Clinical Trial Details
— Status: Active, not recruiting
Administrative data
| NCT number |
NCT04036864 |
| Other study ID # |
RECHMPL19_0339 |
| Secondary ID |
|
| Status |
Active, not recruiting |
| Phase |
|
| First received |
|
| Last updated |
|
| Start date |
March 1, 2019 |
| Est. completion date |
June 1, 2021 |
Study information
| Verified date |
December 2020 |
| Source |
University Hospital, Montpellier |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Observational
|
Clinical Trial Summary
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.
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
