A critical view of the yawn-sigh as a voice therapy technique

The purpose of this study was to take a critical look at a voice therapy technique known as the yawn-sigh. The voiced sigh as an approach in voice therapy has had increased use in recent years, particularly with problems of vocal hyperfunction. In this study, the physiology of the yawn-sigh was studied with video nasoendoscopy in eight normal subjects; their taped voices were also studied acoustically for possible fundamental frequency and formant changes in producing selected vowels under normal and sigh conditions. Although each subject was given a model by the examiner of a yawn-sigh, one of the eight subjects could not produce a true yawn-sigh. Endoscopic findings for seven of the eight subjects performing the yawn-sigh demonstrated retracted elevation of the tongue, a lower positioning of the larynx, and a widened pharynx. Acoustic analyses for the seven subjects producing the sigh found a marked lowering of the second and third formants. Implications for using the yawn-sigh in voice therapy are given, such as using a modified “silent” yawn-sigh, as an easy method for producing greater vocal tract relaxation.     

Voice Source Characteristics in Mongolian “Throat Singing” Studied with High-Speed Imaging Technique, Acoustic Spectra, and Inverse Filtering

Mongolian “throat singing” can be performed in different modes. In Mongolia, the bass-type is called Kargyraa. The voice source in bass-type throat singing was studied in one male singer. The subject alternated between modal voice and the throat singing mode. Vocal fold vibrations were observed with high-speed photography, using a computerized recording system. The spectral characteristics of the sound signal were analyzed. Kymographic image data were compared to the sound signal and flow inverse filtering data from the same singer were obtained on a separate occasion. It was found that the vocal folds vibrated at the same frequency throughout both modes of singing. During throat singing the ventricular folds vibrated with complete but short closures at half the frequency of the true vocal folds, covering every second vocal fold closure. Kymographic data confirmed the findings. The spectrum contained added subharmonics compared to modal voice. In the inverse filtered signal the amplitude of every second airflow pulse was considerably lowered. The ventricular folds appeared to modulate the sound by reducing the glottal flow of every other vocal fold vibratory cycle.     

Dimensionality in Voice Quality

This study concerns speaking voice quality in a group of male teachers (n = 35) and male actors (n = 36), as the purpose was to investigate normal and supranormal voices. The goal was the development of a method of valid perceptual evaluation for normal to supranormal and resonant voices. The voices (text reading at two loudness levels) had been evaluated by 10 listeners, for 15 vocal characteristics using VA scales. In this investigation, the results of an exploratory factor analysis of the vocal characteristics used in this method are presented, reflecting four dimensions of major importance for normal and supranormal voices. Special emphasis is placed on the effects on voice quality of a change in the loudness variable, as two loudness levels are studied. Furthermore, the vocal characteristics Sonority and Ringing voice quality are paid special attention, as the essence of the term "resonant voice" was a basic issue throughout a doctoral dissertation where this study was included.     

Supraglottic contribution to voice quality

Although there has been continuing interest in voice quality, much of this research has focused on the vocal folds rather than the supraglottal structures. This paper reports the use of videoendoscopy for studying supraglottal participation in various singing tasks. In a preliminary study presented last year by the present authors, CT scanning was used to corroborate videoendoscopic observation. Vocal tract activities observed included variation of laryngeal height with pitch, variation of pharyngeal wall dimension with pitch and vowel, and marked supraglottic constriction with certain vocal imitations. In order to gain a better understanding of vocal training, and its effect upon vocal tract physiology, a study was designed using videoendoscopy to observe singers with significant experience and training while performing various vocal tasks. The tasks focused on the following: (1) vocal tract activity associated with pitch changes; (2) the physiology involved in the production of “cover”; (3) the structures involved in the production of vibrato; and (4) the physiology of the singer's “ring.” It would appear that videoendoscopy will become increasingly more valuable to the voice community as our understanding of vocal tract physiology improves.     

Fragments of a Greek Trilogy: impact on phonation

This study documents the vocal characteristics of an actor before and after a series of eight performances involving extended voice use. The hypothesis was that this type of extended voice use would result in symptoms of vocal abuse and that damage to the actor's voice would be evident in measures made after the performance series. Three pre-performance and three post-performance speech samples were gathered and analyzed using the CSL and Visipitch II. Measurements taken included maximum phonational range; maximum sustained phonation; fundamental frequency during reading; maximum intensity levels; sound pressure levels for soft, moderate, and loud productions of sustained /a/; and perturbation including jitter, shimmer, harmonics-to-noise ratio, and an s/z ratio. Pre- and post-performance samples of the “Rainbow passage” and sustained vowel phonation were rated by a group of blinded listeners that included professional voice trainers and speech pathologists. In addition, sample lines from the performance were played for the listeners to judge whether this technique would result in symptoms of vocal abuse. Eleven out of 12 professional voice trainers rated that this technique would result in symptoms of vocal abuse. The data revealed post-performance improvement in phonational range, maximum intensity levels, perturbation measures, and s/z ratio. Measures of maximum sustained phonation, fundamental frequency, and sound pressure levels remained stable. Videoendoscopy revealed normal function of the larynx and vocal folds.     

What is “Twang”?

A single female professional vocal artist and pedagogue sang examples of “twang” and neutral voice quality, which a panel of experts classified, in almost complete agreement with the singer's intentions. Subglottal pressure was measured as the oral pressure during the occlusion during the syllable /pae/. This pressure tended to be higher in “twang,” whereas the sound pressure level (SPL) was invariably higher. Voice source properties and formant frequencies were analyzed by inverse filtering. In “twang,” as compared with neutral, the closed quotient was greater, the pulse amplitude and the fundamental were weaker, and the normalized amplitude tended to be lower, whereas formants 1 and 2 were higher and 3 and 5 were lower. The formant differences, which appeared to be the main cause of the SPL differences, were more important than the source differences for the perception of “twanginess.” As resonatory effects occur independently of the voice source, the formant frequencies in “twang” may reflect a vocal strategy that is advantageous from the point of view of vocal hygiene.     

Preliminary evaluation of selected acoustic and glottographic measures for clinical phonatory function analysis

Acoustic and glottographic measures may provide important information that could enhance clinical management and documentation of vocal dysfunction. Acoustic measures such as jitter and shimmer reflect “short-term” perturbations, or instabilities of the voice, and the coefficients of variation for frequency and for amplitude reflect “long-term” perturbations. Interpretations of these acoustic measures are based on the assumption that vocal perturbations may be related to laryngeal tissue abnormalities, asymmetries in vocal fold movement, or neuromuscular fluctuations in the respiratory, laryngeal, or vocal tract systems. The abduction quotient is a glottographic measure related to laryngeal adduction and is obtained from an analysis of the electroglottograph signal. The adduction measure appears to be independent of the acoustic perturbation measures. Interpretations of the acoustic and adductory measures may, therefore, complement each other for greater understanding of a patient's laryngeal behavior. Visual displays of the acoustic and glottographic signals also are discussed to demonstrate their value in voice signal interpretations. Case studies illustrate potential interpretations of the acoustic perturbation and abduction quotient measures.     

The ChatterVox™ Portable Voice Amplifier: A Means to Vibration Dose Reduction?

By speaking loudly for extended periods, teachers are vulnerable to laryngeal and voice changes associated with vocal fold “vibration overdose.” Voice clinicians frequently recommend voice amplification ostensibly designed to reduce vibration dose and improve voice. However, there are few data regarding the degree of vocal loudness attenuation achieved by specific amplification devices. The purpose of this investigation was to examine the effectiveness of the ChatterVox™ Portable Voice Amplification System (Siemens Hearing Instruments) for reducing the sound pressure level (SPL) of a speaker's voice during a simulated classroom lecture. Ten participants were instructed to continuously read one of two phonetically balanced passages while amplified and unamplified. Voice intensity measurements were obtained at three inches from the mouth (i.e., mouth level) and at the back of a classroom in both amplified and unamplified conditions. When amplified with the ChatterVox™, speakers experienced an average decrease in vocal intensity at mouth-level of 6.03 dB SPL (p < 0.002). Furthermore, an average increase of 2.55 dB SPL (p < 0.038) at the back of the classroom was observed. Collectively, these results indicate that the ChatterVox™ amplification device reduced the speaker's vocal intensity level at the microphone, while it augmented the voice heard at the back of the classroom. By inference, this degree of vocal attenuation at mouth level should contribute to a desirable reduction in vibration dose, thus lowering the risk of vibration overdose.     

“Compensatory falsetto”: Effects on vocal quality

The term “compensatory falsetto”, for the purpose of this investigation, refers to the development of an abnormally high-pitched voice in the presence of laryngeal pathology where more socially acceptable lower pitched voice production is possible. The purpose of this investigation was to compare laryngeal compensations and their effects on objective measures of vocal function during production of compensatory falsetto voice. Eighteen patients with abnormally high-pitched voice in the presence of underlying laryngeal pathology were evaluated in the Department of Otolaryngology at the University of Miami School of Medicine from January 1988 through December 1992 and were diagnosed with “compensatory falsetto”. Vocal fold paralysis (n = 11) was the most common laryngeal pathology. Vibratory characteristics were evaluated through videostrobolaryngoscopic examination. Acoustic and aerodynamic parameters assessed included fundamental frequency, jitter rate, harmonic-to-noise ratio, glottal air flow, and maximum phonation time. Production of a higher-pitched voice appeared to improve glottic closure and decrease the amount of air loss during phonation. A corresponding increase in maximum phonation time and improvement in acoustic characteristics of jitter and harmonic-to-noise ratio was also observed.     

Phonetographic profiles and F0-SPL characteristics of untrained versus trained vocal groups

The phonetogram has been recommended as an international tool for voice analysis. However, the capability of this technique to distinguish between different vocal groups has not been clearly established. The purpose of this study was to examine untrained versus trained vocalists using the phonetogram and the fundamental frequency by intensity (F₀/SPL) information derived through that method. In this study, “musical” or “controlled” ranges of phonation were stressed rather than “physiological” ranges. Results indicated that (a) characteristic phonetographic profiles may be established for untrained versus trained vocalists, and (b) trained vocalists show significantly increased capability in terms of F₀ range and maximum, minimum, and comfortable SPL production. Elicitation of “controlled” phonations may be the key to revealing the underlying vocal capabilities of seemingly different vocal groups.     

The contribution of aryepiglottic constriction to “ringing” voice quality—A videolaryngoscopic study with acoustic analysis

Fiberscopic video laryngoscopy was performed on five professional singers to determine the presence or absence of aryepiglottic narrowing as a function of voice quality. Each sang “Happy Birthday” and parts of the “Star Spangled Banner” in six different voice qualities: speech, falsetto, sob (a low larynx with a vocal tract expanded by relaxing the middle constrictors), twang, belting, and opera. Several features were found to be common among the subjects and related to specific qualities. Aryepiglottic constriction was present in all singers in twang, belting, and opera qualities. Spectrographic analysis related the constriction to the presence of the “singer's formant.” The presence of this type of constrictive behavior will require further research to ascertain the possible benefits to those for whom a louder voice is essential and to understand the relationship of this constrictive maneuver to the natural closure functions of the larynx.     

Comparison of microphone and neck-mounted accelerometer monitoring of the performing voice

One method for monitoring individuals in live performances may be the use of vibration sensors, or accelerometers, rather than using microphones that pick up environmental noises as well as the vocal signals of interest. This study was concerned with a comparison of microphone and accelerometer monitoring of the amplitude characteristics of singers' voices. From the results obtained it appears that accelerometers are not applicable for monitoring amplitude characteristics of the voice, but are useful for periodicity measures. In addition, accelerometers may be of use in verifying the kinesthetic patterns sensed by a performer during the process of “singing into a mask” or producing the singer's “ring.”     

Vocal aging and the impact on daily life: a longitudinal study

Longitudinal studies on vocal aging are scarce, and information on the impact of age-related voice changes on daily life is lacking. This longitudinal study reports on age-related voice changes and the impact on daily life over a time period of 5 years on 11 healthy male speakers, age ranging from 50 to 81 years. All males completed a questionnaire on vocal performance in daily life, and perceptual and acoustical analyses of vocal quality and analyses of maximum performance tasks of vocal function (voice range profile) were performed. Results showed a significant deterioration of the acoustic voice signal as well as increased ratings on vocal roughness judged by experts after the time period of 5 years. An increase of self-reported voice instability and the tendency to avoid social parties supported these findings. Smoking males had a lower speaking fundamental frequency compared with nonsmoking males, and this seemed reversible for males who stop smoking. This study suggests a normal gradual vocal aging process with clear consequences in daily life, which should be taken into consideration in clinical practice as well as in studies concerning communication in social life.     

G. Paul Moore Lecture—1993: New voices for old

Otolaryngology and voice science have entered the era of “phonosurgery.” Several techniques allow voice professionals to intervene to restore or modify the voice in patients with immobile vocal folds and other problems related to voice production. It is necessary and appropriate that physicians and speech and language pathologists critically examine what has been accomplished and what may yet be possible for further voice improvement.     

Voice problems and risk factors among aerobics instructors

Fifty female and four male aerobics instructors completed a questionnairepertaining to vocal problems and variables that could indicate an increased risk for developing problems. The questions concerned teaching experience, physical data regarding instructional facilities, method of voice projection, music volume, history of illness, allergies, voice loss, hoarseness, smoking habits, and knowledge of vocal hygiene. The results showed that a significant number of instructors experienced partial or complete voice loss (44%) during and after instructing, as well as increased episodes of voice loss, hoarseness, and sore throat unrelated to illness since they began instructing. Significant variables associated with voice problems included sore throat and hoarseness following instruction, and shouting to cue the participants. It was also found that very few instructors in this study had any knowledge of vocal hygiene techniques.     

Laryngostroboscopic, Acoustic, and Environmental Characteristics of High-Risk Vocal Performers

Vocal performance often requires excessively high vocal demand. In particular “high-risk” performers, a group of individuals who use their voices at their maximum effort level, are often exposed to unique vocal abuse characteristics which include high environmental and performance demands and inconsistencies of cast performance. Three categories of high-risk performers were studied: musical theater, choral ensemble, and street theater. Musical theater performers produce a Broadway, West End “belting” style voice. Street theater performers use a high-energy pitch varying dialogue in order to imitate a desired character voice. Choral ensemble performance requires group cohesion and blending of four-part harmony. The melodies require sustained vocal durations within each of the respective registers. For each of these studied groups vocal tasks of sustained production of /i/ and /a/ were subjected to analysis. Acoustic measures included fundamental frequency, standard deviation of fundamental frequency, jitter percent, shimmer percent, and noise-to-harmonic ratio. Laryngostroboscopic parameters were assessed during sustained /i/. Environmental acoustic sound field measurements were made using an A weighting and linear weighting sound pressure level. These weightings were used to describe noise levels and vocal output, respectively, within the performance environments. Results of the analysis suggest that high-risk performers are a unique performance type defined by distinctive, acoustic, laryngostroboscopic, and environmental characteristics.     

Voice characteristics, effects of voice therapy, and long-term follow-up of contact granuloma patients

This study evaluates the laryngoscopic findings and voice characteristics of male contact granuloma patients before and after voice therapy and at a follow-up about 9 years later. Pre- and posttherapy recordings as well as follow-up recordings were made for 19 granuloma patients. Pretherapy revealed the most salient perceptual voice characteristics were low pitch, monotony, and a high degree of vocal fry and hyperfunction. Interjudge reliability for these traits was high. Immediately following therapy the healed patients (n = 10) had a decrease in hyperfunction, vocal fry, and monotony, while the unhealed patients (n = 9) had an increase in hyperfunction and vocal fry decreased only marginally. Monotony decreased significantly in this group. As regards the acoustic analyses, no significant differences were found in mean fundamental frequency (F₀) or perturbation. At the follow-up assessment 4 patients had granuloma while 15 had normal laryngeal status. Perceptually their voice characteristics resembled those pretherapy independently of the laryngeal findings. The results suggest that reduced hyperfunction and decreased vocal fry may create better circumstances for the healing process at the posterior glottis.     

Acoustical Aspects of Vocal Function Following Radiotherapy for Early T1a Laryngeal Cancer

We evaluated acoustic voice characteristics of 18 male patients undergoing radiotherapy. The subjects were seen for voice assessment preradiotherapy and at 1 month, 3 months, 6 months, and 1 year following radiotherapy. A multidimensional voice analysis computer program (IVANS, Avaaz Innovations, 1998) was employed to evaluate measures of traditional frequency and amplitude perturbation as well as time-based and linear prediction (LP) modeled "noise" parameters of the acoustic output in conjunction with perceptual judgments of overall vocal quality. The results indicate vocal deterioration of vocal function immediately following radiotherapy with gradual and significant improvement in acoustic and perceptual features over 9 to 12 months following the radiation treatment. Measures of glottal noise demonstrated higher sensitivity than frequency-based measures of voice perturbation, and with more consistent, less variable changes in acoustical voice output from the preradiation to the 12 month postradiation periods. Future research evaluating vowel type and acoustic perturbation measures with a larger sample of subjects over a longer time period seems warranted.     

Some physical characteristics of the male falsetto voice

Previous research indicated that, as groups, male (bass/baritone) and female (soprano) professional singers tend to exhibit differing vocal tract and voice source behaviours. The use of an objective measure of voice [xeroradiographic-electrolaryngographic analysis (XEL)] revealed differences between the two voice types, especially at the highest sample pitches (e, 330 Hz for bass/baritones, and e″, 1,320 Hz for sopranos). XEL analysis combines two known techniques, i.e., soft-tissue radiographic imaging (xeroradiography), and an analysis of voice-source vibratory patterning (electrolaryngography). Subsequent to this investigation, interest centered on the male professional falsetto voice over a two-octave range (E 165 Hz to e′ 660 Hz) using a sample (n=9) of professional countertenors. Results suggest that there are characteristic trends in the patterning of the male professional falsetto register, but there is also evidence of within-group variability. The subjects significantly increased the size of the pharyngeal tube area during phonation. ANOVA and Trend Analysis revealed ventricular space as the only measure to expand systematically and consistently as sung pitch increases.