Singing-voice Disorders and Aerodynamic Profiles in Dysodic Singers (AeroDysodiaPro)

December 28, 2020 updated by: University Hospital, Montpellier

Retrospective Study of Singing-voice Disorders and Aerodynamic Profiles in Dysodic Singers

Singers are over-represented in phoniatric consultation; they present increased risk of developing voice disorders. They represent a specific population among phoniatric patients (specific singing-voice complaints, increased sensitivity to voice). Singing-voice disorder is called dysodia in the same way as dysphonia, which refers to speaking-voice disorders. The diagnosis of dysodia is made after a laryngeal examination and a voice assessment to identify patient's speech and singing difficulties. Most studies on prevalence of voice disorders in singers come from the American continent. Very few descriptions of this population have been made in France.

Voice assessment of dysodic singers includes aerodynamic voice measurements. The use of aerodynamic measurements for the diagnosis of voice pathologies is now widely demonstrated. These parameters include measurements of estimated subglottal pressure (ESGP), phonation threshold pressure (PTP) (minimum pressure to initiate a sound) and oral airflow (OAF). They depend on the level of training of singers and the type of vocal dysfunction. Aerodynamic behaviours of dysodic singers have not yet been described, although they can help to better identify the singer's vocal difficulties and could be essential parameters for targeting more precisely rehabilitation exercises proposed in voice therapy.

This study aims to describe the characteristics of a French population of singers consulting in phoniatrics and their aerodynamic behaviours. Do the singers' aerodynamic parameters (pressure, flow) reflect the dysfunctions in singing voice? Based on results of the literature on speaking and singing non-pathological voice, the investigators hypothesize that during voice assessment, ESGP values will be increased and OAF ones will be decreased over the entire vocal range of the singer in case of voice pathology.

Study Overview

Status

Unknown

Conditions

Detailed Description

Singers are over-represented in phoniatric consultation; they present increased risk of developing voice disorders whether they are amateurs or professionals. They represent a specific population among phoniatric patients because of their increased sensitivity to the slightest voice change that makes them consult earlier than non-. In addition, their complaints are specific to singing voice. The most common lesion found in singers is vocal-fold nodule. It comes from a vocal straining characterized by the use of a pressed phonation mode, resulting in an increased subglottal pressure and a decreased flow rate.

Singing-voice disorder is called dysodia in the same way as dysphonia, which refers to speaking-voice disorders. Dysodia results in a variety of symptoms. Acoustic signs are the most numerous: tonal anomalies (lack of accuracy, reduction of vocal range); dynamic anomalies (problem to sing softly or loudly); timbre abnormalities (vibrato problems, strained voice, roughness, difficulties on attacks). Dysodia also results in respiratory disorders, physical signs, psychological consequences and damage to hedonistic properties (loss of comfort, vocal endurance, musicality). It can reach amateur or professional singers. For professional singers, voice is the main working tool. When they have dysodia, professional difficulties can be temporary or even lead to the loss of work. In addition, dysodia can lead to financial loss and well-documented anxiety. For amateur singers, dysodia hinders their musical practice, thus limiting the recognized benefits of choral singing on cohesion, social integration and personal development. The diagnosis of dysodia is made after a laryngeal examination and a vocal assessment to identify patient's speech difficulties.

Voice assessment includes subjective voice analyses but also instrumental analyses that include acoustic, electrophysiological and aerodynamic voice measurements. The interest of aerodynamic parameters for the diagnosis of vocal pathologies is now widely demonstrated. These parameters include measurements of estimated subglottal pressure (ESGP), phonation threshold pressure (PTP) (minimum pressure to initiate a sound) and oral air flow (OAF). They depend on the level of training of singers and the type of vocal dysfunction. These aerodynamic data are collected with devices such as the Assisted Voice Evaluation Device (EVA2©) used in the laryngeal department of the Gui de Chauliac University Hospital. These pressure and flow parameters are higher in opera singers than in non-singers. In clinical practice, the ESGP and PTP are higher during vocal straining in dysphonic patients. Concerning OAF, results remain controversial: increase with vocal effort in euphonics non-singers; decrease with intensity increase in euphonic non-singers. Aerodynamic behaviours of dysodic singers have not yet been described, although they can help to better identify the singer's vocal difficulties and could be essential parameters for targeting more precisely rehabilitation exercises proposed in voice therapy.

In addition, most studies on prevalence of vocal disorders in singers come from the American continent. Very few descriptions of this population have been made in France. The few that exist are quite old or involve limited samples. Moreover, to date, no study has explored the aerodynamic profiles (flow and pressure) of singers, although these profiles are considered to be relevant clinical indicators to describe the singer's vocal difficulties and thus precise more specific therapeutic objectives.

In this context, our project aims to fill these gaps by describing a French population of singers consulting in phoniatrics and describing their aerodynamic behaviours. Do the singers' aerodynamic parameters (pressure, flow) reflect the dysfunctions in singing voice? Based on results of the literature on speaking and singing non-pathological voice, the investigators hypothesize that during voice assessment, the values of ESGP and PTP will be increased and that those of OAF will be decreased over the entire range of the singer in case of vocal pathology

Study Type

Observational

Enrollment (Actual)

100

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Montpellier, France, 34295
        • UH Montpellier

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Patients who have consulted the phoniatrician (Dr Amy de la Bretèque) of the ENT department of the Gui de Chauliac hospital between January 2015 and June 2018.

Description

Inclusion Criteria:

  • have consulted Dr Amy de la Bretèque, phoniatrist, between January 2015 and June 2018
  • be a singer (professional or amateur)
  • be over 18 years old

Exclusion Criteria:

  • under 18 years old

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Other
  • Time Perspectives: Retrospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Aerodynamic data : estimated subglottal pressure
Time Frame: 1 day
estimated subglottal pressure (values in hPa)
1 day
Aerodynamic data : phonation pressure threshold
Time Frame: 1 day
phonation pressure threshold (values in hPa)
1 day
Aerodynamic data : oral airflow rate
Time Frame: 1 day
oral airflow rate (values in l/s).
1 day

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
social and medical data : age
Time Frame: 1 day
age (yo)
1 day
social and medical data : sex
Time Frame: 1 day
sex (male or female)
1 day
social and medical data : occupation
Time Frame: 1 day
occupation : profession noted in the file by the phoniatrician
1 day
social and medical data : singing style
Time Frame: 1 day
singing style : opera, concert/oratorio/recital, recording artist, pop, rock, jazz, gospel and soul, country and western, world music, vocal groups, French commercial singing.
1 day
social and medical data : level of training
Time Frame: 1 day
level of training : superstars, international singers, national/big city singers, regional/touring, local community (including semiprofessionals), full-time students of singing and amateur.
1 day
social and medical data : voice complaint
Time Frame: 1 day
voice complaint : vocal difficulties reported by the patient to the phoniatrician and noted in the medical files
1 day
social and medical data : phoniatric diagnosis
Time Frame: 1 day
phoniatric diagnosis : diagnosis by the phoniatrician specifying whether there are laryngeal lesions
1 day
social and medical data : tobacco consumption
Time Frame: 1 day
tobacco consumption (yes or no, volume)
1 day
social and medical data : voice treatment
Time Frame: 1 day
voice treatment : treatment proposed by the phoniatrician (no treatment, surgery, voice therapy)
1 day

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Marion BEAUD, UH Montpellier

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 1, 2019

Primary Completion (Actual)

November 1, 2020

Study Completion (Anticipated)

June 1, 2021

Study Registration Dates

First Submitted

July 22, 2019

First Submitted That Met QC Criteria

July 25, 2019

First Posted (Actual)

July 30, 2019

Study Record Updates

Last Update Posted (Actual)

December 29, 2020

Last Update Submitted That Met QC Criteria

December 28, 2020

Last Verified

December 1, 2020

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Undecided

IPD Plan Description

NC

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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