Prevalence of Laryngopharyngeal Reflux Symptoms, Dysphonia, and Vocal Tract Discomfort in Amateur Choir Singers

Carlo Robotti; Antonio Schindler; Jerome R Lechien; Antonio Di Sabatino; Silvia Capobianco; Antonio Schindler; Francesco Ottaviani; H Steven Sims; Giulia Bertino; Marco Benazzo; Francesco Mozzanica

doi:10.1016/j.jvoice.2021.06.024

Prevalence of Laryngopharyngeal Reflux Symptoms, Dysphonia, and Vocal Tract Discomfort in Amateur Choir Singers

J Voice. 2023 Nov;37(6):932-944. doi: 10.1016/j.jvoice.2021.06.024. Epub 2021 Aug 14.

Affiliations

¹ Department of Otolaryngology - Head and Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
² Department of Biochemical and Clinical Science "L. Sacco", Luigi Sacco University Hospital, University of Milan, Milan, Italy.
³ Department of Otolaryngology - Head and Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France.
⁴ Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
⁵ Department of Surgical Pathology, Medical, Molecular and Critical Area, ENT section, Pisa, Italy.
⁶ Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Department of Otorhinolaryngology, IRCCS Multimedica, Milan, Italy.
⁷ Chicago Institute for Voice Care, Department of Otolaryngology, University of Illinois Medical Center, Chicago, Illinois.
⁸ Department of Otolaryngology - Head and Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
⁹ Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Department of Otorhinolaryngology, IRCCS Multimedica, Milan, Italy. Electronic address: francesco.mozzanica@gmail.com.

PMID: 34404581
DOI: 10.1016/j.jvoice.2021.06.024

Abstract

Introduction: Vocal tract discomfort (VTD), dysphonia, and laryngopharyngeal reflux (LPR) symptoms are complaints frequently reported by amateur singers. There are two aims of this study. The first is to evaluate the prevalence of these symptoms using validated questionnaires. The second is to correlate singing-related variables with the questionnaire responses.

Methods: A total of 392 amateur choir singers (ACS) and 514 control subjects completed an online survey divided into four parts: (1) clinical and demographic characteristics, (2) training in singing and singing experience, (3) history of gastroesophageal reflux disease and LPR symptoms, (4) validated questionnaires. Specifically, the reflux symptom index (RSI), the vocal tract discomfort scale (VTDS), and the voice symptom scale (VoiSS) were included to analyze the actual burden related to LPR symptoms, VTD, and dysphonia.

Results: ACS demonstrated a healthier lifestyle and a lower prevalence of gastroesophageal reflux disease symptoms in comparison with control subjects. ACS scored significantly higher in VTDS and VoiSS than control subjects, while no differences in the RSI results were found. Significant correlations among the questionnaires' results were demonstrated. Occasional professional singing was the variable influencing VTDS and VoiSS results the most.

Conclusion: ACS do not evidently manifest a higher impairment connected to LPR (RSI score), while they do report higher levels of voice (VoiSS score) and vocal tract (VTDS score) impairments, in comparison with control subjects. The relevant correlations among the PRO measures suggest that LPR symptoms, VTD, and dysphonia are related to each other. Given the relevant repercussion on the severity of VTD and dysphonia, providers should specifically ask about occasional professional singing when treating amateur singers.

Keywords: Quality of life—Dysphonia—Vocal tract—Laryngopharyngeal reflux.

MeSH terms

Dysphonia* / diagnosis
Dysphonia* / epidemiology
Humans
Laryngopharyngeal Reflux* / diagnosis
Laryngopharyngeal Reflux* / epidemiology
Prevalence
Singing*
Voice*