A model for vocal fold vibratory motion, contact area, and the electroglottogram

The electroglottogram (EGG) has been conjectured to be related to the area of contact between the vocal folds. This hypothesis has been substantiated only partially via direct and indirect observations. In this paper, a simple model of vocal fold vibratory motion is used to estimate the vocal fold contact area as a function of time. This model employs a limited number of vocal fold vibratory features extracted from ultra high-speed laryngeal films. These characteristics include the opening and closing vocal fold angles and the lag (phase difference) between the upper and lower vocal fold margins. The electroglottogram is simulated using the contact area, and the EGG waveforms are compared to measured EGGs for normal male voices producing both modal and pulse register tones. The model also predicts EGG waveforms for vocal fold vibration associated with a nodule or polyp.     

Restraining mechanisms in regulating glottal closure during phonation

Recent experimental studies showed that isotropic vocal fold models were often blown wide apart and thus not able to maintain adductory position, resulting in voice production with noticeable breathy quality. This study showed that the capability of the vocal fold to resist deformation against airflow and maintain adductory position can be improved by stiffening the body-layer stiffness or increasing the anterior-posterior tension of the vocal folds, which presumably can be achieved through the contraction of the thyroarytenoid (TA) and cricothyroid (CT) muscles, respectively. Experiments in both physical models and excised larynges showed that, when these restraining mechanisms were activated, the vocal folds were better able to maintain effective adduction, resulting in voice production with much clearer quality and reduced breathiness. In humans, one or more restraining mechanisms may be activated at different levels to accommodate the varying degree of restraining required under different voice conditions.     

Electroglottography – An Update

Electroglottography (EGG) is a low-cost, noninvasive technology for measuring changes of relative vocal fold contact area during laryngeal voice production. EGG was introduced about 60 years ago and has gone through a “golden era” of increased scientific attention in the late 1980s and early 90s. During that period, four eminent review papers were written. Here, an update to these reviews is given, recapitulating some earlier landmark contributions and documenting noteworthy developments during the past 25 years.After presenting an algorithmic bibliographic analysis, some methodological aspects pertaining to measurement technology, qualitative and quantitative analysis, and respective interpretation are discussed. In particular, the interpretation of landmarks in the (first derivative of the) EGG waveform is critically examined. It is argued that because of inferior-superior and anterior-posterior phase differences of vocal fold vibration, vocal fold (de)contacting does not occur instantaneously, but over an interval of time. For this reason, instants of vocal fold closing and opening cannot be resolved exactly from the EGG signal. Consequently, any quantitative analysis parameter relying on the determination of (de)contacting events (such as the EGG contact quotient) should be interpreted with care.Finally, recent developments are reviewed for the various fields of application of EGG, including basic voice science and voice production physiology, speech signal processing and classification, clinical practice including swallowing, phonetics, hearing sciences, psychology, singing, trumpet playing, and mammalian and avian bioacoustics. Overall, EGG has over the past six decades developed into a mature technology with a wide range of applications. However, due to current limitations, the full potential of the methodology has as yet not been fully exploited. Future development may occur on three levels: (a) rigorous validation of existent measurement approaches; (b) introduction and rigorous validation of novel quantitative and interpretative approaches; and (c) advancement of the measurement technology itself.     

Approximations of open quotient and speed quotient from glottal airflow and egg waveforms : Effects of measurement criteria and sound pressure level

Noninvasive measures of vocal fold activity are useful for describingnormal and disordered voice production. Measures of open and speed quotient from glottal airflow and electroglottographic (EGG) waveforms have been used to describe timing events associated with vocal fold vibration. To date, there has been little consistency in the measurement criteria used to calculate quotient values. In this study, criteria of 20% and 50% were applied to the AC amplitude of glottal airflow and inverted EGG waveforms for measurement of open quotient. Criteria of 20%, 50%, and 80%, and a midslope criterion that segmented the waveform between 20% and 80% of the waveform amplitude, were used for the calculation of speed quotient. Subjects produced waveforms at sound pressure levels (SPL) of 70, 75, 80 and 85 dB. Results indicated that approximations of open quotient obtained from the glottal airflow waveform significantly decreased using both the 20% and 50% criteria as SPL increased from 80 to 85 dB. No significant changes were found in open quotient from the EGG waveform as a function of SPL. Results of speed quotient measures from the glottal airflow and EGG waveforms showed a generally increasing trend as SPL increased, although the differences were not statistically significant. The data suggest that the signal type, measurement criterion and SPL must be considered in interpreting quotient measures.     

Frequency and amplitude perturbation analysis of electroglottograph during sustained phonation

Electroglottography (EGG) was used to monitor vocal fold vibration patterns in normal subjects and patients with various laryngeal disorders. In order to evaluate the regularity of vocal fold vibration, frequency and amplitude perturbation of EGG waves during sustained phonation were measured with a laboratory computer. The data were compared to the degree of hoarseness evaluated by auditory perception and by sound spectrographic analysis. Frequency and amplitude perturbation measures showed some overlap between normal and pathological groups. However, there was a close relation between perturbation analysis of EGG waves and degree of hoarseness (Spearman's rank correlation coefficient rs = 0.73, p less than 0.0005). Amplitude perturbation was found to be a more sensitive measure of the irregularity of vocal fold vibration than frequency perturbation.     

An electroglottographic study of vocal vibrato

This study investigated vocal vibrato in trained singers through the use of electroglottography (EGG). Ten adult trained singers (7 women, 3 men) were each required to produce four singing tasks. The tasks involved the production of /a/ during an ascending interval of a third in both chest and falsetto registers, once with and once without vibrato. Audio and EGG output during these tasks were directly digitized for subsequent analysis. Results pertaining to changes in the EGG waveform as a function of the singer's gender, the vocal register and the vibrato condition are discussed. A major finding was the apparent absence of consistent, distinctive differentiation in the EGG waveforms when comparing the vibrato and vibrato-inhibited conditions for the majority of subjects. Possible explanations for the majority findings, as well as comment on the feasibility of the EGG for investigating vocal vibrato, are discussed.     

Visualization and Quantification of the Medial Surface Dynamics of an Excised Human Vocal Fold During Phonation

SUMMARY: The purpose of this investigation was to investigate physical mechanisms of vocal fold vibration during normal phonation through quantification of the medial surface dynamics of the fold. An excised hemilarynx setup was used. The dynamics of 30 microsutures mounted on the medial surface of a human vocal fold were analyzed across 18 phonatory conditions. The vibrations were recorded with a digital high-speed camera at a frequency of 4,000 Hz. The positions of the sutures were extracted and converted to three-dimensional coordinates using a linear approximation technique. The data were reduced to principal eigenfuctions, which captured over 90% of the variance of the data, and suggested mechanisms of sustained vocal fold oscillation. The vibrations were imaged as the following phonatory conditions were manipulated: glottal airflow, an adductory force applied to the muscular process, and an elongation force applied to the thyroid cartilage. Over the range of variables studied, only the variation in glottal airflow yielded significant changes in subglottal pressure and fundamental frequency. All recordings showed high correlation for the distribution of the dynamics across the medial surface of the vocal fold. The distribution of the different displacement directions and velocities showed the highest variations around the superior region of the medial surface. Although the computed vibration patterns of the two largest empirical eigenfunctions were consistent with previous experimental observations, the relative prominence of the two eigenfunctions changed as a function of glottal airflow, impacting theories of vocal efficiency and vocal economy.     

Multiparametric Analysis of Vocal Fold Vibrations in Healthy and Disordered Voices in High-Speed Imaging

Objectives

The aim of this study was to look for visual subjective and objective parameters of vocal fold dynamics being capable of differentiating healthy from pathologic voices in daily clinical practice applying endoscopic high-speed digital imaging (HSI).

Study Design and Methods

Four hundred ninety-six datasets containing 80 healthy and 416 pathologic subjects (232 functional dysphonia (FD), 13 bilateral, and 171 unilateral vocal fold nerve paralysis) were analyzed retrospectively. Videos at 4000 Hz (256 × 256 pixel) were recorded during sustained phonation. Subjective parameters were visually evaluated and complemented by an analysis of objective parameters. Visual subjective parameters were mucosal wave, glottal closure type, glottal closure insufficiency (GI), asymmetries of the vocal folds, and phonovibrogram (PVG) symmetry. After image segmentation, objective parameters were computed: closed quotient, perturbation measures (PMs) of glottal area, and left-right asymmetry values.

Results

HSI evaluation enabled to distinguish healthy from pathologic voices. For visual subjective parameters, GI, symmetrical behavior, and PVG symmetry exhibited statistical significant differences. For 95% of the data, objective parameters could be computed. Among objective parameters, closed quotient, jitter, shimmer, harmonic-to-noise ratio, and signal-to-noise ratio for the glottal area function differentiated statistically significant normal from pathologic voices. Applying linear discriminant analysis by combining visual subjective and objective parameters, accurate classifications were made for 63.2% of the female and 87.5% of the male group for the three-class problem (healthy, FD, and unilateral vocal fold nerve paralysis).

Conclusion

Actual acoustically applied PMs can be transferred to clinical beneficial HSI analysis. Combining visual subjective and objective basic parameters succeeds in differentiating pathologic from healthy voices. The presented evaluation can easily be included into everyday clinical practice. However, further research is needed to broaden our understanding of the variability within and across healthy and pathologic vocal fold vibrations for diagnosing voice disorders and therapy control.     

Electroglottographic wavegrams: a technique for visualizing vocal fold dynamics noninvasively

A method for analyzing and displaying electroglottographic (EGG) signals (and their first derivative, DEGG) is introduced: the electroglottographic wavegram ("wavegram" hereafter). To construct a wavegram, the time-varying fundamental frequency is measured and consecutive individual glottal cycles are identified. Each cycle is locally normalized in duration and amplitude, the signal values are encoded by color intensity and the cycles are concatenated to display the entire voice sample in a single image, similar as in sound spectrography. The wavegram provides an intuitive means for quickly assessing vocal fold contact phenomena and their variation over time. Variations in vocal fold contact appear here as a sequence of events rather than single phenomena, taking place over a certain period of time, and changing with pitch, loudness and register. Multiple DEGG peaks are revealed in wavegrams to behave systematically, indicating subtle changes of vocal fold oscillatory regime. As such, EGG wavegrams promise to reveal more information on vocal fold contacting and de-contacting events than previous methods.     

Strobophotoglottographic transillumination as a method for the analysis of vocal fold vibration patterns

The purpose of this exploratory study was to determine if laryngeal transillumination in combination with stroboscopy (strobophotoglottography; SPGG) is useful for (1) the visualization of vocal fold vibration (VFV) opening patterns, (2) the localization of initial vocal fold opening in horizontal glottal thirds (anterior, midmembranous, and posterior), (3) determination of the temporal correspondence of the so-called electroglottography (EGG)-knee and initial vocal fold separation, and, finally, (4) automatized quantitative measurements of glottal area function within endoscopic images. With stroboscopic transillumination, initial inferior vocal fold separation was detectable during the "closed" phase, where the vocal folds were still closed in the upper portion and therefore initial inferior vocal fold separation could not be visualized with usual laryngoscopy techniques. In the horizontal plane within similar fundamental frequencies in modal voice registers in two male subjects, localization of initial glottal opening depended on the voice types used (soft, normal, or pressed phonation). We found zipperlike posterior-to-anterior openings, initial midmembranous openings, initial anterior openings, as well as simultaneous initial opening of all three portions in the two healthy male adults examined. This technique proved to add temporal and spatial information to vocal fold opening patterns and extends our examination techniques to the very beginning of vocal fold opening at the inferior portion. Simultaneous electroglottogram tracking and comparison with bidirectionally illuminated stroboscopic images revealed a time-locked correspondence of the EGG-knee with the aforementioned initial inferior vocal fold separation. Bidirectional illumination combined with digital color extraction techniques allowed for image separation of subglottally and supraglottally illuminated structures. This facilitated vocal fold contour detection and automatized image processing, for example, for determination of glottal area function, and is considered to be a further step to objective automatized quantitative measurements within endoscopic images.     

Problems and pitfalls of electroglottography

The popularity and usefulness of the electroglottograph (EGG) has increased remarkably since its introduction over a decade ago. It has been used to measure fundamental frequency of phonation, fundamental frequency perturbation, details of the vocal fold vibratory cycle, as well as to provide an indication of laryngeal vertical movement. It has also been used with a variety of speech and voice disorders. The EGG is not without its limitations and problems. Some of these are found in the electronic designs of specific instruments, whereas other problems are related to subject characteristics, the placement of the electrodes, electrode symmetry, and subject/instrument interaction. This article explores some of these concerns, primarily from the perspective of two individuals who have used the EGG extensively with children, men and women, voice patients, stutterers, and neurologically impaired persons. Some of the concerns to consider and pitfalls to avoid in the interpretation and measurement of EGG signal are discussed.     

Effects of a Vocally Fatiguing Task and Systemic Hydration on Men''s Voices

Voice disorders, specifically vocal fatigue, are more commonly reported by women than by men. Previously, 4 women with normal untrained voices read loudly for 2 hours in an attempt to fatigue the voice. Vocal function deteriorated, as indicated by increases in phonation threshold pressure (PTP) and self-perceived phonatory effort. The increase in PTP was delayed or attenuated to some degree in 3 of the women when they drank ample amounts of water before the experiment. The current study examined the same vocal-loading task and water-drinking condition in 4 vocally normal men. PTP increased after the loud-reading task. Although 2 of the men appeared to benefit from increased systemic hydration (PTP increased more when they were underhydrated than well-hydrated), the other 2 men's data changed in the opposite direction. Phonatory effort correlated well with PTP; this varied across subject and pitch. Laryngeal endoscopy revealed an anterior glottal gap in two men after the loud-reading task. Amplitude of vocal fold vibration was judged to be reduced after the loud-reading task in three subjects when underhydrated and one subject when well hydrated. The high between-subject variability prohibits a conclusion that drinking water is beneficial to vocal function in men, but all subjects studied to date demonstrated detrimental vocal effects of prolonged loud talking.     

Electroglottographic quasi-open quotient and amplitude in crescendo phonation

Crescendo phonation (swelltone) was used to evaluate the laryngeal tensioning behavior of seven normal speakers and of 12 dysphonic patients. EGG quasi-open quotient (qOq), stroboscopic open quotient, and vocal sound pressure level (SPL) were measured, and EGG amplitude and the mucosal wave were assessed qualitatively. For normal speakers, the qOq decreased greatly as vocal intensity increased. The same tendency was observed, but to a lesser extent, among hyperfunctional dysphonics. In contrast, qOq increased with vocal intensity among the hypofunctional dysphonics. The crescendo task combined with EGG assessment appears to offer a valid approach to the classification of laryngeal dysfunctions.     

On the influence of laryngeal pathologies on acoustic and electroglottographic jitter measures

This study compared acoustic and electroglottographic (EGG) jitter from [a] vowels of 103 dysphonic speakers. The EGG recordings were chosen according to their intensity, signal-to-noise ratio, and percentage of unvoiced intervals, while acoustic signals were selected based on voicing detection and the reliability of jitter extraction. The agreement between jitter measures was expressed numerically as a normalized difference. In 63.1% (65/103) of the cases the differences fell within +/-22.5%. Positive differences above +22.5% were associated with increased acoustic jitter and occurred in 12.6% (13/103) of the speakers. These were, typically, cases of small nodular lesions without problems in the posterior larynx. On the other hand, substantial rises in EGG jitter leading to differences below -22.5% took place in 24.3% (25/103) of the speakers and were related to hyperfunctional voices, creaky-like voices, small laryngeal asymmetries affecting the arytenoids, or small-to-moderate glottal chinks. A clinically relevant outcome of the study was the possibility of detecting gentle laryngeal asymmetries among cases of large unilateral increase in EGG jitter. These asymmetries can be linked with vocal problems that are often overlooked in endoscopic examinations.     

Standardized laryngeal videostroboscopic rating: Differences between untrained and trained male and female subjects, and effects of varying sound intensity, fundamental frequency, and age

To determine the influence of the factors gender, vocal training, sound intensity, pitch, and aging on vocal function, videolaryngostroboscopic images of 214 subjects, subdivided according to gender and status of vocal training, were evaluated by three judges with standardized rating scales, comprising aspects of laryngeal appearance (larynx/pharynx ratio; epiglottal shape; asymmetry arytenoid region; compensatory adjustments; thickness, width, length, and elasticity of vocal folds) and glottal functioning (amplitudes of excursion; duration, percentage, and type of vocal fold closure; phase differences; location of glottal chink). The video registrations were made while the subjects performed a set of phonatory tasks, comprising the utterance of the vowel /i/ at three levels of both fundamental frequency and sound intensity. Analysis of the rating scales showed generally sufficient agreement among judges. With the exception of more frequently observed complete closure and lateral phase differences of vocal fold excursions in trained subjects, no further differences were established between untrained and trained subjects. With an α level of p = 0.005, men differed from women with respect to laryngeal appearance (larynx/pharynx ratio, compensatory adjustments, and the presence of omega and deviant-shaped epiglottises), and their vocal folds were rated thicker in the vertical dimension, smaller in the lateral dimension, longer, and more tense, with smaller amplitudes of excursion during vibration. Glottal closure in male subjects was rated more complete, but briefer in duration. Significant effects of the factors pitch, sound intensity, and age on vocal fold appearance and glottal functioning were ascertained. Awareness of the influence of these factors, as well as the factor gender, on the rated scales is essential for an adequate evaluation of laryngostroboscopic images.     

Vocal Parameters of Aerobic Instructors with and without Voice Problems

Aerobic instructors frequently experience vocal fatigue and are at risk for the development of vocal fold pathology. Six female aerobic instructors, three with self-reported voice problems and three without, served as subjects. Measures of vocal function (perturbation and EGG) were obtained before and after a 30-minute exercise session. Results showed that the group with self-reported voice problems had greater amounts of jitter, lower harmonic-to-noise ratios, and less periodicity in sustained vowels overall, but no significant differences in measures of perturbation and EGG were found before and immediately after instruction. Measures of vocal parameters showed that subjects with self-reported voice problems projected with relatively greater vocal intensity and phonated for a greater percentage of time across beginning, middle, and ending periods of aerobic instruction than subjects with no reported voice problems.     

Membranous and cartilaginous vocal fold adduction in singing

While vocal fold adduction is an important parameter in speech, relatively little has been known on the adjustment of the vocal fold adduction in singing. This study investigates the possibility of separate adjustments of cartilaginous and membranous vocal fold adduction in singing. Six female and seven male subjects, singers and non-singers, were asked to imitate an instructor in producing four phonation types: "aBducted falsetto" (FaB), "aDducted falsetto" (FaD), "aBducted Chest" (CaB), and "aDducted Chest" (CaD). The phonations were evaluated using videostroboscopy, videokymography (VKG), electroglottography (EGG), and audio recordings. All the subjects showed less posterior (cartilaginous) vocal fold adduction in phonation types FaB and CaB than in FaD and CaD, and less membranous vocal fold adduction (smaller closed quotient) in FaB and FaD than in CaB and CaD. The findings indicate that the exercises enabled the singers to separately manipulate (a) cartilaginous adduction and (b) membranous medialization of the glottis though vocal fold bulging. Membranous adduction (monitored via videokymographic closed quotient) was influenced by both membranous medialization and cartilaginous adduction. Individual control over these types of vocal fold adjustments allows singers to create different vocal timbres.     

Measurement of Characteristic Leap Interval Between Chest and Falsetto Registers

A markedly smaller time constant distinguishes a chest-falsetto leap from the more usual execution of a sung interval by muscular adjustments in the length and tension of the vocal folds. The features of such a chest-falsetto leap are examined in detail with respect to F0, peak-to-peak amplitude of the vocal-fold contact area signal (EGG), and the closed quotient. A method is proposed to standardize and quantify this chest-falsetto leap in the characteristic leap interval (CLI), a measure of the separation between the natural registers in a given singing voice. The measure is applied to a varied group of experienced singers. Preliminary results include a suggested dimorphic pattern with respect to sex, with female voices exhibiting smaller CLIs and less individual diversity than male voices.     

Investigation of vocal fold impact stress in human subjects

The primary purpose of the study was to explore a methodology for measuring vocal fold impact stress (SI) in awake humans, and to provide information about the general magnitude of SIs that may occur at the midpoint of the membranous vocal folds during phonation. A secondary purpose was to examine the potential use of the electroglottographic closed quotient (EGG CQ) to indirectly reflect SI. Seven male and 13 female adults were enrolled as subjects, of whom 18 had normal larynges and normal voices, 1 had nodules, and 1 had vocal fold paresis and bowing. Subjects attempted to produce 3 different voice types (pressed, normal, breathy), at 3 different pitches (low, medium, high) and 3 different loudness levels (quiet, medium, loud). For a first set of trials, only EGG data were collected. For a second set, a sensor was also introduced to the midmembranous glottis for the collection of SI data. The primary findings were that (1) endolaryngeal sensor placement was achieved during phonation trials for 17 of 20 subjects; however, grossly consistent anteroposterior positioning was accomplished, and analyzable data were obtained, for only 7 subjects; (2) SIs ranged from less than 1 kPa to about 3 kPa for those 7 subjects; and (3) no relation was detected between simultaneous CQs and SIs for individual data, although a relation was reported in a prior canine study. One possible reason for the failure to show such a relation in the present study was subtle variations in vertical as well as anteroposterior positioning of the sensor during the trials. Future studies should focus on developing a methodology for ensuring invariant 3-dimensional sensor positioning between the membranous folds, so that the stability of both SI and simultaneous CQ data can be improved.     

Vocal Tract Resonance Analysis of Aging Voice Using Long-Term Average Spectra

This study is the first to use long-term average spectra (LTAS) to investigate resonance characteristics of dynamic speech in young adulthood and old age. A total of 80 speakers participated, divided equally by age group and gender. All elderly speakers were healthy, active members of the community. Measurement of the first three spectral peaks in LTAS from the first paragraph of the Rainbow Passage revealed significant lowering of peak 1 from young adulthood to old age in both men and women. Peaks 2 and 3 also lowered significantly across the adult lifespan in women and showed a tendency to lower in men. These acoustic findings are consistent with anatomic data suggesting that aging results in lengthening of the supraglottic vocal tract. Findings that women demonstrate more substantial lowering of spectral peaks with aging than men suggest that women may undergo more pronounced age-related lengthening of the supraglottic vocal tract. Alternatively, it is possible that elderly men systematically alter tongue position during vowel articulation while elderly women are less inclined to do so. Taken in conjunction with previous research, these findings suggest a "mixed model" of vocal tract resonance changes with aging in which an interaction exists between gender, the resonance effects of laryngeal lowering, and vowel articulatory patterns.