Predominant Vertical Location of Benign Vocal Fold Lesions by Sex and Music Genre: Implication for Pathogenesis

Mayu Hirosaki, Takeharu Kanazawa, Daigo Komazawa, Ujimoto Konomi, Yu Sakaguchi, Yukio Katori, Yusuke Watanabe

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives/Hypothesis: Vertical locations of vocal fold mucosal lesions (VFMLs) vary along the free edge. As the vertical contact area of vocal folds (VFs) depends on the vocal register, lesions may occur in the contact area of more frequently used vocal registers. This study investigated the cause of location variations by comparing the vertical sites of VFMLs in singers of both sexes with different music genres. Study Design: Retrospective review. Methods: Sixty professional classical and rock singers (11 male classical [M-classical], 22 male rock [M-rock], 13 female classical [F-classical], and 14 female rock [F-rock] singers) who underwent microlaryngeal surgery for VF polyps and nodules and their 108 lesions were enrolled. The VF free edge was vertically divided into three equal parts and classified into the following four lesion sites: upper, middle, lower, and multiple sites. Results: Upper lesions were most common among F-classical singers (73.9%), whereas lower lesions were most common among M-classical (90.0%) and M-rock (60.6%) singers. Among lesions localized to a single site, lower lesions were most common among F-rock singers (37.0%). F-classical singers had significantly more upper lesions than the other groups (P <.001). M-classical singers had significantly more lower lesions than female singers of any genre (P <.001). Conclusion: Upper lesions were most common among F-classical singers who mostly used the head voice. Lower lesions were most common among singers who mainly used the modal voice. This study suggests that sex, the dominant vocal register used for singing, and mechanical stress on VFs influence the vertical site of VFMLs. Level of Evidence: 4 Laryngoscope, 2021.

Original languageEnglish
JournalLaryngoscope
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • Mechanical stress
  • vertical location
  • vocal fold nodule
  • vocal fold polyp
  • vocal register

ASJC Scopus subject areas

  • Otorhinolaryngology

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