Association of Genre of Singing and Phonotraumatic Vocal Fold Lesions in Singers

Objectives/Hypothesis: To determine if (1) the likelihood of presenting with phonotraumatic lesions differs by singing genre in treatment-seeking singers and (2) if the distribution of phonotraumatic lesion types differs by singing genre. Study Type: Retrospective. Methods: Records of singers who presented with a voice complaint over the course of 2.5 years (June 2017–December 2019) were reviewed to determine the proportion of those with phonotraumatic lesions as a function of genre (Study 1). Separately, the lesion types and genres of singers diagnosed with phonotraumatic lesions over a 9-year period (July 2011–March 2020) were determined (Study 2). Results: In Study 1, 191 of 712 (26.8%) dysphonic singers were diagnosed with phonotraumatic lesions. Country/folk, gospel/jazz, and musical theater singers were more likely to present with phonotraumatic lesions. In Study 2, in 443 singers with phonotraumatic lesions, polyps and pseudocysts, but not nodules, were found to be distributed unequally across genres (χ² p = 0.006, p < 0.0001, p = 0.064, respectively). Praise/worship singers had significantly higher proportions of polyps compared to choral singers (OR 4.8 [95% CI 1.9–12.5]) or compared to musical theater singers (OR 7.2 [95% CI 2.5–20.8]). Opera singers had significantly higher proportions of pseudocysts than choral singers (OR 3.1 [95% CI 1.5–6.1]) or musical theater singers (OR 3.7 [95% CI 1.8–7.6]). Conclusions: The higher incidence of polyps in praise/worship singers likely reflects the more emphatic nature of singing and the tendency for acute injury. The higher incidence of pseudocysts in opera singers may reflect a more chronic nature of injury. Level of Evidence: 4 Laryngoscope, 133:1683–1689, 2023.