• Michelle Kwok and Guy D Eslick.
• The Whiteley-Martin Research Centre, Discipline of Surgery, Sydney Medical School, Nepean Hospital, The University of Sydney, Penrith, New South Wales, Australia.
• J Voice. 2019 Jan 1; 33 (1): 58-65.

ObjectiveProfessional singers are more likely to develop laryngeal pathologies and symptoms associated with misuse and overuse of the voice. However, different studies have shown conflicting evidence. We aim to perform a systematic review and quantitative meta-analysis to determine the prevalence and risk of laryngeal pathologies and symptoms among professional singers.MethodsFour electronic databases (MEDLINE, PubMed, EMBASE, and CINAHL) were searched, with no language restrictions. From 3368 potential studies, a total of 21 studies met our inclusion criteria. A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. All cohort, case-control, or cross-sectional studies that reported the risk of laryngeal pathologies in singers were included. Data were pooled by a random effects model and the pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.ResultsThere was a positive relationship between singing and laryngeal pathologies. There was an increased risk of hoarseness (OR: 2.00, 95% CI: 1.61-2.49), gastroesophageal reflux disease (GERD) (OR: 1.45, 95% CI: 1.19-1.77), Reinke edema (OR: 2.15, 95% CI: 1.08-4.30), and polyps (OR: 2.10, 95% CI: 1.06-4.14) in professional singers.ConclusionProfessional singers are at an increased risk of laryngeal pathologies and symptoms associated with vocal misuse and overuse, particularly hoarseness, GERD, edema, and polyps.Crown Copyright © 2019. Published by Elsevier Inc. All rights reserved.

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