title: A Comparison of Initial and Subsequent Follow-Up Strobovideolaryngoscopic Examinations in Singers.
abstract: OBJECTIVE
  Previous studies have identified abnormal findings in up to 86.1% of singers on initial screening strobovideolaryngoscopy (SVL) examinations. No studies have compared the prevalence of abnormalities in singers on their subsequent follow-up SVL. Our study evaluates the frequency of these findings in both the initial and subsequent examinations.
  
  
  METHODS
  Retrospective charts and SVL reports were reviewed on students from an opera conservatory from 1993 to 2014. All students had initial screening SVL, but only students who later returned with acute voice complaints were included in the study (n = 51, 137 follow-up visits). Normal SVL was defined as an examination without structural or functional abnormalities and reflux finding score ≤7. Data were analyzed using the chi-square test.
  
  
  RESULTS
  For initial examinations, 90.2% (including reflux) and 88.2% (excluding reflux) were abnormal. In follow-up examinations, 94.9% (including reflux) and 94.2% (excluding reflux) had abnormal findings, which included muscle tension dysphonia (40.1%), vocal fold (VF) masses (unilateral 48.9%, bilateral 30.7%), vascular abnormalities (unilateral 27.0%, bilateral 5.8%), sulcus (unilateral 17.5%, bilateral 5.1%), VF hypomobility (unilateral 36.3%, bilateral 5.9%), phase (30.6%) and amplitude (44.8%) asymmetries, and glottic insufficiency (49.3%). Follow-up examinations revealed a significant increase in laryngopharyngeal reflux (χ(2) = 7.043; P < 0.05).
  
  
  CONCLUSIONS
  We found a higher prevalence of abnormal findings compared with previous studies, which we attributed to a more inclusive definition of abnormal pathologies, improvements in SVL technology, and possibly increased experience with SVL interpretation. This high prevalence of abnormal findings in asymptomatic singers further supports the importance of baseline examinations.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.
authors.forename: Calvin
authors.initials: C
authors.lastname: Myint
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Jaime Eaglin
authors.initials: JE
authors.lastname: Moore
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania. Electronic address: amanda.cm.hu@gmail.com.
authors.forename: Amanda
authors.initials: A
authors.lastname: Hu
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Jaworek
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Sataloff
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D055154:Dysphonia / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007828:Laryngoscopy; D007830:Larynx / Q000503:physiopathology*; D008297:Male; D009790:Occupations; D015143:Philadelphia / Q000453:epidemiology; D010699:Phonation; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D063346:Singing; D049489:Stroboscopy; D013997:Time Factors; D014741:Video Recording; D014833:Voice Quality; D055815:Young Adult
keywords: Dysphonia; Stroboscopy; Strobovideolaryngoscopy; Voice abnormalities in singers; Voice pathology in asymptomatic singers