The gender of singers may play a role in voice injuries

The gender of singers may play a role in voice injuries

Raquel Lindemann Nguyen, a folk singer/songwriter, began to lose her voice and was referred to Dr. Lesley Childs at UT Southwestern. Dr. Childs diagnosed her with muscle tension dysphonia and referred her for voice therapy with Amy Harris, a speech pathologist at UTSW.

DALLAS – 05 December 2022 – A singer’s primary gender can impact the likelihood of developing vocal cord injury and may even influence the specific type of injury that occurs, according to a recent study by researchers at the UT Southwestern.

Lesley Childs, MD

The two-part study, led by Lesley Childs, MD, associate professor of otolaryngology-head and neck surgery and medical director of the Voice Center at UT Southwestern, involved the detailed examination of over 1,000 patient records. The findings, published in The Laryngoscopeprovide new insights into possible mechanisms of vocal injury in singers, which could help facilitate preventive measures and earlier recognition and treatment.

Phonotraumatic lesions that develop on the vocal cords include benign nodules, pseudocysts, and hemorrhagic polyps, all of which can cause hoarseness. These injuries are usually caused by overuse or strain of the voice.

The study found that while nodules were almost equally distributed across all singing genres, opera singers had a significantly higher proportion of pseudocysts and praise/worship singers had significantly more bleeding polyps.

“These findings, combined with clinical observations, suggest that the nodules may be more related to the speaking voice than the singing voice, as they were more or less evenly distributed between genders,” Dr. Childs said. “At the same time, genre-specific singing style, acoustic environment and vocal demands clearly impact both the frequency and type of injuries that develop, with opera singers exhibiting patterns more chronic injuries and praise/worship singers with more acute injuries.

The first part of the study reviewed the medical records of 712 singers who presented with dysphonia from June 2017 to December 2019. Of these patients, 191 (26.8%) were diagnosed with phonotraumatic injury.

The second part involved the examination of 443 singing patients diagnosed with vocal cord damage from July 2011 to March 2020, referenced against their primary singing genre. This survey allowed researchers to identify which genders had higher injury rates than others.

“Understanding the likelihood and potential causes of chronic and acute vocal cord injuries is extremely beneficial for singers and vocal instructors,” said Dr. Childs. “By taking into account the unique vocal load of their singing genre, acoustic environment, and vocal technique used, they can work to modify behaviors and possibly prevent vocal cord injury.”

The new study complements previous findings by UTSW Voice Center researchers on the causes and treatments of voice injuries. In May, the Voice Center released an in-depth study of more than 400 patients that identified the most common vocal injuries experienced by singers, both professional and amateur.

“It was impossible to pursue my passion, and I was resigned to never sing again,” Ms. Lindemann Nguyen said. “Dr. Childs gave me back my life and more. She treated me with such compassion and kindness.”

Raquel Lindemann Nguyen, 43, is a folk singer-songwriter who also works as an elementary school music and art teacher. She began to lose her voice and was referred to Dr. Childs, who diagnosed her with muscle tension dysphonia.

“I couldn’t sing or teach,” Ms. Lindemann Nguyen said. “It was impossible to pursue my passion, and I was resigned to never singing again. Dr. Childs gave my life back to me and more. She treated me with such compassion and kindness.

Dr. Childs referred Ms. Lindemann Nguyen for voice therapy with Amy Harris, MA, CCC-SLP, speech pathologist at UT Southwestern.

Working with Ms. Harris once a week at first, then twice a month, made all the difference. Ms Harris focused on improving Ms Lindemann Nguyen’s airflow, rebalancing vocal subsystems and teaching her to relax her throat muscles to sing more effectively and reduce the tension that led to her his overuse injury.

“It’s always a challenge, but I know I can always count on the support of the UT Southwestern Voice Center,” she said.

The Voice Center, one of the largest in the South, employs a collaborative, multidisciplinary team of passionate voice care specialists to diagnose and treat injured singers. Several members of the Voice Center are singers, including Dr. Childs, who is a classically trained soprano with singing experience in professional chamber ensembles and with Walt Disney Records.

Other UTSW researchers who contributed to this study include Ted Mau, Alexandra D’Oto, Dylan R. Beams, and Linda Hynan.

About UT Southwestern Medical Center

UT Southwestern, one of the nation’s leading academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has received six Nobel Prizes and includes 24 members of the National Academy of Sciences, 18 members of the National Academy of Medicine, and 14 researchers from the Howard Hughes Medical Institute. Full-time faculty of more than 2,900 are responsible for groundbreaking medical advances and committed to rapidly translating scientific research into new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 100,000 inpatients, more than 360,000 emergency room cases, and oversee nearly 4 million outpatient visits annually.

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