Presbyphonia as an Individual Process of Voice Change

ObjectiveThe aim of the study was to determine the individual variability of the severity of dysphonia in the population of older women and men using the initial perceptual voice assessment (GRBAS) and objective diagnosis of the clinical form of Presbyphonia with laryngeal visualization technique (High-Speed Digital Imaging [HSDI]) and acoustic voice analysis (Diagnoscope Specjalista).MethodsThe study included 302 elderly women and men. Application of perceptual GRBAS scale allowed to extract 230 subjects with voice disorders (Group I). Remaining 72 elderly subjects without the symptoms of dysphonia consisted Group II. Group III included 50 subjects with euphonic voice. In the assessment of dysphonia, visualization technique (HSDI) as well as acoustic method (Diagnoscope Specjalista). The observation of real vibration of vocal folds using HSDI technique and HS camera allowed to examine symmetricity (Shaw-Deliyski scale), periodicity and amplitude of vibration, Mucosal Wave (MW) morphology, Glottal Closure Type, and value of Open Quotient (OQ). Acoustic analysis allowed to assess value of Fundamental Frequency (F0), Maximum Phonation Time (MPT) as well as Jitter, Shimmer, Noise-to-Harmonics Ratio (NHR) parameters. Narrowband Spectrography was performed.ResultsHSDI technique allowed to register in elderly women with voice disorders a mild asymmetry and aperiodicity of vibrations, MW reduction, amplitude increase and glottal insufficiency in the posterior segment of glottis which indicated edematous changes in the larynx. In 90% of men in this group, moderate asymmetry and aperiodicity were observed as well as amplitude decrease, significant limitation of MW and glottal insufficiency in the middle segment of the glottis which indicated atrophic changes in the larynx. In remaining 10% of men, amplitude of vibration was increased which indicated the existence of hypofunctional dysphonia. Objective confirmation of glottal insufficiency in women with edematous changes was high value of OQ in posterior segment of the glottis registered with HSDI technique. In men with larynx atrophy, the value of OQ was the highest in the middle segment of the glottis. Glottal insufficiency, especially in the middle segment, coexisted with the increase of NHR parameter observed in acoustic examination and with numerous nonharmonic components in the scope of high frequencies revealed in narrowband spectrography, especially in men with larynx atrophy. What is more, in men, the increase of F0 and reduction of MPT was registered. In women with edematous changes of the larynx, acoustic analysis revealed decrease of F0 value, increase of Jitter, Shimmer, NHR as well as reduction of MPT. Narrowband sopectrography revealed not only harmonic components but also nonharmonics in the range of low, medium, and high frequencies.ConclusionsThe course of Presbyphonia varies individually in the elderly. In many subjects, the process of aging does not influence the quality of voice. Crucial importance in the diagnosis of Presbyphonia is assigned to High-Speed Digital Imaging technique which confirms the existence of edematous changes in the larynx in women as well as atrophy and hypofunctional dysphonia in men. The acoustic examination of voice confirmed the individual variability of the severity of Presbyphonia in the elderly depending on the clinical form of dysphonia determined by the gender of the diagnosed person.     

Three registers in an untrained female singer analyzed by videokymography, strobolaryngoscopy and sound spectrography

There has been a lack of objective data on the singing voice registers, particularly on the so called "whistle" register, occurring in the top part of the female pitch range, which is accessible only to some singers. This study offers unique strobolaryngoscopic and high-speed (7812.5 imagess) videokymographic data on the vocal fold behavior of an untrained female singer capable of producing three distinct voice qualities, i.e., the chest, head and whistle registers. The sound was documented spectrographically. The transition from chest to head register, accompanied by pitch jumps, occurred around tones B4-C#5 (500-550 Hz) and was found to be associated with a slight decrease in arytenoids adduction, resulting in decrease of the closed quotient. The register shifts from head to whistle, also accompanied by pitch jumps, occurred around tones E5-B5 (670-1000 Hz) without any noticeable changes in arytenoids adduction. Some evidence was found for the vocal tract influence on this transition. The mechanism of the vocal fold vibration in whistle register was found principally similar to that at lower registers: vibrations along the whole glottal length and vertical phase differences (indicated by sharp lateral peaks in videokymography) were seen on the vocal folds up to the highest tone G6 (1590 Hz).     

Relation between perceived voice register and flow glottogram parameters in males

The perception of modal and falsetto registers was analyzed in a material consisting of a total of 104 vowel sounds sung by 13 choir singers, 52 sung in modal register, and 52 in falsetto register. These vowel sounds were classified by 16 expert listeners in a forced choice test and the number of votes for modal was compared to the voice source parameters: (1) closed quotient (Q(closed)), (2) level difference between the two lowest source spectrum partials (H1-H2), (3) AC amplitude, (4) maximum flow declination rate (MFDR), and (5) normalized amplitude quotient (NAQ, AC amplitude/MFDR(*) fundamental frequency). Tones with a high value of Q(closed) and low values of H1-H2 and of NAQ were typically associated with high number of votes for modal register, and vice versa, Q(closed) showing the strongest correlation. Some singer subjects produced tones that could not be classified as either falsetto or modal register, suggesting that classification of registers is not always feasible.     

Voice Characteristics of Young Girl Role in Kunqu Opera

Three electroglottographic parameters, fundamental frequency, contact quotient, and speed quotient were analyzed for two singers of Young girl role in Kunqu Opera. Each singer performed three conditions, singing, stage speech, and reading lyrics. The phonation types adopted in different conditions were explored based on electroglottographic parameters. Fundamental frequency, contact quotient, and speed quotient showed different distributions among conditions. Five phonation types were used in singing and stage speech, which include (1) breathy voice, (2) modal voice with low degree of posterior glottal adduction, (3) modal voice, (4) falsetto, and (5) falsetto with high degree of posterior glottal adduction. The phonation strategies partly showed differences between singers. Different phonation type collocations were employed in singing and stage speech. The relationship between phonation types and pitch was complex. The phonation types actually used were different from and more complex than those in traditional Kunqu Opera singing theory.     

Comparing closed quotient in children singers' voices as measured by high-speed-imaging, electroglottography, and inverse filtering

The closed quotient, i.e., the ratio between the closed phase and the period, is commonly studied in voice research. However, the term may refer to measures derived from different methods, such as inverse filtering, electroglottography or high-speed digital imaging (HSDI). This investigation compares closed quotient data measured by these three methods in two boy singers. Each singer produced sustained tones on two different pitches and a glissando. Audio, electroglottographic signal (EGG), and HSDI were recorded simultaneously. The audio signal was inverse filtered by means of the decap program; the closed phase was defined as the flat minimum portion of the flow glottogram. Glottal area was automatically measured in the high speed images by the built-in camera software, and the closed phase was defined as the flat minimum portion of the area-signal. The EGG-signal was analyzed in four different ways using the matlab open quotient interface. The closed quotient data taken from the EGG were found to be considerably higher than those obtained from inverse filtering. Also, substantial differences were found between the closed quotient derived from HSDI and those derived from inverse filtering. The findings illustrate the importance of distinguishing between these quotients.     

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.     

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.     

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.     

Bifurcations and chaos in register transitions of excised larynx experiments

Experimental data from an excised larynx are analyzed in the light of nonlinear dynamics. The excised larynx provides an experimental framework that enables artificial control and direct observation of the vocal fold vibrations. Of particular interest in this experiment is the coexistence of two distinct vibration patterns, which closely resemble chest and falsetto registers of the human voice. Abrupt transitions between the two registers are typically accompanied by irregular vibrations. Two approaches are presented for the modeling of the excised larynx experiment; one is the nonlinear predictive modeling of the experimental time series and the other is the biomechanical modeling (three-mass model) that takes into account basic mechanisms of the vocal fold vibrations. The two approaches show that the chest and falsetto vibrations correspond to two coexisting limit cycles, which jump to each other with a change in the bifurcation parameter. Irregular vibrations observed at the register jumps are due to chaos that exists near the two limit cycles. This provides an alternative mechanism to generate chaotic vibrations in excised larynx experiment, which is different from the conventionally known mechanisms such as strong asymmetry between the left and right vocal folds or excessively high subglottal pressure.     

The relationship among voice onset, voice quality, and fundamental frequency: a dynamical perspective

In dynamical motor theory, skill acquisition occurs as a modification of preexisting coordination patterns or attractor states. The purpose of this study was to assess how different levels of voice onset, voice quality, and fundamental frequency (F₀) combine to form the attractor states common to voice motor control. Three levels of voice onset (glottal, simultaneous, and breathy), voice quality (modal speech, mixed, and falsetto), and fundamental frequency (low, mid, and high) were manipulated by vocally untrained, female subjects. Percent correct of acquisition trials and self-report of effort were used as measures of stable phonations indicative of an attractor state. Using intensity as a covariate, the results provided support for two of the three predicted triads representing attractor states in female speakers: (1) glottal onset/modal speech quality/low F₀; and (2) breathy onset/falsetto quality/high F₀. The results of this study suggest that certain parameters of voice motor control, such as onset, quality, and F₀, exist as part of a dynamical system that can be identified and manipulated in voice motor acquisition and learning.     

Comparison of biomechanical modeling of register transitions and voice instabilities with excised larynx experiments

Voice instabilities were studied using excised human larynx experiments and biomechanical modeling. With a controlled elongation of the vocal folds, the experiments showed registers with chest-like and falsetto-like vibrations. Observed instabilities included abrupt jumps between the two registers exhibiting hysteresis, aphonic episodes, subharmonics, and chaos near the register transitions. In order to model these phenomena, a three-mass model was constructed by adding a third mass on top of the simplified two-mass model. Simulation studies showed that the three-mass model can vibrate in both chest-like and falsetto-like patterns. Variation of tension parameters which mimic activities of laryngeal muscles could induce transitions between both registers. For reduced prephonatory areas and damping constants, extended coexistence of chest and falsetto registers was found, in agreement with experimental data. Subharmonics and deterministic chaos were observed close to transitions between the registers. It is concluded that the abrupt changes between chest and falsetto registers can be understood as shifts in dominance of eigenmodes of the vocal folds.     

Vibrato Rate Adjustment

The goal of the present study was to document the acoustic changes that occur as singers attempt to increase or decrease their vibrato rate to match target stimuli. Eight advanced singing students produced vowels with vibrato in three registers, both naturally and while attempting to match faster or slower rate stimuli. Slower rates were associated with lower intensity and less steady vibrato. Faster rates involved increased vibrato extent in the chest register and increased intensity in the head register. Singers whose spontaneous vibrato rates were naturally either slower or faster tended to also be relatively slower or faster when matching target rates. This ability to modify rate may have beneficial effects on the artistic quality of the voice for performance.     

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.     

Laryngeal electromyographic responses to perturbations in voice pitch auditory feedback

The present study was conducted to test the hypothesis that intrinsic laryngeal muscles are involved in producing voice fundamental frequency (F(0)) responses to perturbations in voice pitch auditory feedback. Electromyography (EMG) recordings of the cricothyroid and thyroarytenoid muscles were made with hooked-wire electrodes, while subjects sustained vowel phonations at three different voice F(0) levels (conversational, high pitch in head register, and falsetto register) and received randomized pitch shifts (±100 or ±300 cents) in their voice auditory feedback. The median latencies from stimulus onset to the peak in the EMG and voice F(0) responses were 167 and 224 ms, respectively. Among the three different F(0) levels, the falsetto register produced compensatory EMG responses that occurred prior to vocal responses and increased along with rising voice F(0) responses and decreased for falling F(0) responses. For the conversational and high voice levels, the EMG response timing was more variable than in the falsetto voice, and changes in EMG activity with relevance to the vocal responses did not follow the consistent trend observed in the falsetto condition. The data from the falsetto condition suggest that both the cricothyroid and thyroarytenoid muscles are involved in generating the compensatory vocal responses to pitch-shifted voice feedback.     

Vocal quality factors: analysis, synthesis, and perception.

The purpose of this study was to examine several factors of vocal quality that might be affected by changes in vocal fold vibratory patterns. Four voice types were examined: modal, vocal fry, falsetto, and breathy. Three categories of analysis techniques were developed to extract source-related features from speech and electroglottographic (EGG) signals. Four factors were found to be important for characterizing the glottal excitations for the four voice types: the glottal pulse width, the glottal pulse skewness, the abruptness of glottal closure, and the turbulent noise component. The significance of these factors for voice synthesis was studied and a new voice source model that accounted for certain physiological aspects of vocal fold motion was developed and tested using speech synthesis. Perceptual listening tests were conducted to evaluate the auditory effects of the source model parameters upon synthesized speech. The effects of the spectral slope of the source excitation, the shape of the glottal excitation pulse, and the characteristics of the turbulent noise source were considered. Applications for these research results include synthesis of natural sounding speech, synthesis and modeling of vocal disorders, and the development of speaker independent (or adaptive) speech recognition systems.     

Effect of a Single Injection of Basic Fibroblast Growth Factor into the Vocal Folds: A 36-Month Clinical Study

ObjectiveA single injection of basic fibroblast growth factor (bFGF) into the vocal folds of patients with glottal insufficiency has been shown to be effective for a few years. However, the long-term therapeutic effect of a single injection of bFGF into the vocal folds has yet to be demonstrated. In this study, the therapeutic effect of a single injection of bFGF into the vocal folds was investigated over several years by monitoring patients for 36 months following this treatment.MethodsNineteen patients with glottal insufficiency received injections of bFGF diluted to 20 μg/mL in the superficial layer of the lamina propria of the bilateral vocal folds. The following parameters were evaluated at preinjection baseline and 6, 12, 18, 24, and 36 months later, and statistical comparisons were performed. The parameters evaluated were: the Grade, Rough, Breathy, Asthenic, and Strained (GRBAS) scale score; maximum phonation time; acoustic analysis; and glottal wave analysis (GWA) and kymograph edge analysis (KEA) using high-speed digital imaging (HSDI). The amplitude perturbation quotient (APQ) and period perturbation quotient (PPQ) were measured by acoustic analysis. The mean minimum glottal area during vocalization and mean minimum distance between the vocal folds were measured by GWA. The amplitudes of the bilateral vocal folds were measured by KEA.ResultsPostinjection, the GRBAS scale score decreased from 6 months after injection, and maximum phonation time was prolonged. The mean minimum glottal area during vocalization and the mean minimum distance between the vocal folds calculated by GWA of HSDI decreased significantly after 6 months. These effects persisted until 36 months postinjection. APQ and PPQ derived from acoustic analysis tended to decrease, but not significantly. There was no clear change in the amplitudes of the bilateral vocal folds calculated by KEA of HSDI before and after injection.ConclusionsThese results suggest that the effects of a single injection of bFGF into the vocal folds persist for 36 months.     

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.     

The perceptual nature of vocal register change

This study focuses on the perceptual nature of chest and falsetto registers as a function of various production tokens and methods of perceptual evaluation. Fifteen target tones, ranging from G#3 to A#4, were sung by a male and a female subject in the context of ascending and descending sequences on the vowels /a/ and /i/. Register transitions were elicited by setting strict constraints on production. Segments of 1-s duration were extracted from the target notes, digitized, and acoustically analyzed. These excerpts were presented to ten trained listeners in four different perceptual tasks. Identification and discrimination tasks yielded nearly identical results, suggesting that the primary registers are perceived as distinct entities. The marked change from chest to falsetto as well as the locus of the transition between these registers did not vary systematically as a function of production token or perceptual task. Mean register shift-point frequencies of the male and female subjects were perceived at 320 Hz and 353 Hz, respectively. Multidimensional scaling and hierarchical clustering analyses were utilized to capture the dimensionality and the internal structure of perceptual data sets derived from the pair-wise similarity ratings. Optimal spatial representation of these data required no more than two orthogonal dimensions, with the quality attribute represented by the dominant dimension. The representation of pitch differences was reflected only in the internal ordering of the stimuli within registers, but did not affect the perceptual discontinuity between registers.     

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.