The Impact of Crohn's Disease on a Classical Singer: Vocal Fold Function, Voice Production, and Implications for Quality of Life

Purpose: Crohn's disease (CD) is a systemic inflammatory condition with documented laryngeal involvement; however, its impact on vocal function in singers remains underexplored. This study examined changes in laryngeal structure, perceptual voice quality, acoustic and aerodynamic measures, and self-reported vocal function across biologic infusion cycles in a classically trained singer with CD. Method: A longitudinal single-case design was used to assess an 18-year-old singer across nine sessions over 1 year. Data were collected pre- and post-infusion using videostroboscopy, acoustic and aerodynamic measures, perceptual ratings (Consensus Auditory-Perceptual Evaluation of Voice and Classical Voice Perceptual Measurement Tool), and the Singing Voice Handicap Index (SVHI). Results: Videostroboscopic findings demonstrated increased erythema, edema, and glottal insufficiency during pre-infusion sessions, with improvement following infusion. Perceptual ratings and SVHI scores showed consistent cyclical variation, indicating reduced vocal function pre-infusion and improvement post-infusion. In contrast, acoustic and aerodynamic measures remained largely within normative ranges and did not show consistent cyclical change. Conclusions: Findings suggest that CD may produce cyclical changes in vocal function associated with treatment timing. The observed dissociation between acoustic and perceptual measures highlights the importance of multimodal assessment, particularly in highly trained voice users.