Lechien Jérôme R, Briganti Giovanni
Department of Surgery, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Division of Laryngology and Bronchoesophagology, Department of Otolaryngology Head Neck Surgery, EpiCURA Hospital, Baudour, Belgium; Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France; Department of Otolaryngology, Elsan Hospital, Paris, France.
Department of Computational Medicine and Neuropsychiatry, Faculty of Medicine, University of Mons, Mons, Belgium; Department of Clinical Sciences, Faculty of Medicine, University of Liège, Liège, Belgium.
J Voice. 2024 Dec 7. doi: 10.1016/j.jvoice.2024.11.032.
To investigate the laryngopharyngeal reflux disease (LPRD) features in singers.
According to the PRISMA statements, two investigators searched the literature related to the prevalence of symptoms, findings, and clinical therapeutic outcomes of reflux in singers through a PubMed, Scopus, and Cochrane Library systematic review.
Of the 91 identified studies, 18 publications met the inclusion criteria, accounting for 2288 singers and 1398 controls, respectively. There were 1243 (54.3%) professional singers, 450 (19.7%) amateurs, 329 (14.4%) singing students, and 102 (4.5%) singing teachers. The LPRD diagnosis and findings were based on objective evaluations in 2/18 studies. According to validated and unvalidated patient-reported outcome questionnaires, reflux symptoms have been found in 25.0% to 65% of singers, with a RSI > 13 in 25.0%-33.9% of cases. The prevalence of LPRD signs ranged from 18.1% to 73.4% of singers without voice complaints and 18.1%-73.4% of singers with voice complaints at the time of the evaluation. No study investigated the pretreatment to post treatment changes in symptoms, findings, and voice outcome. Substantial heterogeneity was found between studies for reflux diagnosis, symptom and sign evaluations, singer profiles (musical styles, voice range), and association outcomes.
The prevalence of symptoms and findings attributed to LPRD can be high in singer populations. However, the nonspecificity of symptoms and findings, the lack of objective reflux testing, and the heterogeneity in the singer profile limit the drawing of valid conclusions for the prevalence of LPRD. Based on the findings collected in this systematic review, the authors proposed a semistructured questionnaire, including key points for primary singer evaluation.
探讨歌手的喉咽反流病（LPRD）特征。
根据PRISMA声明，两名研究者通过PubMed、Scopus和Cochrane图书馆系统评价，检索与歌手反流症状患病率、检查结果及临床治疗效果相关的文献。
在91项已识别的研究中，18篇出版物符合纳入标准，分别涉及2288名歌手和1398名对照。其中有1243名（54.3%）职业歌手、450名（19.7%）业余歌手、329名（14.4%）声乐学生和102名（4.5%）声乐教师。18项研究中有2项基于客观评估进行LPRD诊断和检查。根据经过验证和未经验证的患者报告结局问卷，发现25.0%至65%的歌手有反流症状，25.0% - 33.9%的病例反流症状指数（RSI）> 13。在评估时，无嗓音问题的歌手中LPRD体征的患病率为18.1%至73.4%，有嗓音问题的歌手中该患病率为18.1% - 73.4%。没有研究调查治疗前至治疗后症状、检查结果和嗓音结局的变化。在反流诊断、症状和体征评估、歌手特征（音乐风格、音域）以及关联结局方面，研究之间存在很大异质性。
歌手群体中归因于LPRD的症状和检查结果患病率可能较高。然而，症状和检查结果的非特异性、缺乏客观的反流检测以及歌手特征方面的异质性，限制了对LPRD患病率得出有效结论。基于本系统评价收集的结果，作者提出了一份半结构化问卷，包括歌手初步评估的要点。
