Objectives/Hypothesis The purpose of the study was to compare the prevalence of vocal fold pathologies among first‐year singing students from the classical, musical theatre, and contemporary commercial music (CCM) genres. Study Design Prospective cohort study. Methods Videostroboscopic examinations were rated by blinded expert raters. Vocal pathology was defined as a vocal fold abnormality on the membranous or cartilaginous portions of the vocal folds or hypomobility. Consensus among three of four raters confirmed presence of pathology. Association between genre of singer and presence of pathology, interrater reliability, and intrarater reliability were calculated. Differences in singing voice handicap, and voice use and vocal hygiene were compared. Results Fifty‐seven participants were included. Seventeen percent of CCM, 40% of musical theatre, and 0% of classical singers were found to have vocal fold pathology. Interrater reliability was 0.522 between all four raters, 0.591 between the two laryngologists, and 0.581 between the two speech–language pathologists, showing a moderate agreement (P < .0001). Intrarater reliability was 1.000 (P < .0001) for the two laryngologists and 0.452 (P = .949) and 0.622 (P = .828) for the two speech–language pathologists. Singing Voice Handicap Index‐10 data across genre showed differences between CCM and classical singers. No significant differences were found in voice usage or vocal hygiene. Conclusions No classical students were found to have vocal fold pathology, whereas CCM and musical theatre students had significantly higher prevalence of pathologies. Voice use, vocal hygiene, and physiologic phonatory differences among classical, musical theatre, and CCM genres may be risk factors for development of vocal pathology. Level of Evidence 2b Laryngoscope, 130: 1996–2002, 2020
The prevalence of voice disorders in teachers as professional voice users has been analyzed at some length, especially compared to the general population. In the general population, it has been reported that nearly 30% of adults has experienced a voice problem in their life, and around 7% have a current voice problem. 3 Bhattacharyya reported similar findings of prevalence, indicating 1 in 13 adults annually will experience voice difficulty. 4 Smith et al. determined that 32% of teachers reported an episode of voice difficulty at some point in their career compared to only 1% in nonteachers group. 5 Additionally, about 20% of teachers missed work for voice problems compared to only 4% of not-teachers. In 2004, Roy et al. reported on the prevalence of current voice problems: 11.0% of teachers and 6.2% of nonteachers. The prevalence of voice disorders during their lifetime was 57.7% for teachers versus 28.8% for nonteachers. 6 These findings are comparable to those reported by Angelillo et al.; this study found that 8.7% of teachers reported a current voice problem, while 2.9% of nonteachers admitted to a current voice problem. The prevalence of voice difficulty at some point during their lifetime was 51.4% for IntroductIonWhen considering the phrase professional voice user, singers or actors may come to mind initially because of the intricacies and projection often required of their voices. However, professional voice users extend far beyond those involved in the arts; any person who requires their voice to do their job is considered a professional voice user. While this includes singers and other performers, teachers, salespeople/telemarketers, counselors, medical professionals, lawyers, religious clergy, and broadcasters are frequently seen in the voice clinic. It is estimated that professional voice users make up approximately one-third of the workforce worldwide. 1 The term occupational voice user has also been used to differentiate between those who use their voice for performance and require unique qualities of voice (professional voice users) and those who rely heavily on their typical speaking voice just to do their job, such as teachers, salespeople, and clergy (occupational voice users). For the purpose of continuity and consistency, the term professional voice user will be used in this paper to refer to all professional and occupational voice users.
ObjectiveThis study aimed to compare the prevalence and incidence of vocal fold pathologies among undergraduate classical, musical theatre, and contemporary commercial music (CCM) students over two‐time points.MethodsThis study is part of a longitudinal investigation. Videostroboscopic examinations were rated, with consensus among three of four expert blinded raters confirming the presence of pathology. Association between genre of singer and the presence of pathology, interrater reliability, and intra‐rater reliability were calculated. Prevalence and incidence of pathologies were compared across genres.ResultsDuring first‐year evaluations, 32% of musical theatre, 18% of CCM, and 0% of classical students had vocal pathologies. The prevalence at third‐year evaluations showed 22% of classical, 39% of musical theatre, and 27% of CCM participants having vocal fold pathologies. The incidence of pathologies was 67% of musical theatre students compared to 22% of classical students and 27% of CCM students. The four raters demonstrated fair to moderate interrater agreement. Singing Voice Handicap Index‐10 scores were normal for CCM singers at both time points but elevated for musical theatre and classical singers.ConclusionNo classical singers were found to have pathology during first‐year evaluations, although CCM and musical theatre singers showed evidence of vocal fold pathologies. At third‐year evaluations, all three genres had an apparent increase in prevalence of pathologies. Implications of this study suggest that more time in the field and intense voice usage may lead to a greater risk of pathology for all singers, regardless of genre.Level of Evidence2 Laryngoscope, 133:2317–2324, 2023
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