Objective
Pediatric performers do not commonly seek an evaluation from a laryngologist. Due to a void in the literature, it is unknown if pediatric performers report differing complaints from pediatric non-performers, or if there is a greater risk for certain diagnoses among performers when compared to the general pediatric patient.

Methods/Design
This retrospective study determines presenting complaints and diagnoses among 100 pediatric singers and 100 pediatric non-singers who presented to a single pediatric Voice Clinic.

Results
Singers’ performing levels included avocational, professional, solo performer, choral, music theatre, classical, and pop/commercial. The age range for singer patients was 8-20 years, while the age range for non-singer patients was 4 months to 21 years. Females dominated the singer group (27 males,73 females) while males dominated the non-singer group (58 males, 42 females). Organized sports involvement was similar for both groups. Voice disability (pVHI) was significantly higher for non-singers (non-singers 37.9, singers 21.5). The most common diagnoses for singers were reflux, dysphonia, allergic rhinitis, muscle tension dysphonia, and vocal fold mass. Most common diagnoses for non-singers were dysphonia, vocal fold mass, reflux, vocal fold paralysis, and tonsillar hypertrophy. Non-singers were referred for phonosurgery and tonsillectomy at significantly higher incidence compared to the singer group. Referral to gastroenterologist and referral to allergist were similar between groups.

Conclusions
Laryngologists need to recognize the complexity of performance demands on their child performers, while still addressing the common childhood diagnoses well as the recognizing the concerns of the pediatric performer and their support team. Reflux laryngitis was a common diagnosis in both groups, but at a significantly higher incidence for singers. Vocal fold mass was a common diagnosis in both groups but at a significantly higher incidence for non-singers.