Difficulty producing high-pitched sounds in singing: correlations with laryngostroboscopy and electromyographic findings

Abstract Introduction: Difficulties or limitations in producing high-pitched sounds while singing may be due to the vocal technique used or organic factor. The observation of such difficulty or limitation by singing teachers is one of the main reasons affected individuals are referred to otolaryngologists. Objective: To evaluate the laryngostroboscopic and electromyographic changes in the cricothyroid muscles of singers with difficulties or limitations producing high-pitched sounds. Methods: This is a cross-sectional study. Ten singers with difficulty producing high-pitched sounds underwent voice, laryngostroboscopic, and electromyographic evaluations. Results: None of the evaluated singers presented signs of impairment of the superior laryngeal nerve on laryngostroboscopy. The electromyographic findings for the cricothyroid muscle were normal for all singers. Six singers presented vocal fold lesions, seven had signs suggestive of laryngopharyngeal reflux, and two presented vascular changes. Conclusion: No signs suggestive of superior laryngeal nerve paresis or paralysis were observed on laryngostroboscopy and electromyography of the cricothyroid muscle in singers with difficulties or limitations producing high-pitched sounds. The presence of vocal fold lesions should be investigated in this population.

摘要
引言：歌手演唱时出现高音发声困难或受限，可能与所采用的歌唱技法或器质性因素有关。歌唱教师观察到此类发声困难或受限情况，是受影响个体被转诊至耳鼻咽喉科医师的主要原因之一。
目的：评估存在高音发声困难或受限的歌手，其环甲肌的喉动态镜（laryngostroboscopy）及肌电图（electromyography）变化。
方法：本研究为横断面研究。纳入10名存在高音发声困难的歌手，对其开展嗓音评估、喉动态镜检查及肌电图检测。
结果：所有受评估歌手的喉动态镜检查均未发现喉上神经受损的征象。所有歌手的环甲肌肌电图结果均正常。其中6名歌手出现声带病变，7名存在提示喉咽反流的征象，2名出现血管改变。
结论：在存在高音发声困难或受限的歌手中，喉动态镜检查及环甲肌肌电图均未发现提示喉上神经轻瘫或麻痹的征象。此类人群需对声带病变进行排查。