Vocal allergy: recent advances in understanding the role of allergy in dysphonia

Purpose of review To examine recent advances in our understanding of the laryngeal effects of allergies with particular attention to the impact on vocal production. Recent findings A growing body of literature suggests an association between allergies and dysphonia evidenced by the increased likelihood of singers with vocal complaints to self-identify allergic rhinitis by standardized questionnaire compared with singers without vocal complaints, the severity of vocal symptoms of allergic patients in relationship to nonallergic controls, and the increased vocal complaints of allergic individuals from the nonallergy to allergy seasons. Arguments have also been made for the misdiagnosis of allergic dysphonia as laryngopharyngeal reflux disease. A recent study has demonstrated the first evidence of a causal relationship between allergen exposure and voice changes in the absence of a sinus or lower airway allergic response. Summary New evidence has highlighted the likelihood that allergies are indeed associated with dysphonia. The existence of a direct allergic response in the larynx has meaningful implications for the diagnosis and treatment of dysphonia. Further research is needed to identify the underlying pathways mediating the laryngeal response to allergy so that improved diagnostic and therapeutic techniques can be developed.