap index