VOCAL DISORDERS AND THE PROFESSIONAL VOICE USER - THE ALLERGISTS ROLE

Background: As the modulating and power source for the voice, the uppe r and lower respiratory tracts play a key role in management of voice production. Allergic respiratory disease can impair vocalization, whic h can be a particular problem in the professional voice user. Objectiv e: The goal of this review is to facilitate the evaluation and managem ent of professional voice users who have allergic respiratory problems contributing to their vocal dysfunction. This articles discusses the anatomy and physiology of voice production, laryngeal pathology, and s pecial diagnostic and therapeutic considerations relative to the aller gist's role in treatment of these patients. Methods: Mechanisms of voi ce production are reviewed, as well as common laryngeal pathology effe cting voice production. Allergic respiratory diseases are summarized, with particular attention to those aspects of management that are alte red in professional voice users, Results: Professional voice users req uire modification in their management to optimize vocal function and m inimize abnormalities of the vocal tract. This includes avoidance of m edications that produce drying of the airway, as well as avoidance of inhaled corticosteroids. Subtle changes in respiratory function, which may be of no consequence to other individuals, may adversely affect p erformance ability, and need aggressive management. Allergen immunothe rapy, because of its lack of adverse effect on the vocal apparatus, is particularly well suited for treatment of professional voice users. C onclusions: Allergists have an important role to play in management of the professional voice user. With careful attention to the unique req uirements of these highly trained individuals, the allergist can enhan ce their performance ability while minimizing side effects from treatm ent.