Arytenoid Asymmetry in Relation to Posture, Neck Tension and Glottal Attack in Singers

Abstract

Objectives: To look at the incidence of arytenoid asymmetry in a group of healthy singers and to investigate whether the asymmetry correlates with posture, neck tension and glottal attack. Materials and Method: The medical records and video recordings of 42 singers were reviewed retrospectively. Posture, neck tension and glottal attack were evaluated in relation to arytenoid asymmetry during adduction. Results: The number of singers was 42, with a male-to-female ratio of 2:1. The age range was 16–38 years, with a mean of 24 ± 4.13 years. The total prevalence of arytenoid asymmetry was 50%, with a predominance in males and on the right side. The most common asymmetry was that of the cuneiform cartilages, accounting for 40.5% of the total sample and 81% of the total asymmetries. There was no correlation between arytenoid asymmetry and either posture, neck tension or glottal attack (p = 0.343, 0.489 and 0.945, respectively). Conclusion: One out of 2 singers is likely to have arytenoid asymmetry during adduction. The presence of asymmetry does not correlate with posture, neck tension or glottal attack.

Prevalence of arytenoid adduction asymmetry in normophonic speakers: a retrospective study

“…Arytenoid asymmetry can manifest as the anterior positioning of cuneiform cartilages, overlapping posture of corniculate cartilages and sharpening of the aryepiglottic fold. 2,4 Extensive literature review could not help us find a single diagnostically significant parameter to diagnose arytenoid adduction asymmetry in normophonic speakers. When isolating our investigation to the corniculate cartilage overlaps, the prevalence of arytenoid adduction asymmetry was 36.4 per cent in our study.…”

“…Arytenoid asymmetry can manifest as the anterior positioning of cuneiform cartilages, overlapping posture of corniculate cartilages and sharpening of the aryepiglottic fold. 2,4…”

“…Arytenoid adduction plays a crucial role in producing normal voice by its anteromedial inferior displacement termed 'positive pitch'. 2 This movement of arytenoids pulls the vocal folds medially and brings them together. Adequate voice production requires the medial approximation of vocal folds and their proper vertical and horizontal alignment.…”

Efeitos da aritenoidectomia superomedial no fechamento glótico posterior incompleto provocado por assimetria posicional de aritenoides em laringes excisadas de cadáveres humanos

“…Há carência de estudos na literatura sobre o impacto que a assimetria de cartilagens aritenoides pode provocar no fechamento glótico posterior e na voz. Apesar de algumas pesquisas mostrarem resultados que não evidenciam correlação da assimetria de aritenoides com sintomas vocais (Hirano et al,1989;Lindestad et al, 2004;Husseini et al, 2011), Romak et al (2014) relataram um caso de paralisia de prega vocal direita com assimetria de cartilagens aritenoides, em que esta assimetria comprometia o fechamento glótico posterior, sendo realizada uma aritenoidectomia parcial superomedial com melhora da qualidade vocal. Além deste estudo, Bonilha et al (2009) observaram que na adução das pregas vocais, caso uma aritenoide adquira posição anterior à aritenoide contralateral, é provável que a prega vocal seja encurtada e apresente menor tensão, podendo criar um desequilíbrio e resultar em vibração anormal.…”

“…Husseini et al, 2011.Figura 3 -Tipos de assimetria de aritenoides. A) Cartilagem corniculada esquerda sobrepondo a direita.…”