Quantifying Laryngopharyngeal Reflux in Singers: Perceptual and Objective Findings

Lloyd, Adam; Ruddy, Bari Hoffman; Silverman, Erin; Lewis, Vicki; Lehman, Jeffrey

doi:10.1155/2017/3918214

Cited by 7 publications

(5 citation statements)

References 38 publications

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“…Using only RSI or RFS values for the diagnosis of LPR might lead us to false-positive diagnoses. 49,52,[54][55][56] In the our sample 26.8% of the clinical group met pH monitoring diagnoses criteria and similar prevalence, detected with the same gold standard, was reported in recent contemporary scientific research from the Asian, 57,58 Europe 59 and Italy. [60][61][62] Although the threshold found with the original version is similar to the first validation work (Belafsky: 2002) the scores from RSI Binary version had better known-groups criterion validity, with prevalence values approaching the gold standard (26.8%), we would recommend this approach in future applications.…”

Section: Discussionsupporting

confidence: 81%

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Assessment and Diagnostic Accuracy Evaluation of the Reflux Symptom Index (RSI) Scale: Psychometric Properties using Optimal Scaling Techniques

Nacci

Bastiani

Barillari

et al. 2020

Ann Otol Rhinol Laryngol

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Objectives: To investigate the psychometric properties of the reflux symptom index (RSI) as short screening approach for the diagnostic of laryngopharyngeal reflux (LPR) in patients with confirmed diagnosed regarding the 24-hour multichannel intraluminal impedance-pH monitoring (MII-pH). Methods: From January 2017 to December 2018, 56 patients with LPR symptoms and 71 healthy individuals (control group) were prospectively enrolled. The LPR diagnosis was confirmed through MII-pH results. All subjects (n = 127) fulfilled RSI and the Reflux Finding Score (RFS) was performed through flexible fiberoptic endoscopy. The sensitivity and the specificity of RSI was assessed by ROC (Receiver Operating Characteristic) analysis. Results: A total of 15 LPR patients (26.8%) of the clinical group met MII-pH diagnostic criteria. Among subjects classified as positive for MII- pH diagnoses, RSI and RFS mean scores were respectively 20 (SD ± 10.5) and 7.1 (SD ± 2.5), values not significantly different compared to the negative MII-pH group. The metric analysis of the items led to the realization of a binary recoding of the score. Both versions had similar psychometric properties, α was 0.840 for RSI original version and 0.836 for RSI binary version. High and comparable area under curve (AUC) values indicate a good ability of both scales to discriminate between individuals with and without LPR pathology diagnosis. Based on balanced sensitivity and specificity, the optimal cut-off scores for LPR pathology were ≥ 5 for RSI binary version and ≥ 15 for RSI original version. Both version overestimated LPR prevalence. The original version had more sensitivity and the RSI Binary version had more specificity. Conclusions: It would be necessary to think about modifying the original RSI in order to improve its sensitivity and specificity (RSI binary version, adding or changing some items), or to introduce new scores in order to better frame the probably affected of LPR patient.

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Section: Discussionsupporting

confidence: 81%

“…Using only RSI or RFS values for the diagnosis of LPR might lead us to false-positive diagnoses. 49,52,54-56…”

Section: Discussionmentioning

confidence: 99%

Assessment and Diagnostic Accuracy Evaluation of the Reflux Symptom Index (RSI) Scale: Psychometric Properties using Optimal Scaling Techniques

Nacci

Bastiani

Barillari

et al. 2020

Ann Otol Rhinol Laryngol

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“…Ingestion of substances such as tobacco, caffeine, alcohol, and high-fat foods also favors the return of gastric contents to the glottic level, causing vocal irritation. 9 20 33 The study by Lloyd et al 34 investigated the relationship between GER symptoms and oropharyngeal pH levels in professional and semiprofessional singers, and found that mild GER was present in 95% of the participants by objective evaluation, although only 75% of the participants had signs of self-reported GER using subjective evaluation. The same occurred in another study, 13 in which among laryngeal alterations, GER was the prevalent pathology in popular singers, with a slight predominance in women 13 ( Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

Singing Style, Vocal Habits, and General Health of Professional Singers

Santos

Montagner

Bastilha

et al. 2019

Int Arch Otorhinolaryngol

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Introduction For the singer, the voice is a medium used to express feelings that capture the listener. Every singing style has specific demands, and a vocal alteration may prevent the singer from meeting them. Objective To compare the singing style, the vocal habits, and the general health data of professional singers. Methods Cross-sectional, quantitative and retrospective study of a survey database. Data on the singing style, the vocal habits, and the health conditions and history of 57 professional singers, 31 female singers and 26 male singers, aged from 19 to 57 years old (average of 32 years old), from a mid-sized town were analyzed Results There was a prevalence of female (54 ± 2%) popular singers (91 ± 2%), in the adult age (51 ± 2%), nonsmokers (89 ± 2%), nonusers of alcohol (77 ± 2%), with respiratory problems (53 ± 2%), mainly rhinitis (23 ± 2%), and without other health problems. There was a significant use of alcohol in males ( p = 0.010); among the alcohol users, there was a significant presence of respiratory problems ( p = 0.046), of pharyngitis/tonsillitis ( p = 0.003), and of gastroesophageal reflux (GER) ( p = 0.043); there was a significant presence of GER in subjects reporting endocrine problems ( p = 0.023), of gastritis ( p = 0.023), and of pharyngitis/tonsillitis ( p = 0.030). Conclusion There was a predominance of adult professional popular female singers, with complaints of respiratory issues (with a higher prevalence of rhinitis), without other general health issues, of nonsmokers, and of nonusers of alcohol.

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“…Lately, reflux has been increasingly associated with voice disorders among singers, whether it is related to macroscopic and microscopic changes in the mucosa of the vocal folds [6,7] or to the singers' enhanced sensitivity to it [8].…”

Section: Introduction 1singing and Riskmentioning

confidence: 99%

Risk Factors for Voice Disorders among Fado Singers: A Cross-Sectional Study

Pestana

Freitas

Manso

2023

OHBM

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Fado is an urban Portuguese musical style rooted in popular culture. Previously found data suggests that Fado singers may have an increased risk of developing voice disorders. (1) Aim: To determine the risk factors for the development of voice disorders among Fado singers. (2) Methods: A cross-sectional study was conducted through the administration of a questionnaire containing questions related to voice disorders in singers. The relationship between personal and social data, musical background, performance demands and habits, vocal health and wellbeing, and strategies to overcome voice problems are reported. Beyond a comprehensive characterization, odds ratios (ORs) and their 95% confidence intervals (CIs) for the association with voice disorders were calculated through univariate and multivariate logistic regression analyses. (3) Results: The significant risk factors for voice disorders were as follows in decreasing order: nose-related disorders; decongestants or antihistamines; oral contraceptives or hormone replacement therapy; previous smoking habits; and vocal fatigue after performances. (4) Conclusion: These activities significantly increased the risk of developing voice disorders. The evidence from this study and the relative low prevalence of self-reported voice disorders suggest that these singers may develop a kind of protective combination of factors beyond the scope of this research.

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Quantifying Laryngopharyngeal Reflux in Singers: Perceptual and Objective Findings

Cited by 7 publications

References 38 publications

Assessment and Diagnostic Accuracy Evaluation of the Reflux Symptom Index (RSI) Scale: Psychometric Properties using Optimal Scaling Techniques

Assessment and Diagnostic Accuracy Evaluation of the Reflux Symptom Index (RSI) Scale: Psychometric Properties using Optimal Scaling Techniques

Singing Style, Vocal Habits, and General Health of Professional Singers

Risk Factors for Voice Disorders among Fado Singers: A Cross-Sectional Study

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