![]() ![]() There is a similar effect during prolonged expiration, as with singing, as the abdominal muscles are activated and exert pressure against the stomach wall as the thoracic cavity compresses. During inspiration, the thoracic cavity expands and the diaphragm compresses the stomach, putting pressure against the LES, potentially causing stomach acids to reflux into the esophagus. Tasks which emphasize coordinated contractions of the diaphragm and intercostal and abdominal muscles may place singers at an elevated risk for developing LPR due to high-magnitude changes in intrathoracic pressures that may occur during such maneuvers. Singing requires a high magnitude of recruitment and activation of respiratory and laryngeal structures. Less common upper airway symptoms include worsening asthma, wheezing, shortness of breath, dental hypersensitivity, laryngospasm, nausea, otalgia, muscle spasms, bronchospasm from aspiration, and halitosis. Common symptoms of LPR include hoarseness, throat clearing, the perception of excessive mucous accumulation within the throat, difficulty swallowing, breathing difficulties, globus sensation, cough, persistent “tickle” sensation within the throat, sore throat, and regurgitation. ![]() Laryngopharyngeal reflux (LPR) refers to retrograde movement of gastric contents into the larynx, pharynx, and upper aerodigestive tract and is commonly associated with a number of voice disorders, particularly among singers. This study emphasizes the importance of sensitive and objective measures of reflux severity as well as consideration of the cumulative time of reflux exposure in addition to the number of reflux episodes. Our results suggest that singers may exhibit enhanced sensitivity to LPR and may therefore manifest symptoms, even in response to subtle changes in pH. Large sample sizes are necessary to determine if true correlations exist. Symptom severity did not correlate with pH levels however, we found a number of covariances of interest. Correlations were performed to examine potential relationships between reflux symptoms and duration of LPR episodes. Mild, moderate, or severe pH exposure was recorded during oropharyngeal pH monitoring. Twenty professional/semiprofessional singers completed the Reflux Symptom Index (RSI) and underwent oropharyngeal pH monitoring. We hypothesized that reported symptoms would correlate with objective measures of pH levels from the oropharynx, including the number and total duration of reflux episodes. This study examines the relationship between laryngopharyngeal reflux (LPR) symptoms and oropharyngeal pH levels in singers. ![]()
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