Send to

Choose Destination
J Voice. 2014 Sep;28(5):608-13. doi: 10.1016/j.jvoice.2014.03.003. Epub 2014 May 16.

Singing voice handicap and videostrobolaryngoscopy in healthy professional singers.

Author information

Boston University School of Medicine, Boston, Massachusetts.
Department of Cell and Neurobiology, University of Southern California, Los Angeles, California.
Department of Music Education, Boston University School of Music, Boston, Massachusetts.
Department of Otolaryngology-Head and Neck Surgery, Duke University School of Medicine, Durham, North Carolina.
Department of Otolaryngology-Head and Neck Surgery, Boston University School of Medicine, Boston, Massachusetts. Electronic address:



This study correlates the Singing Voice Handicap Index (SVHI) scores with videostrobolaryngoscopy in healthy professional singers as a measure of self-perceived vocal health versus actual pathology seen on examination. The objective was to measure the strength of self-assessment among professional singers and determine if there is a benefit of combining SVHI and videostrobolaryngoscopy for routine assessment of singers without an obvious singing voice problem.


Prospective cross-sectional study.


Forty-seven singers were included in the study. Singers produced spoken and sung pitches during videostrobolaryngoscopy. Examinations were blindly rated by two independent fellowship-trained laryngologists who assessed vocal fold appearance and function. The correlation between SVHI scores and total pathologic findings seen on videostrobolaryngoscopy was analyzed using linear regression and serial t tests.


SVHI scores (mean of 22.45/144) were as expected for healthy singers. However, although all singers self-identified as healthy, laryngeal abnormalities were relatively common. The interrater reliability of total pathologic findings between two laryngologists was 71% (P = 0.006). Linear regression found no significant correlation (P = 0.9602) between SVHI scores and videostrobolaryngoscopy findings.


Greater than expected laryngeal pathology was seen in these professional singers, who identified themselves as healthy, which possibly indicates a minimal impact on their singing voice and/or perception of vocal health. These findings demonstrate that laryngeal appearance alone does not dictate nor fully explain the sound or apparent health of a professional singer. Sustaining good vocal health is complex, and even experienced singers may not reliably assess the presence of pathology.


Laryngoscopy; Professional singers; Singing; Videostrobolaryngoscopy; Vocal health; Voice; Voice handicap index

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center