{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T02:39:26Z","timestamp":1776134366665,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,1,9]],"date-time":"2021-01-09T00:00:00Z","timestamp":1610150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Vertical locations of vocal fold mucosal lesions (VFMLs) vary along the free edge. As the vertical contact area of vocal folds (VFs) depends on the vocal register, lesions may occur in the contact area of more frequently used vocal registers. This study investigated the cause of location variations by comparing the vertical sites of VFMLs in singers of both sexes with different music genres.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sixty professional classical and rock singers (11 male classical [M\u2010classical], 22 male rock [M\u2010rock], 13 female classical [F\u2010classical], and 14 female rock [F\u2010rock] singers) who underwent microlaryngeal surgery for VF polyps and nodules and their 108 lesions were enrolled. The VF free edge was vertically divided into three equal parts and classified into the following four lesion sites: upper, middle, lower, and multiple sites.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Upper lesions were most common among F\u2010classical singers (73.9%), whereas lower lesions were most common among M\u2010classical (90.0%) and M\u2010rock (60.6%) singers. Among lesions localized to a single site, lower lesions were most common among F\u2010rock singers (37.0%). F\u2010classical singers had significantly more upper lesions than the other groups (<jats:italic>P\u2009&lt;<\/jats:italic>\u00a0.001). M\u2010classical singers had significantly more lower lesions than female singers of any genre (<jats:italic>P\u2009&lt;<\/jats:italic>\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Upper lesions were most common among F\u2010classical singers who mostly used the head voice. Lower lesions were most common among singers who mainly used the modal voice. This study suggests that sex, the dominant vocal register used for singing, and mechanical stress on VFs influence the vertical site of VFMLs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:E2284\u2013E2291, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29378","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T00:38:46Z","timestamp":1610671126000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Predominant Vertical Location of Benign Vocal Fold Lesions by Sex and Music Genre: Implication for Pathogenesis"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6800-5727","authenticated-orcid":false,"given":"Mayu","family":"Hirosaki","sequence":"first","affiliation":[{"name":"Tokyo Voice Center International University of Health and Welfare  Tokyo Japan"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Tohoku University Graduate School of Medicine  Miyagi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3735-684X","authenticated-orcid":false,"given":"Takeharu","family":"Kanazawa","sequence":"additional","affiliation":[{"name":"Tokyo Voice Center International University of Health and Welfare  Tokyo Japan"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daigo","family":"Komazawa","sequence":"additional","affiliation":[{"name":"Tokyo Voice Center International University of Health and Welfare  Tokyo Japan"},{"name":"AKASAKA Voice Health Center  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ujimoto","family":"Konomi","sequence":"additional","affiliation":[{"name":"Tokyo Voice Center International University of Health and Welfare  Tokyo Japan"},{"name":"Voice and Dizziness Clinic Futakotamagawa Otolaryngology  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Sakaguchi","sequence":"additional","affiliation":[{"name":"Tokyo Voice Center International University of Health and Welfare  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukio","family":"Katori","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Tohoku University Graduate School of Medicine  Miyagi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Tokyo Voice Center International University of Health and Welfare  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,1,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.7162\/S1809-97772013000300008"},{"key":"e_1_2_6_3_1","first-page":"E12","article-title":"Influence of the macroscopic features of vocal fold polyps on the quality of voice: a retrospective review of 101 cases","volume":"89","author":"Dursun G","year":"2010","journal-title":"Ear Nose Throat J"},{"key":"e_1_2_6_4_1","unstructured":"GarciaM.Traite comlet de l'art du chant in French (Minkoff 1847 reprinted in 1985)."},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0095-4470(19)31188-X"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2005.01.008"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000263363"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000263771"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24911"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22421"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.5935\/1808-8694.20130078"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2006.12.009"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1044\/1058-0360.0603.66"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1675391"},{"key":"e_1_2_6_15_1","first-page":"188","volume-title":"Principles of Voice Production","author":"Titze IR","year":"1994"},{"key":"e_1_2_6_16_1","first-page":"99","volume-title":"The Diagnosis & Correction of Vocal Faults: A Manual for Teachers of Singing and for Choir Directors","author":"JC MK","year":"2005"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2007.10.014"},{"key":"e_1_2_6_18_1","unstructured":"MillerDG.Registers in Singing: Empirical and Systematic Studies in the Theory of the Singing Voice [PhD thesis]. 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