Airway reactivity-induced asthma in singers (Arias)

Professional singers are particularly attuned to changes in air flow that can alter their ability to perform. We describe four singers who complained primarily of performance-related vocalization problems, but who had normal larynges and fundamentally good voice technique. All had normal or near-normal spirometry. Subsequent studies revealed evidence of increased airway reactivity, either by response to bronchodilators or to methacholine. All responded to treatment with bronchodilators with improvement in vocal performance. This represents a form of airway reactivity-induced asthma in singers similar to that found with exercise or hyperventilation.