Postoperative Voice Surgical Outcomes in Professional Singers vs Non-Singers

Professional singers often are described as vocal athletes, and just as professional athletes get injured, injuries to professional singers can occur during practice and performances. In other fields of medicine, research has shown that competitive sports athletes recover more quickly after orthopedic surgical procedures compared to non-athletes. The purpose of this study was to determine whether similar differences occur with voice patients by comparing voice surgical outcomes between professional singers and non-singers.

A retrospective cohort study was conducted that included a consecutive sample of 194 adult subjects who underwent voice surgical procedures in the operating room. All surgeries were performed by the same surgeon, the senior author of this study (RTS). Data were reviewed for patients with medical records between January 1, 2010 to February 1, 2022. Subjects who reported receiving income from singing or reported studying voice at a collegiate level or higher were classified as professional singers. Subjects reporting careers in all other professions, including unpaid avocational singers or singers without formal training, were assigned to the non-singer control group. The data were analyzed using SPSS statistical software. Statistical significance was determined using independent samples t test for continuous variables and Fisher's exact test or binary logistic regression for binary outcomes.

There were 194 subjects included in this study (43.81% male/56.19% female). The average age was 42.60 ± 15.17. Ninety subjects were professional singers and 104 were non-singers. Revision of surgical plan was significantly different for professional singers compared to non-singers (14.44% versus 0%, P < 0.001). The rate of postoperative complications did not differ significantly between the singer and non-singer groups, even when adjusting for other factors. Professional singers presented with slightly more severe vocal fold hemorrhages on the first postoperative visit compared to non-singers (1.73 ± 0.73 versus 1.32 ± 0.65, P = 0.003), but there was no difference by the second visit. Following surgery, professional singers adhered to a longer duration of voice rest. However, both groups participated equally in voice therapy postoperatively.

No differences were found in operative complications between professional singers and non-singers. This study describes outcomes and considerations in patient care for professional singers. It also provides insight into potentially modifiable factors, such as voice rest, that could impact patient care postoperatively.