Comparison of young adult singers and nonsingers with vocal nodules

Comparisons were made between 10 singers and 10 nonsingers with vocal nodules and two control groups of normals, 10 singers and 10 nonsingers, on a wide range of acoustic, aerodynamic, psychoacoustic, and videostroboscopic measures. Results showed significant differences between the normals and those with nodules as well as differences between the singers and nonsingers. The singers with nodules had smaller nodules, less impairment of vibratory function, and less severe vocal symptoms than their nonsinging counterparts. The singing normals were found to be superior to the nonsinging normals on acoustic measures including jitter, shimmer, and signal-to-noise ratio. In addition, the singers, even in the presence of nodules, had superior maximum performance skills than their nonsinging counterparts.     

Voice Handicap Index in singers

The Voice Handicap Index (VHI) was developed to assess patients' perception of the severity of their voice disorder. The purpose of this study was to determine the degree of handicap expressed by professional and recreational presenters with a voice complaint. Singers (n = 106) and nonsingers (n = 369) with voice symptoms were studied. The results of the VHI for singers indicate that singers score significantly lower (less severe) on the VHI compared to nonsingers. Singers with vocal fold nodules had a lower mean VHI than singers with vocal fold cysts or polyps. Singers who perform classical music had the lowest mean VHI of all types of singers studied. A low VHI in singers may represent a significant handicap and should not be ignored when considering the severity of a singer's voice problem.     

Phonational profiles of female professional singers and nonsingers

Measures of the SFF, vocal intensity, phonational range, and habitualpitch level are reported for 39 professional singer and 39 nonsinger females, who were divided into three age groups (young, middle, and old age), with the professionals further divided into sopranos and altos. Each read the “Rainbow Passage” and spoke extemporaneously, from which measures of the SFF and vocal intensity were calculated; phonational range and habitual pitch levels were also determined. No significant differences were noted between the reading and speaking tasks. The SFF and intensity levels were significantly higher for the professionals in comparison to the nonsingers, but only for certain age groups. Moreover, whereas the nonsinger SFF levels varied significantly as a function of age, those for the professional singers did not. Although trends occurred, no significant differences were found for the mean phonational range or habitual pitch levels when the professionals and nonsingers were compared.     

Characteristics of Phonatory Function in Singers and Nonsingers With Vocal Fold Nodules

Purpose

The goals of this study were to determine if there were significant differences between singers and nonsingers in the morphology of vocal nodules and the associated impact on vocal function.

Method

Participants were 10 professionally trained singers with nodules, eight nonsingers with nodules, and 10 individuals with healthy normal voice (controls). Surface electromyography (sEMG) from three anterior neck locations and acoustic rise times for vowels /a/ and /i/ were measured in all the participants. In individuals with nodules, dB SPL/cm H₂O, glottal airflow, and nodule location and size were also measured.

Results

There were no significant differences between singers and nonsingers with nodules in terms of airflow, dB SPL/cm H₂O, nodule size, or nodule location. In nonsingers with nodules, airflow and nodule size were significantly correlated, but were not significantly correlated in singers. Vowel rise times and sEMG during vocal tasks did not differentiate among nodule and control groups. Sternocleidomastoid sEMG during initiation of the vowel /a/ was statistically significantly stronger in nonsingers with nodules relative to singers with nodules and controls.

Conclusions

Nodule morphology did not differ between singers and nonsingers, although some behavioral aspects of phonation differed between the groups.     

Pitch-matching accuracy in singers and nonsingers

The present study determined the accuracy and the effect of repeated trials for singers and nonsingers when matching their vocal fundamental frequency to a preset tone near the midpoint of their modal-loft phonational range. Two measures of accuracy were obtained for nine trials for five singers and five age-matched nonsingers: (a) the difference between the target frequency and the first measureable waveform, and (b) the difference between the target and the average of the first five measureable waveforms. The results indicate that singers are more accurate than nonsingers are in their ability to match the first measureable waveform and the mean of the first five measureable waveforms to targets presented aurally. In addition, singers as a group improved from the first three trials to the final three trials in accuracy for both measures, whereas the nonsingers did not demonstrate a group trend toward improvement. The results suggest that singers as a group may rely on their training or experience to perform a pitch-matching task superiorly to nonsingers.     

Comparisons of Voice Onset Time for Trained Male Singers and Male Nonsingers During Speaking and Singing

This study was designed to examine the temporal acoustic differences between male trained singers and nonsingers during speaking and singing across voiced and voiceless English stop consonants. Recordings were made of 5 trained singers and 5 nonsingers, and acoustically analyzed for voice onset time (VOT). A mixed analysis of variance showed that the male trained singers had significantly longer mean VOT than did the nonsingers during voiceless stop production. Sung productions of voiceless stops had significantly longer mean VOTs than did the spoken productions. No significant differences were observed for the voiced stops, nor were any interactions observed. These results indicated that vocal training and phonatory task have a significant influence on VOT.     

Acoustic Analyses of Trained Singers Perceptually Identified from Speaking Samples

This study investigated selected acoustic cues in the speaking voices of five professional singers; cues that may have enabled na?ve listeners to differentiate them from nonsingers and other trained singers who were not consistently identified from their speaking voices. Subjects were divided into three groups based on listeners' perceptual judgments. Group I, the identified singers, consisted of five professional singers, three males and two females, with an average identification score, from their speaking utterances, of 79%. Group II, the unidentified singers, consisted of 15 trained singers, seven males and eight females, who, as a group, were identified correctly from their speaking utterances only 52% of the time. Group III consisted of 20 nonsingers who were incorrectly identified from their speaking utterances as singers only 36% of the time, that is, they were correctly identified as nonsingers from their speech 64% of the time. Acoustic parameters chosen for measurement from vowel productions were: (1) percent jitter, (2) percent shimmer, and (3) noise-to-harmonic ratio. The second sentence of the "Rainbow Passage" was selected to compare several frequency and duration measures between the three groups. These were: (1) mean speaking fundamental frequency, (2) standard deviation of the fundamental frequency, (3) sentence duration, (4) word duration, and (5) consonant/vowel ratio. The data indicated that the acoustic parameters that most consistently distinguished the identified singers from the unidentified singers and the nonsingers were fundamental frequency variation and durational differences. The identified singers varied their speaking fundamental frequency significantly more than did both the unidentified singers and the nonsingers. The identified singers also had longer vocalic segments than did the others.     

Effects of systematized vocal warm-up on voices with disorders of various etiologies

This investigation studied the effect of a systematized vocal warm-up procedure on voices with disorders. There were 4 subjects with voice disorders. To optimize vocal function a systematized vocal warm-up system was developed by the author for singers and nonsingers alike. Subjects were asked to practice the vocal warm-up exercises daily, with weekly monitoring in the studio. Data from independent raters and subjects' self-ratings were compared to and corroborated with computer analysis of audio samples. Results indicated significant improvement in subjects' voices that were increasingly maintained over time.     

Perceptual and acoustic study of professionally trained versus untrained voices

Acoustic and perceptual analyses were completed to determine the effect of vocal training on professional singers when speaking and singing. Twenty professional singers and 20 nonsingers, acting as the control, were recorded while sustaining a vowel, reading a modified Rainbow Passage, and singing "America the Beautiful." Acoustic measures included fundamental frequency, duration, percent jitter, percent shimmer, noise-to-harmonic ratio, and determination of the presence or absence of both vibrato and the singer's formant. Results indicated that, whereas certain acoustic parameters differentiated singers from nonsingers within sex, no consistently significant trends were found across males and females for either speaking or singing. The most consistent differences were the presence or absence of the singer's vibrato and formant in the singers versus the nonsingers, respectively. Perceptual analysis indicated that singers could be correctly identified with greater frequency than by chance alone from their singing, but not their speaking utterances.     

A Preliminary Study of Vocal Health Among Collegiate A Cappella Singers

ObjectiveCollegiate a cappella groups have grown significantly in popularity and prominence; however, there have been few studies that evaluate the vocal health of this subgroup of young singers. The objective of this preliminary study was to conduct a multiparametric evaluation of the vocal health characteristics of a sample of collegiate a cappella singers. We further tested whether differences in vocal health assessments exist between a cappella singers with and without vocal training and trained collegiate singers who do not participate in a cappella groups.Study designPoint prevalence study.MethodsForty-one collegiate singers participated in this study. Participants were divided into the following three groups: trained singers (TS), trained a cappella singers (ATS), and untrained a cappella singers (AUS). Participants were administered a set of surveys to assess self-perception of singing voice health and perceived access and attitudes toward voice-related health care. Acoustic and laryngoscopic assessments of participant's speaking and singing voice was performed and validated vocal health questionnaires administered as a means to objectively evaluate for the presence of voice problems.ResultsOverall, 87.5% of the ATS and 60% of the AUS groups reported experiencing problems with their singing voice. However, no vocal abnormalities were detected during laryngoscopic and acoustic assessments. Furthermore, minimal differences between any of the measured vocal health parameters were observed between the TS, ATS, and AUS groups.ConclusionCollectively, a high percentage of collegiate a cappella singers with and without vocal training report singing voice problems. However, our sample of a cappella singers did not have increased singing voice problems as compared to vocally trained collegiate singers not in a cappella groups. We did find that a cappella singers may be more inclined to seek information about maintaining a healthy singing voice from their fellow musicians as opposed to singing teachers or other voice health professionals. Singing teachers, otolaryngologists, and speech-language pathologists may need to play a more active role in educating a cappella singers regarding maintaining good vocal health.     

Relationship between changes in voice pitch and loudness

Changes in mean fundamental frequency accompanying changes in loudness of phonation are analyzed in 9 professional singers, 9 nonsingers, and 10 male and 10 female patients suffering from vocal functional dysfunction. The subjects read discursive texts with noise in earphones, and some also at voluntarily varied vocal loudness. The healthy subjects phonated as softly and as loudly as possible at various fundamental frequencies throughout their pitch ranges, and the resulting mean phonetograms are compared. Mean pitch was found to increase by about half-semitones per decibel sound level. Grossly, the subject groups gave similar results, although the singers changed voice pitch more than the nonsingers. The voice pitch changes may be explained as passive results of changes of subglottal pressure required for the sound level variation.     

Speaking fundamental frequency characteristics as a function of age and professional singing

The purposes of this project were to discover (1) if the speaking fundamental frequency (SFF) levels of professional singers differ significantly from those of nonsingers and (2) if the age-related SFF patterns are similar for these two classes of individuals. Sixty professional singers and 94 nonsingers were recorded reading the first paragraph of the “Rainbow Passage;” both males and females were included. Three paired groups (young, middle, and old age) were studied; they were selected on the basis of health and age. The professional singer groups were further divided by a binary voice classification system, specifically that of soprano/alto for women and tenor/baritone for men. It was found that the sopranos and tenors exhibited significantly higher SFF levels then did the age-matched nonsingers, whereas the altos and baritones did not differ significantly from the controls. Relationships within the performer groups were mixed. For example, there appeared to be a systemic trend for the sopranos and tenors to exhibit higher SFF levels than the altos and baritones. Finally, although the nonsinger SFF levels varied significantly as a function of age, those for the professional singers did not.     

Spectral Changes Due to Performance Environment in Singers, Nonsingers, and Actors

From postrecording interviews of professional singers, it was hypothesized that recording environments, i.e., sound-treated environment versus an auditorium, may induce different vocal behaviors. To test this hypothesis, three groups consisting of nonsingers, singers, and actors were recorded in two different recording environments: a sound-treated booth (IAC) and an auditorium (AUD). Three recordings were obtained from each participant: recording one (IAC) and two (AUD1) required the participants to read in a normal voice; recording three (AUD2) required participants to pretend that they were "performing" before a full house. Results indicated that only the singers and the actors exhibited significant spectral and/or frequency/duration differences from one recording environment to another, with the most dramatic differences exhibited by the singers. It was concluded that the environment in which we record experimental samples from professional voice users, especially singers, should be considered as a variable that can affect results.     

Singing power ratio: Quantitative evaluation of singing voice quality

This paper presents a parameter for objectively evaluating singing voice quality. Power spectrum of vowel sound / a / was analyzed by Fast Fourier Transform. The greatest harmonics peak between 2 and 4 kHz and the greatest harmonics peak between 0 and 2 kHz were identified. Power ratio of these peaks, termed singing power ratio (SPR), was calculated in 37 singers and 20 nonsingers. SPR of sung / a / in singers was significantly greater than in nonsingers. In singers, SPR of sung / a / was significantly greater than that of spoken / a /. By digital signal processing, power spectrum of sung / a / was varied, and the processed sounds were perceptually analyzed. SPR had a significant relationship with perceptual scores of “ringing” quality. SPR provides an important quantitative measurement for evaluating singing voice quality for all voice types, including soprano.     

Effects of Vocal Training and Phonatory Task on Voice Onset Time

OBJECTIVES/HYPOTHESIS: The purpose of this study was to examine the temporal-acoustic differences between trained singers and nonsingers during speech and singing tasks. METHODS: Thirty male participants were separated into two groups of 15 according to level of vocal training (ie, trained or untrained). The participants spoke and sang carrier phrases containing English voiced and voiceless bilabial stops, and voice onset time (VOT) was measured for the stop consonant productions. RESULTS: Mixed analyses of variance revealed a significant main effect between speech and singing for /p/ and /b/, with VOT durations longer during speech than singing for /p/, and the opposite true for /b/. Furthermore, a significant phonatory task by vocal training interaction was observed for /p/ productions. CONCLUSIONS: The results indicated that the type of phonatory task influences VOT and that these influences are most obvious in trained singers secondary to the articulatory and phonatory adjustments learned during vocal training.     

Phonation threshold pressure: a missing link in glottal aerodynamics.

Phonation threshold pressure has previously been defined as the minimum lung pressure required to initiate phonation. By modeling the dependence of this pressure on fundamental frequency, it is shown that relatively simple aerodynamic relations for time-varying flow in the glottis are obtained. Lung pressure and peak glottal flow are nearly linearly related, but not proportional. For this reason, traditional power law relations between vocal power and lung pressure may not hold. Glottal impendance for time-varying flow should be defined differentially rather than as a simple ratio between lung pressure and peak flow. It is shown that the peak flow, the peak flow derivative, the open quotient, and the speed quotient of inverse-filtered glottal flow waveforms all depend explicitly on phonation threshold pressure. Data from singers are compared with those from nonsingers. The primary difference is that singers obtain two to three times greater peak flow for a given lung pressure, suggesting that they adjust their glottal or vocal tract impedance for optimal flow transfer between the source and the resonantor.     

The frequency of hard glottal attacks in patients with muscle tension dysphonia, unilateral benign masses and bilateral benign masses

Hard or abrupt glottal attack (HGA) is one of the vocal behaviors often associated with benign lesion of the vocal folds. This study was designed to determine whether the frequency of HGA was different in hyperfunctional voice patients with and without vocal fold masses. One hundred and forty-seven subjects were studied. All subjects received a complete otolaryngological evaluation including strobovideolaryngoscopy, objective voice measures, and evaluation by a speech-language pathologist. Thirty-two patients were diagnosed with muscle tension dysphonia (19 male, 13 female) without vocal fold masses. Fifty-seven patients were diagnosed with unilateral vocal fold masses (29 male, 28 female), most of which were cysts. Fifty-eight patients were diagnosed with bilateral vocal fold masses (13 male, 45 female). Of the 45 females with bilateral vocal fold masses. 26 had a vocal cyst and reactive nodule and 19 had bilateral vocal fold nodules. The control group was balanced and matched based on sex and on percentage of singers and nonsingers. It consisted of 49 subjects with no vocal fold pathology (20 male, 29 female). The group was composed of professional speakers, singers, and nonprofessional speakers. All voice disordered groups demonstrated higher frequencies of HGA than the control group. Differences were found between the male and female subjects in this study. No differences were found between the various disorders. Differences were also found between the subgroups of bilateral masses, where the bilateral nodules group presented a higher frequency of HGA than the cyst and contralateral reactive nodule.     

Airway Considerations for Professional Singers—A Survey of Expert Opinion

The objective of this study was to survey physician experts in voice disorders/treatment to establish consensus guidelines for translaryngeal intubation (TLI) and tracheotomy when treating professional singers or other voice professionals. A written survey was sent to all physician members of the Voice Foundation seeking opinions/recommendations about route of TLI, duration of TLI before tracheotomy, size of endotracheal and tracheotomy tubes, and special interventions during patient care as these might differ between professional singers and nonsingers. Fifty-five percent of the physicians responded, of whom 73% classified their experience in voice care as “extensive.” A strong consensus (76%) favored a smaller endotracheal tube for singers (6–7 mm I.D. for males and 6.0 mm I.D. for females) via the oral (46%) versus nasal (36%) route. Intubation/extubation by the most expert/experienced personnel was emphasized so as to minimize direct trauma to the larynx. While intubated, strong recommendations were made to suppress gastric acid production and to minimize motion of the endotracheal tube, including patient sedation. Preferences for an early tracheotomy (6 days) versus their usual time (10 days) were approximately equal (44% vs. 50%, respectively) and most respondents (69%) recommended the same size tracheotomy tube (8.0 mm I.D. for males and 6.0 mm I.D. for females) for singers and nonsingers. Post extubation/decannulation care emphasized voice rest, retraining, continued gastric acid suppression, and the possibility of direct laryngoscopy to assess post-TLI or tracheotomy injuries.     

Phonetogram Changes for Trained Singers Over a Nine-Month Period of Vocal Training

Professional vocalists encounter demands requiring voluntary control of phonation, while utilizing a considerable range of frequency and intensity. These quantifiable acoustic events can be measured and represented in a phonetogram. Previous research has compared the phonetograms of trained and untrained voices and found significant differences between these groups. This study was designed to assess the effects of vocal training for singers over a period of nine months. Phonetogram contour changes were examined, with the primary focus on expansion of frequency range and/or intensity control. Twenty-one first-year, master's level, vocal music students, who were engaged in an intensive vocal performance curriculum, participated in this study. Following nine months of vocal training, significant differences were revealed in the subjects' mean frequency range and minimum vocal intensity across frequency levels. There was no significant difference for the mean maximum vocal intensity across frequency levels following vocal training.     

Vocal fold strain and vocal pitch in singing:Radiographic observations of singers and nonsingers

The relationship between vocal fold strain and vocal pitch in singersand nonsingers singing a rising pitch series has been indirectly investigated by means of lateral radiographs. Nonsingers tend to exhibit more strain than singers. To standardize the degree of strain, an index of strain per semitone is proposed. The semitone strain indicates the average amount of strain per 1 semitone of pitch increase or decrease. The index has been shown to be affected by several factors: gender, singing training, singing technique, voice class, age, and status of muscle function. Observations suggest that similar groups of individuals occupy different positions on the stress-strain curve, indicated by their semitone strain values.