AIRWAY REACTIVITY INDUCED REVERSIBLE VOICE DYSFUNCTION IN SINGERS

As the power source for vocalization, the lower respiratory tract play s a key role in voice production. This is particularly true with susta ined singing, where continued high ventilatory demands are present. Ch anges in pulmonary function that are insignificant with normal speech have been shown to lead to performance impairment. The purpose of this study was to examine and characterize this problem in a large group o f singers. Systematic evaluation of a defined population, along with i nhalational and singing challenge, was the design. The demographic cha racteristics, history pulmonary function, and response to treatment we re evaluated in 20 professional or serious amateur singers with voice problems, who did nor have causal laryngeal pathology, whose history a nd evaluation suggested increased airway reactivity, and who responded to anti-asthma therapy. An additional patient was challenged by the e xercise of singing in the office with pulmonary function measurements before and after. This group of serious singers demonstrated vocalizat ion complaints referable to bronchodilator responsive airway obstructi on. They responded to treatment for asthma, with improvement in their performance-related difficulties. An additional subject demonstrated a small decline in expiratory flow rates with only 20 minutes of singin g in the office This was readily reversed by an inhaled bronchodilator . Singers who present with complaints of impaired vocalization, such a s vocal fatigue, decreased control, and excessive muscular tension, sh ould be evaluated for increased airway reactivity as a possible cause of their complaints.