Nasal patency in opera singers – first examinations on the premises of Medical University – Varna

Abstract

Background:
Human voice is produced by air going through the vocal folds, causing them to vibrate. Human brain controls how they would fold and snap in order to produce the different sound waves. The Syndrome of Obstructive sleep apnea and snoring (SOSAS) is a widespread disease of significant social importance. Rhinomanometry can be used to assess nasal patency and monitor the effectiveness of CPAP therapy in severe forms of the syndrome by determining tissue resistance. The response of patients with milder forms of OSA treated with intraoral devices can be monitored with the help of rhinomanometry. The method is utilized in patients with allergic rhinitis, sinusitis of rhinogenic and other origins, and in patients with orthodontic deformities.
The aim of the following article is to study the nasal resistance in opera singers and to continue the fruitful collaboration between the University medical and dental center, Medical University „Prof. Dr. Paraskev Stoyanov” – Varna and the Varna Opera theater.
Methods:
A total of 50 patients (27 males and 23 females) encompassing different voice types and ranges (soprano, tenor, baritone, bass, mezzo-soprano, alt), all from Varna Opera Theatre, have been recruited to the following study in the period November 2023-December 2024. The study was the first of its kind on the premises of Medical University – Varna. All of them were examined in the Sector „Audio-vestibular and Sleep medicine”, University medical and dental center, Medical University – Varna. All patients were examined by the same specialist in otorhinolaryngology. All participants, included in the study, underwent а full otorhinolaryngologic examination, including otoscopy, rhinoscopy and a hearing check-up – audiometry, tympanometry, OAE (all done with Interacoustics®, Dennmark devices) and rhinomanometry (Atmos® Rhino 31, Germany). The anterior measuring method is utilized when rhinomanometry examinations were executed. All examinees filled in written informed consent forms and questionnaires regarding their health status, general diseases, allergies present, surgical interventions done in the head and neck area. According to the specific clinical case, X-ray and CT-scans were done. Treatment and prophylactic measures have been prescribed. The study has received approval from Medical University – Varna’s Ethics commission (№ 131 / 11.05.2023).
Results and discussion:
Of the examined 50 participants, disorders have been diagnosed in 40 (80 %, 20 male and 20 female patients) of them. In 10 participants (7 male, 3 female) no ENT disorders have been diagnosed (control group). Chronic sinusitis, chronic pharyngitis, chronic laryngitis and allergic rhinitis were the most frequent diagnoses reached. Moderate symptoms of harshness and changed timbre and pitch were diagnosed. No cases of severe voice disorders caused by gastroesophageal reflux, vocal nodules, cancer of the larynx or neurological diseases were reported. No cases of hearing loss – either of conductive, sensorineural or mixed type were diagnosed. Rhinomanometry is a valuable and effective functional method for additional diagnostics and monitoring of patients with obstructive sleep apnea, allergic rhinitis (with and without nasal polyposis), sinusitis of rhinogenic and other origin, orthodontic deformities, monitoring of patients after COVID-19 infection and other diseases. Early detection of the changed upper airway resistance through rhinomanometry can slow and prevent the development of obstructive sleep apnea and snoring syndrome. It is important to emphasize the effects of allergic conditions on the nasal mucosa, as well as the prolonged use of nasal decongestants.
Conclusions:
Collaboration between different types of medical and dental specialists should be implemented nowadays in order to provide the right initial diagnostics, following treatment and care for patients. Prophylactic and preventive measures are to be executed on a daily basis to keep the health of the voice apparatus, including oncologic diseases.