Objective: To determine whether there is a relationship between the voice type and the prevalence of voice disorders, and to investigate the frequency of laryngological controls and voice rehabilitation amongst professional opera singers. Study design: Cohort study, composed of a survey, videolaryngoscopy and videostroboscopy. Setting: Referral center (Clarós Otorhinolaryngology Clinic) Subject and methods: Highly professional opera singers performing in the Gran Teatro del Liceo in Barcelona, were divided into 7 study groups based on their voice types. Study was composed of a survey about singing and voice care habits, followed by videolaryngoscopy and videostroboscopy determining the prevalence of voice disorders. Results: We examined 70 opera singers (30 females, 40 males; aged 19-70), divided into 7 equally numerous study groups based on their voice types. The prevalence of voice disorders was the highest amongst sopranos, i.e. 50% (50%,95%,CI:12-88,SD=.53), in comparison to 20% (20%,95%,CI:10-50,SD=.42) amongst countertenors, tenors and baritones, 10% (10%,95%,CI:13-33,SD=.32) amongst contraltos and mezzo-sopranos, and 0% amongst basses. Statistical significance was confirmed for difference between the group of the highest female and highest male voice (soprano and countertenor), and the group of the lowest female and lowest male voice, i.e. contralto and bass (Z=2.32,P=.02). Frequency of attending laryngological appointments and voice rehabilitation was generally very low, although was highest amongst sopranos. Conclusion: Results supported our hypothesis that the higher voices are at a heightened risk of having voice disorders. It can start the process of evaluating actual risk of vocal fold pathologies that opera singers are exposed to during their careers.

We present a case of a 52-year old woman suffering from severe fibromyalgia, unable to manage even the lightest of housework, she gradually became crippled and her life became a ‘couch potato’ in patient’s own words. Treatment with topical phenytoin (5% titrated up to 15%) transformed her life, pain nearly vanished, and she became active, looking for a job, doing housework and she can walk rapidly. One explanation of this phenomenon could be that a number of patients suffering from fibromyalgia and having tender points suffer from localized length non-dependent small fiber neuropathy, and this pathology can be found in the skin above the tender points.

Ocular open globe injuries are often disabling for both the victim and society, as most of these eyes may remain unsalvageable. Many initial variables have been identified which can help in predicting the final visual outcome in these eyes. Also, various prognostic tools have been validated by previous studies. This article aims to review all these factors.