The Relationship Between the Stomatognathic System and Voice in Classical Singers

Abstract

PurposeTo evaluate stomatognathic system’s structures and functions in classical singers, relating them to the auditory-perceptual judgment of voice quality and voice self-perception. MethodsA cross-sectional pilot study was conducted to evaluate the Stomatognathic System (SS) using orofacial myofunctional evaluation (MBGR Protocol). Voice handicap self-perception was assessed by the Classical Singing Handicap Index (CSHI) and the Voice Handicap Index (VHI-10). Voice samples, recorded according to the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) protocol, underwent auditory-perceptual judgment by two voice experts. All statistical analyses adopted a 5% significance level. ResultsThe study included 15 classical singers (nine women and six men). Adequate assessments of lip and tongue functionality and mobility, upper and lower lip, mentum, and tongue tone were higher compared with altered assessments (P < 0.001). Nasal and oronasal breathing showed similar proportions among singers (P = 0.273). Participants reported greater pain in the masseter muscle (P ≤ 0.001), temporomandibular joint (TMJ) (P ≤ 0.001), and sternocleidomastoid muscle (SCM), especially on the left side (P ≤ 0.001). MBGR score showed no association with singers’ voice handicap and voice quality self-perception. ConclusionMBGR-evaluated SS items were not related to auditory-perceptual judgment of voice quality and voice self-perception. Singers reported more pain with palpation in the SCM, masseter muscle, and TMJ. Preference for a chewing side was higher than bilateral chewing. Assessing SS is paramount for the multidimensional evaluation of classical singers’ voice.