Optimal glottal configuration for ease of phonation

Recent experimental studies have shown the existence of optimalvalues of the glottal width and convergence angle, at which the phonation threshold pressure is minimum. These results indicate the existence of an optimal glottal configuration for ease of phonation, not predicted by the previous theory. In this paper, the origin of the optimal configuration is investigated using a low dimensional mathematical model of the vocal fold. Two phenomena of glottal aerodynamics are examined: pressure losses due to air viscosity, and air flow separation from a divergent glottis. The optimal glottal configuration seems to be a consequence of the combined effect of both factors. The results agree with the experimental data, showing that the phonation threshold pressure is minimum when the vocal folds are slightly separated in a near rectangular glottis.     

Glottal closure, transglottal airflow, and voice quality in healthy middle-aged women

Seventeen healthy women, 45 to 61 years old, were examined using videofiberstroboscopy during phonation at three loudness levels. Two phoniatricians evaluated glottal closure using category and ratio scales. Transglottal airflow was studied by inverse filtering of the oral airflow signal recorded in a flow mask (Glottal Enterprises System) during the spoken phrase /ba:pa:pa:pa:p/ at three loudness levels. Subglottal pressure was estimated from the intraoral pressure during p occlusion. Running speech and the repeated /pa:/ syllables were perceptually evaluated by three speech pathologists regarding breathiness, hypo-, and hyperfunction, using continuous scales. Incomplete glottal closure was found in 35 of 46 phonations (76%). The degree of glottal closure increased significantly with raised loudness. Half of the women closed the glottis completely during loud phonation. Posterior glottal chink (PGC) was the most common gap configuration and was found in 28 of 46 phonations (61%). One third of the PGCs were in the cartilaginous glottis (PGCc) only. Two thirds extended into the membranous portion (PGCm); most of these occurred during soft phonation. Peak flow, peak-to-peak (AC) flow, and the maximum rate of change for the flow in the closing phase increased significantly with raised loudness. Minimum flow decreased significantly from normal to loud voice. Breathiness decreased with increased loudness. The results suggest that the incomplete closure patterns PGCc and PGCm during soft phonation ought primarily to be regarded as normal for Swedish women in this age group.     

Effects of prolonged oral reading on F0, SPL, subglottal pressure and amplitude characteristics of glottal flow waveforms

The effects of prolonged (5x45 minute) reading (vocal loading) on fundamental frequency (F0), sound pressure level (SPL), subglottal (intraroral) pressure (p), and two glottal flow waveform parameters (AC amplitude of glottal flow, f, and negative peak amplitude of differentiated flow (d) of normal female and male subjects (N = 80) were studied. Two rest (morning and noon) and three loading (two in the morning and one in the afternoon) samples were recorded and analyzed. The glottal waveforms were obtained by inverse filtering of the acoustic pressure waveforms of speaking voice samples. The analyses were based on measurement and inverse filtering of the first stressed syllable of "paappa" words repeated 3x5 times for normal, as soft as possible, and as loud as possible phonation. In normal phonation the parameter values changed statistically significantly due to loading. In many cases the values obtained in the morning samples changed after the first loading session. This is interpreted as a vocal "warming-up effect." Especially in soft phonation p, d, and f were sensitive indicators of vocal loading. In both normal and soft phonation, the SPL, p, d, and f values tended to rise due to prolonged reading in the morning and afternoon samples, indicating increased effort (normal phonation) and a rise in the phonatory threshold (soft phonation). The lunch break vocal rest ("rest effect") considerably affected the parameter values in many cases.     

Analysis of Voice and Quantitative Measurement of Glottal Gap After Thyroplasty Type I in the Treatment of Unilateral Vocal Paralysis

Thyroplasty type I is one of several surgical treatments in which improving the voice of unilateral vocal fold paralysis is the ultimate objective. The goal of the surgery is the medialization of the paralyzed vocal fold. The purpose of this study is to evaluate the effectiveness of thyroplasty type I through acoustical analysis, aerodynamic measures, and quantitative videostroboscopic measurements. We report on 20 patients with unilateral vocal cord paralysis who underwent thyroplasty type I. We performed preoperative and postoperative video image analysis (normalized glottal gap area) and computer-assisted voice analysis (fundamental frequency, jitter, shimmer, noise-to-harmonic ratio, mean phonation time, mean flow rate, mean subglottic pressure) in all patients. The glottal gap was significantly reduced after thyroplasty type I. Postoperative voice quality was characterized by an improved pitch and amplitude pertubation (jitter and shimmer), phonation time (mean phonation time), and subglottic pressure (mean subglottic pressure). Thyroplasty type I is an effective method for regaining glottal closure and vocal function.     

Soft Phonation in the Male Singing Voice: A Preliminary Study

Sustained high notes, diminishing gradually from the loudest to the softest phonation within a maneuver called messa di voce, are examined in two contrasting professional tenor voices. Signals of the sound pressure level, electroglottograph, and mean esophageal pressure are recorded, and similar maneuvers by the same subjects are examined stroboscopically. The lyric voice is found to make a gradual diminuendo while maintaining nearly constant posture of the vocal tract together with a phase of complete closure in the glottal cycle. The robust voice, by contrast, passes abruptly from a production of high subglottal pressure and a high closed quotient to one of low pressure and incomplete closure, and the transition is marked by a sudden opening of the previously constricted laryngeal collar. It is proposed that the mode of soft voice production demonstrated by the robust voice be recognized as a distinct register of the singing voice.     

Respiratory and glottal efficiency measures in normal classically trained singers

Respiratory and glottal efficiency measures were collected from a pool of 40 classically trained singers with normal larynges. All singers had ?3 years of formal classical voice training and were active professional solo classical singers. Mean flow rates were obtained from all subjects to assess glottal efficiency. Additionally, maximum phonation times and phonation quotients were obtained from a subset of the singers. Pulmonary function test data on forced expiratory volume, forced vital capacity, and forced expiratory flow were obtained for all subjects. Results were compared with published normal values, not specifically derived from trained singers, used commonly in voice laboratoires. Differences were found, suggesting the need for separate normative data to be used for evaluation of the vocal athlete.     

The membranous contact quotient: A new phonatory measure of glottal competence

The membranous contact quotient (MCQ) is introduced as a measure of dynamic glottal competence. It is defined as the ratio of the membranous contact glottis (the anterior-posterior length of contact between the two membranous vocal folds) and the membranous vocal fold length. An elliptical approximation to the vocal fold contour during phonation was used to predict MCQ values as a function of vocal process gap (adduction), maximum glottal width, and membranous glottal length. MCQ is highly dependent on the vocal process gap and the maximum glottal width, but not on vocal fold length. Five excised larynges were used to obtain MCQ data for a wide range of vocal process gaps and maximum glottal widths. Predicted and measured MCQ values had a correlation of 0.93, with an average absolute difference of 9.6% (SD = 10.5%). The model is better at higher values of MCQ. The theory for MCQ is also expressed as a function of vocal process gap and subglottal pressure to suggest production control potential. The MCQ measure is obtainable with the use of stroboscopy and appears to be a potentially useful clinical measure.     

Vocal Fold Polyp in a Professional Brass/Wind Instrumentalist and Singer

Wind instrumentalists, especially brass players, and singers share common factors, including vocal tract shape, function and pressure, vocal fold opening and closure, breath vector of force and air flow rates. To understand the mechanism and function of the vocal folds with a pathological lesion, it is necessary to visualize the differing interactions of the vocal tract during wind and brass instrument playing and in singing. A school band director, singer, wind and brass instrumentalist, was referred by musician colleagues with intermittent dysphonia, aphonia, and inability to sing high notes. Simultaneous videolaryngoscopy, with and without stroboscopy, and external video examination were documented. An hourglass glottis with a sessile, cystic polyp of the left vocal fold were recorded and studied during phonation and the playing of 3 instruments. The techniques of glottic opening, closure, configuration and function varied with the type of instrument and phonatory function. Singing was adversely affected by the vocal fold polyp but no harmful interaction occurred during wind/brass instrument playing. Down-stream loading in singers is at the laryngeal level and in wind/brass instrumentalists is at the embouchure. Preoperative voice therapy, phonomicrosurgery, and postoperative voice rest followed by voice therapy, succeeded in restoring her combined wind/brass instrumental and singing career.     

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.     

A preliminary study of particle velocity during phonation in an in vivo canine model

The particle velocity across the glottis was measured with simultaneous electroglottography, photoglottography, and subglottic pressure in an in vivo canine model of phonation. A constant temperature anemometer measured flow velocity at five midline anterior to posterior glottal positions. Tracheal input air flow was varied in five steps from 175 to 500 cc/s, while vocal fold approximation was achieved by constant electrical stimulation of the laryngeal nerves. For all levels of air flow, a decreasing peak velocity gradient was observed from the anterior commissure to the arytenoids. Time-varying features of the flow velocity are discussed in relation to glottal vibratory events and aerodynamics.     

Comparison between electroglottography and electromagnetic glottography

Newly developed glottographic sensors, utilizing high-frequency propagating electromagnetic waves, were compared to a well-established electroglottographic device. The comparison was made on four male subjects under different phonation conditions, including three levels of vocal fold adduction (normal, breathy, and pressed), three different registers (falsetto, chest, and fry), and two different pitches. Agreement between the sensors was always found for the glottal closure event, but for the general wave shape the agreement was better for falsetto and breathy voice than for pressed voice and vocal fry. Differences are attributed to the field patterns of the devices. Whereas the electroglottographic device can operate only in a conduction mode, the electromagnetic device can operate in either the forward scattering (diffraction) mode or in the backward scattering (reflection) mode. Results of our tests favor the diffraction mode because a more favorable angle imposed on receiving the scattered (reflected) signal did not improve the signal strength. Several observations are made on the uses of the electromagnetic sensors for operation without skin contact and possibly in an array configuration for improved spatial resolution within the glottis.     

Changes in glottal configuration in women after loud talking

The purpose of this investigation was to examine changes in glottal configuration in women under a variety of pitch and loudness conditions after an interval of loud reading. Twelve young adult women with normal laryngeal structures were photographed under stroboscopic light and sustained the vowel /i/ for a minimum of 3 s, at three pitch levels and three loudness levels, before and after a 15-min interval of loud reading. Results indicate that female speakers tend to alter glottic configurations across phonatory conditions after loud reading, particularly during high-pitch phonation. Specifically, five subjects tended to increase glottal closure, one tended to increase glottal opening, two tended to maintain the identical configuration, and four demonstrated no consistent pattern of response.     

Outcome of Resonant Voice Therapy for Female Teachers With Voice Disorders: Perceptual, Physiological, Acoustic, Aerodynamic, and Functional Measurements

Teachers have a high percentage of voice problems. For voice disordered teachers, resonant voice therapy is hypothesized to reduce voice problems. No research has been done on the physiological, acoustic, and aerodynamic effects of resonant voice therapy for school teachers. The purpose of this study is to investigate resonant voice therapy outcome from perceptual, physiological, acoustic, aerodynamic, and functional aspects for female teachers with voice disorders. A prospective study was designed for this research. The research subjects were 24 female teachers in Taipei. All subjects received resonant voice therapy in groups of 4 subjects, 90 minutes per session, and 1 session per week for 8 weeks. The outcome of resonant voice therapy was assessed from auditory perceptual judgment, videostroboscopic examination, acoustic measurements, aerodynamic measurements, and functional measurements before and after therapy. After therapy the severity of roughness, strain, monotone, resonance, hard attack, and glottal fry in auditory perceptual judgments, the severity of vocal fold pathology, mucosal wave, amplitude, and vocal fold closure in videostroboscopic examinations, phonation threshold pressure, and the score of physical scale in the Voice Handicap Index were significantly reduced. The speaking Fo, maximum range of speaking Fo, and maximum range of speaking intensity were significantly increased after therapy. No significant change was found in perturbation and breathiness measurements after therapy. Resonant voice therapy is effective for school teachers and is suggested as one of the therapy approaches in clinics for this population.     

Qualitative and quantitative analysis of voice onset by means of a multidimensional voice analysis system (MVAS) using high-speed imaging

High-speed filming is one of the most informative methods for assessing voice physiology data. Tracing high-speed images of the glottis provides quantitative parameters such as the glottal area and the glottal width function. By way of example, a number of studies are discussed which extract quantitative data from high-speed images showing voice onsets. Furthermore, a new computer system (MVAS; multi-dimensional voice analysis system) is presented that synchronously displays a laryngoscopic high-speed film, the electroglottographical signal, and several acoustic analyses of the recorded voice sample. The automatic measurement of glottal width and glottal area from the laryngoscopic images is also provided. Looking at former studies and our analyses of voice onsets reveals a tremendous intersubject and even intrasubject variability (different prephonatory closure, different time span until full amplitude is reached, different open quotient).     

Effects of lung volume on the glottal voice source

According to experience in voice therapy and singing pedagogy, breathing habits can be used to modify phonation, although this relationship has never been experimentally demonstrated. In the present investigation we examine if lung volume affects phonation. Twenty-four untrained subjects phonated at different pitches and degrees of vocal loudness at different lung volumes. Mean subglottal pressure was measured and voice source characteristics were analyzed by inverse filtering. The main results were that with decreasing lung volume, the closed quotient increased, while subglottal pressure, peak-to-peak flow amplitude, and glottal leakage tended to decrease. In addition, some estimates of the amount of the glottal adduction force component were examined. Possible explanations of the findings are discussed.     

Glottal configuration associated withfundamental frequency and vocal register

Simultaneous measurements of mean airflow rate, vocal intensityand fundamental frequency were made during flexible video endoscopic recording of the vowel /i/ sustained in two vocal registers, modal and falsetto. The glottal closure patterns of four males and four females were evaluated by visually inspecting the video images. Acoustic signals were recorded and analyzed to verify the frequency and intensity criteria. Aerodynamic analysis of mean airflow rate was done via Rothenberg mask and commercial software. Incomplete glottic closure was common in both males and females. The degree of closure was significantly higher for modal samples than for falsetto samples with frequency and intensity held constant. The shape of the glottal closure did not vary with changes in the mode of phonation. As expected, the mean airflow rate increased with decreased glottal closure. The results suggest that incomplete glottic closure should be considered as a normal glottal configuration in high frequency modal and falsetto phonation. Moreover, hourglass and spindle glottal configurations may also be found in both the modal and falsetto registers of normal subjects. These results also confirm the positive relationships between degree of glottal gap and mean airflow rate. Thus, mean airflow rate may be regarded as a criterion for judging degree of glottal closure.     

Studying vocal fold vibrations in Parkinson's disease with a nonlinear model

A nonlinear model is applied to study pathologic vocal vibratory characteristics and voice treatments of Parkinson's disease. We find that a number of pathologic vocal characteristics commonly observed in Parkinson's disease, including reduced vibratory intensity, incomplete vocal closure, increased phonation threshold pressure, glottal tremor, subharmonics, and chaotic vocal fold vibrations, can be studied with this nonlinear model. We also find that two kinds of clinical voice treatments for Parkinson's disease, including respiratory effort treatment and Lee Silverman voice treatment can be studied with this computer model. Results suggest that respiratory effort treatment, in which subglottal pressure is increased, might aid in enhancing vibratory intensity, improving glottal closure, and avoiding vibratory irregularity. However, the Lee Silverman voice treatment, in which both subglottal pressure and vocal fold adduction are increased, might be better than respiratory effort treatment. Increasing vocal fold thickness would be further helpful to improve these pathologic characteristics. The model studies show consistencies with clinical observations. Computer models may be of value in understanding the dynamic mechanism of disordered voices and studying voice treatment effects in Parkinson's disease.     

Relationship between aerodynamic measures of glottal efficiency and stroboscopic findings in asymptomatic singing students

Singing requires exquisite coordination between the respiratory and phonatory systems to efficiently control glottal airflow. Asymptomatic singing students underwent pulmonary function testing (PFT), videostrobolaryngoscopic examination, and measures of glottal efficiency (maximum phonation time [MPT], glottal flow rate [GFR], and phonation quotient [PQ]) performed in both a sung and spoken tone. Pulmonary function and glottal efficiency values were within reported normative data for professional singers. However, sung tones were made with significantly higher GFR and PQ and lower PQ than spoken tones. The mean GFR was not related to the degree of glottal closure (by videostrobolaryngoscopy) or underlying pulmonary support.     

Relationship among glottal area, static supraglottic compression, and laryngeal function studies in unilateral vocal fold paresis and paralysis

In this study, we evaluated the relationship between laryngeal function measures and glottal gap ratio and normalized measures of supraglottic behaviors in patients with unilateral vocal fold paresis (UVFP). Thirty-one patients were found to have unilateral vocal fold paresis by videoendoscopy and laryngeal electromyography, and 13 controls participated in this study. Patients with UVFP demonstrated significantly larger glottal gap ratios (p = 0.016) than control subjects. The nonparalyzed or contralateral vocal fold was associated with significantly more static false vocal fold compression (p = 0.03) compared with the paralyzed vocal fold or with the controls. Patients with unilateral vocal fold paresis were divided into subgroups: those with normal or abnormal maximum phonation time, flow, or pressure measures. Smaller glottal gap ratios were identified in patients with normal maximum phonation times and flow measures. Greater false vocal fold activity was identified in unilateral vocal fold paresis patients with normal laryngeal function measures than in unilateral vocal fold paresis patients with abnormal measures. These findings suggest that some patients with documented unilateral paresis and glottal incompetence can compensate for vocal fold weakness such that their acoustic and aerodynamic measures are normal.