A comparison of subglottal and intraoral pressure measurements during phonation

Intraoral pressure and subglottal pressure, derived from tracheal puncture, were recorded with the electroglottographic signal for one normal speaking male during phonation. The mean subglottal pressure for vowels was also estimated by interpolating the intraoral pressure from surrounding /p/ occlusions. The pressure measurements were highly correlated (r = 0.98) and there were small pressure value differences (on average <2%). The effects of varying speech rate and mode of phonation on the pressure measurements are discussed. A decrease in pressure from the mean subglottal pressure for the open phase and an increase for the closed phase was found during the glottal vibratory cycles.     

The Activity Patterns of Neck Muscles in Professional Classical Singing

The study aimed to characterize the activity patterns of neck muscles during classical singing. Muscle usage during inhalation and phonation and the relationship to changes in pitch and vocal loudness was of particular interest. Five professional opera singers (2 males, 3 females) participated. Surface electromyographic activity (EMG) was recorded from the upper trapezius (TR), the sternocleidomastoideus (STM), and the scalenus (SC) muscles and the muscles in the posterior neck region (PN). EMG activity in TR and STM was lowered by EMG biofeedback (BF), and the possible effect of lowered EMG activity in these muscles on the EMG activity of SC and PN was analyzed. A strain gauge sensor recorded the chest circumference of the thorax. Three singing tasks were performed. Each task was performed three times with variation in vocal loudness and pitch. After the first performance of the singing tasks, the BF session was carried out. Thereafter muscle activity was recorded in repeat performances of the same tasks, and the EMG amplitude of all muscles was compared before and after BF. We conclude that STM and SC showed correlated activity patterns during inhalation and phonation by classical singers. Second, substantial muscle activity was observed in PN during inhalation and phonation. BF performed on TR and STM had a secondary effect of lowering EMG activity in SC and PN. The activity of all neck muscles was markedly elevated when singing in the highest pitch. There was no consistent task-based difference in EMG amplitude for the other singing tasks.     

Effects of HearFones on speaking and singing voice quality

HearFones (HF) have been designed to enhance auditory feedback during phonation. This study investigated the effects of HF (1) on sound perceivable by the subject, (2) on voice quality in reading and singing, and (3) on voice production in speech and singing at the same pitch and sound level.

Test 1: Text reading was recorded with two identical microphones in the ears of a subject. One ear was covered with HF, and the other was free. Four subjects attended this test. Tests 2 and 3: A reading sample was recorded from 13 subjects and a song from 12 subjects without and with HF on. Test 4: Six females repeated [pa:p:a] in speaking and singing modes without and with HF on same pitch and sound level.

Long-term average spectra were made (Tests 1–3), and formant frequencies, fundamental frequency, and sound level were measured (Tests 2 and 3). Subglottic pressure was estimated from oral pressure in [p], and simultaneously electroglottography (EGG) was registered during voicing on [a:] (Test 4). Voice quality in speech and singing was evaluated by three professional voice trainers (Tests 2–4).

HF seemed to enhance sound perceivable at the whole range studied (0–8 kHz), with the greatest enhancement (up to ca 25 dB) being at 1–3 kHz and at 4–7 kHz. The subjects tended to decrease loudness with HF (when sound level was not being monitored). In more than half of the cases, voice quality was evaluated “less strained” and “better controlled” with HF. When pitch and loudness were constant, no clear differences were heard but closed quotient of the EGG signal was higher and the signal more skewed, suggesting a better glottal closure and/or diminished activity of the thyroarytenoid muscle.     

Vocal Behavior and Vocal Loading Factors for Preschool Teachers at Work Studied with Binaural DAT Recordings

Preschool teachers are at risk for developing voice problems such as vocal fatigue and vocal nodules. The purpose of this report was to study preschool teachers' voice use during work. Ten healthy female preschool teachers working at daycare centers (DCC) served as subjects. A binaural recording technique was used. Two microphones were placed on both sides of the subject's head, at equal distance from the mouth, and a portable DAT recorder was attached to the subject's waist. Recordings were made of a standard reading passage before work (baseline) and of spontaneous speech during work. The recording technique allowed separate analyses of the level of the background noise, and of the subjects' voice sound pressure level, mean fundamental frequency, and total phonation time. Among the results, mean background noise level for the ten DCCs was 76.1 dBA (range 73.0-78.2), which is more than 20 dB higher than what is recommended where speech communication is important (50-55 dBA). The subjects spoke on an average of 9.1 dB louder (p < 0.0001), and with higher mean fundamental frequency (247 Hz) during work as compared to the baseline (202 Hz) (p < 0.0001). Mean phonation time for the group was 17%, which was considered high. It was concluded that preschool teachers do have a highly vocally demanding profession. Important steps to reduce the vocal loading for this occupation would be to decrease the background noise levels and include pauses so that preschool teachers can rest their voices.     

Inspiratory pressure threshold training for upper airway limitation: a case of bilateral abductor vocal fold paralysis

A single subject design was used to determine if pressure threshold training strengthens the inspiratory muscles in a subject with a limited glottal airway as well as diminish dyspnea and improve parameters of speech. The subject was a 19-year-old woman whose glottal airway was limited due to bilateral abductor vocal fold paralysis following a thyroidectomy. A 5-week inspiratory muscle strength-training program was implemented using a pressure-threshold trainer to strengthen the inspiratory muscles with the intent of enabling the generation of higher inspiratory pressures. The pressure threshold on the trainer was set at 75% of the subject's maximum inspiratory pressure (MIP). The subject was required to generate sufficient inspiratory pressure to bring air through the trainer during an inspiratory maneuver. MIP was the dependent variable used as an indication of inspiratory muscle strength. MIP increased by 47% following the training program. Maximal minute ventilation and oxygen uptake increased posttraining. Dyspnea during exercise and speech decreased as reported by the subject. Total reading duration and pause duration demonstrated a declining trend during connected speech. The results indicated that inspiratory muscle training using a pressure threshold device improves functional tasks such as exercise and speech in a subject with upper airway limitation.     

The role of strap muscles in phonation—In vivo caninelaryngeal model

In spite of the presumed importance of the strap muscles on laryngealvalving and speech production, there is little research concerning the physiological role and the functional differences among the strap muscles. Generally, the strap muscles have been shown to cause a decrease in the fundamental frequency (F₀) of phonation during contraction. In this study, an in vivo canine laryngeal model was used to show the effects of strap muscles on the laryngeal function by measuring the F₀, subglottic pressure, vocal intensity, vocal fold length, cricothyroid distance, and vertical laryngeal movement. Results demonstrated that the contraction of sternohyoid and sternothyroid muscles corresponded to a rise in subglottic pressure, shortened cricothyroid distance, lengthened vocal fold, and raised F₀ and vocal intensity. The thyrohyoid muscle corresponded to lowered subglottic pressure, widened cricothyroid distance, shortened vocal fold, and lowered F₀ and vocal intensity. We postulate that the mechanism of altering F₀ and other variables after stimulation of the strap muscles is due to the effects of laryngotracheal pulling, upward or downward, and laryngotracheal forward bending, by the external forces during strap muscle contraction.     

Relationship between Muscle Flexibility and Characteristics of Muscle Contraction in Healthy Women during Different Menstrual Phases

Objective: Skeletal muscle function is vital for preventing injury during exercise. It has been reported that skeletal muscle function fluctuates with the menstrual cycle and is considered one of the causes of injury. This study aimed to clarify the relationship between muscle flexibility and muscle contraction characteristics and their changes with the menstrual cycle. Methods: The subjects were healthy women who voluntarily participated in the study through recruitment posters. Muscle flexibility was measured with the passive knee extension (PKE) test, isokinetic knee flexor strength, and the maximum muscle strength exertion angle under two conditions of 60°/s and 120°/s in dominant hamstrings. Additionally, their correlations were analyzed and compared between the menstrual and ovulatory phases. Results: Sixteen subjects (mean age: 20.56 ± 0.73 years; body mass index: 20.21 ± 1.60) participated in the study. Correlation analysis showed a significant negative correlation between PKE and the maximum muscle strength exertion angle under the condition of 60°/s during the menstrual phase (r = –0.54; p = 0.03). No significant difference was observed in the two-group comparison of the variables measured during the menstrual and ovulatory phases. Conclusion: This study confirmed that the more flexible muscles generate the maximum strength at a more contracted position during the menstrual phase in women. In the future, it is necessary to examine the relationship between the results of this study and exercise performance and injury occurrence.     

Control of static pressure by expiratory muscles during expiratory effort and phonation

Surface electromyography (EMG) impulse frequency was measured in six subjects at eight recording sites on the chest and abdomen during the maintenance of positive mouth pressures and the phonation of a long vowel ([a:] in the Finnish word aamu) at three intensity levels. The pattern of muscle activation was similar in these two behavioral tasks. In upright posture, at lung volumes from 20% vital capacity (VC) below to 30% above functional residual capacity (FRC), EMG frequency increased rather linearly with increasing mouth pressure within 0 and 20 cm H₂O. A qualitatively similar relationship was observed between EMG frequency and phonation intensity. The results suggest that the expiratory effort task can be used as a model for the control of subglottal pressure during phonation at static subglottal pressures     

Effect of Fasting on Voice in Women

OBJECTIVE/HYPOTHESIS: To study the effect of fasting on voice in women: abstinence from food and water intake between 14 and 18 hours. STUDY DESIGN: A prospective study on female subjects. MATERIAL AND METHOD: A total of 28 female subjects were included in this study. Their age ranged between 21 and 45 years. Subjects with vocal symptoms or vocal fold lesions were excluded. The subjects were tested when they were not fasting and while fasting after the first week of intermittent fasting during Ramadan. Each subject was first asked about her vocal symptoms and the ease of phonation or phonatory effort. Then each underwent acoustic analysis and laryngeal video-endostroboscopy. RESULTS: Vocal fatigue was the most common reported complaint (53.6%) followed by deepening of the voice (21.4%) and harshness (10.2%). Self-reported phonatory effort was significantly affected by fasting (P value < 0.001). Out of the 28 subjects, 23 had an increase in their phonatory effort. Vocal acoustic parameters did not change markedly except for the maximum phonation time, which decreased significantly. Laryngeal video-endostroboscopy did not reveal any significant changes during fasting. All stroboscopic parameters were the same except for a decrease in the amplitude of the mucosal waves in one subject and the presence of a posterior chink in three subjects. CONCLUSION: Fasting affects voice. There is an increase in the phonatory effort, and vocal fatigue is the most common symptom.     

Control of Fundamental Frequency in Dysphonic Patients During Phonation and Speech

PurposeThe pitch-shift reflex (PSR) is the adaptation of the fundamental frequency during phonation and speech and describes the auditory feedback control. Speakers without voice and speech disorders mostly show a compensation of the pitch change in the auditory feedback and adapt their fundamental frequency to the opposite direction. Dysphonic patients often display problems with the auditory perception and control of their voice during therapy. Our study focuses on the auditory and kinesthetic control mechanisms of patients with muscle tension dysphonia (MTD) and speakers without voice and speech problems. Main purpose of the study is the analysis of the functionality of the control mechanisms within phonation and speech between patients with MTD and normal speakers.MethodSixty-one healthy subjects (17 male, 44 female) and 22 patients with MTD (7 male, 15 female) participated following two paradigms including a sustained phonation (vowel /a/) and speech ([‘mama]). Within both paradigms the fundamental frequency of the auditory feedback was increased synthetically. For the analysis of the PSR the electroencephalogram, electroglottography, the voice signal, and the high-speed endoscopy data were recorded simultaneously. The PSR in the electroencephalogram was detected via the N100 and the mismatch negativity. Statistical tests were applied for the detection of the PSR in the physiological response within the electroglottography, voice, and high-speed endoscopy signals. The results were compared between both groups.ResultsNo differences were found between the controls and patients with MTD regarding latency and magnitude of the perception of the pitch shift in both paradigms, but for the magnitude of the behavioral response. Differences also could be found for both groups between the “no pitch” and “pitch” condition of the two paradigms regarding vocal fold dynamics and voice quality. Patients with MTD showed more vibrational irregularities during the PSR than the controls, especially regarding the symmetry of vocal fold dynamics.ConclusionPatients with MTD seem to have a disturbed interaction between the auditory and kinesthetic feedback inducing the execution of an overriding behavioral response.     

Inspiratory pressure threshold training for glottal airway limitation in laryngeal papilloma

A single-subject design was used to determine if inspiratory pressure threshold training increases inspiratory muscle strength and reduces the sensation of dyspnea during exercise and speech. The subject was a 23-year-old female with congenital juvenile papilloma which has been in remission for 10 years. A 4-week inspiratory muscle training program was implemented using an inspiratory pressure threshold trainer. The pressure threshold of the trainer was set by the experimenter. The pressure threshold setting of the trainer was based on a percentage of the subject's maximum inspiratory pressure measured prior to training. The average range of the pressure threshold was 40 to 70 cmH2O. In order for inspiratory air to flow, the subject generated inspiratory pressure, independent of airflow rate. Maximum inspiratory pressure (MIP) was the dependent variable used as the index of inspiratory muscle strength. Exercise dyspnea was a dependent variable rated by the subject during a progressive treadmill test. Dyspnea associated with speech was rated following production of a comfortable and loud speech task. MIP increased by 57% following the training program with a 2-scale point reduction in the perception of dyspnea during exercise. Dyspnea during loud speech decreased from moderate to mild. The changes in dyspnea, both during exercise and speech, are directly related to inspiratory muscle strengthening. The results suggest that inspiratory muscle training may improve respiratory related function in patients with restrictive upper airway disorders.     

The effects of time constraints on phonatory stability in normally speaking adult women

Forty normally speaking women sustained /a/ five times in two conditions,untimed and timed. In the untimed condition, phonation began whenever the subject felt ready. The timed task required subjects to begin phonation as quickly as possible after the examiner's signal. Conditions were counterbalanced across subjects. Jitter and shimmer values were obtained on a Kay Elemetrics Computerized Speech Lab (Pine Brook, NJ). Three distinct patterns of change emerged for fitter and shimmer from the untimed to the timed condition, reflecting either decreases, increases, or no change in values. These changes in jitter and shimmer values across conditions are related to a reaction time model of “bias toward accuracy.”     

Kinematic and electromyographic responses to perturbation of the jaw

The task-dependent organization of sensorimotor mechanisms during the production of speech was investigated using a perturbation paradigm. Six subjects received unanticipated jaw perturbations before and during tongue elevation for [aedae], in which the lips do not participate, and bilabial closure for [aebae], in which the tongue does not participate. A strain gauge system was used to monitor inferior-superior displacements of the upper lip, lower lip, and jaw, while hooked-wire electrodes monitored muscle activity in various muscles of the lips, jaw, and tongue. Results indicated significant compensatory kinematic adjustments to jaw perturbations in the lips and/or jaw during [aebae], but no labial compensations during [aedae] (with the exception of one subject). EMG responses were inconsistent and not necessarily indicative of the kinematic findings. Individual subjects responded to perturbations reliably but differently, using different combinations of involved articulators to achieve bilabial closure and lingua-alveolar contact. The current study supports earlier research which suggests that the components of the motor system are flexibly assembled, based on the requirements of the specific task. That is, compensatory responses to sensory information occur only when such responses are functionally necessary.     

Incidence of supraglottic activity in males and females: a preliminary report

Supraglottic activity was rated from flexible endoscopic video recordings of subjects with normal laryngeal structure and function as they sustained vowels and repeated syllables and sentences. Judges rated these recordings for false vocal fold (FVF) adduction and anterior-to-posterior (A-P) compression at the initiation of the speech task, throughout the whole speech task (static supraglottic activity), and as brief individual adductions within a speech task (dynamic supraglottic activity). Significant differences in A-P (p < 0.0003) and FVF (p < 0.0000001) compression were found between tasks. Dynamic FVF activity was associated with glottal stops. Static A-P and FVF activities were present in males significantly more (p < 0.0001) than females. FVF activity associated with speech initiation was found in females significantly more (p = 0.0256) than males. Supraglottic activity plays a role in normal speech production, and should not necessarily be considered suggestive of a voice use pattern with excessive muscle tension.     

The False Vocal Folds: Shape and Size in Frontal View During Phonation Based on Laminagraphic Tracings

The geometry of the false vocal fold region during phonation is important to the understanding of the aerodynamics and acoustics of voice. The shape and dimensions of this region during phonation were estimated using laminagraphic tracings of the larynx. Laminagrams from two previous studies, one with non-singer subjects (Experiment I, Hollien and Colton, 1969) and the other with singers (Experiment II, Wilson, 1972), were traced, photocopied, and measured. Statistical analysis showed significantly greater false vocal fold height in males than females for both experiments. The false vocal fold gap was also significantly greater in males than females for Experiment II, but reached only borderline significance for Experiment I. For each gender, most of the linear measures were greater in Experiment I when compared to Experiment II; these differences may be passive in nature (due to actual differences in subject size) or active (due to muscle contraction that displaced the false vocal folds during singing).     

Reflex activation of laryngeal muscles by sudden induced subglottal pressure changes.

In measuring the effect of subglottal pressure changes on fundamental frequency (Fo) of phonation, the effects of changing laryngeal muscle activity must be eliminated. Several investigators have used a strategy in which pulsatile increases of subglottal pressure are induced by pushing on the chest or abdomen of a phonating subject. Fundamental frequency is then correlated with subglottal pressure changes during an interval before laryngeal response is assumed to occur. The present study was undertaken to repeat such an experiment while monitoring electromyographic (EMG) activity of some laryngeal muscles, to discover empirically the latency of the laryngeal response. The results showed a consistent response to each push, with a latency of about 30 ms. Despite this response, analyses of fundamental frequency versus subglottal pressure changes during the interval of constant EMG activity were in general agreement with previously published values. With respect to the nature of the electromyographic response itself, its timing was found to be within the range of latencies appropriate for peripheral feedback, and was also similar to that for an acoustically--or tactually--elicited startle reflex.     

Disentangling the effects of phonation and articulation: Hemispheric asymmetries in the auditory N1m response of the human brain

Background  

The cortical activity underlying the perception of vowel identity has typically been addressed by manipulating the first and second formant frequency (F1 & F2) of the speech stimuli. These two values, originating from articulation, are already sufficient for the phonetic characterization of vowel category. In the present study, we investigated how the spectral cues caused by articulation are reflected in cortical speech processing when combined with phonation, the other major part of speech production manifested as the fundamental frequency (F0) and its harmonic integer multiples. To study the combined effects of articulation and phonation we presented vowels with either high (/a/) or low (/u/) formant frequencies which were driven by three different types of excitation: a natural periodic pulseform reflecting the vibration of the vocal folds, an aperiodic noise excitation, or a tonal waveform. The auditory N1m response was recorded with whole-head magnetoencephalography (MEG) from ten human subjects in order to resolve whether brain events reflecting articulation and phonation are specific to the left or right hemisphere of the human brain.     

The Effect of Hemodialysis on Voice: An Acoustic Analysis

Because respiration is part of the well-coordinated process necessary for phonation, this study was conducted with the purpose of analyzing the effect of chronic hemodialysis on voice characteristics of patients with chronic renal failure. A total of 57 patients were recruited for the study, including 31 males and 26 females ranging in age from 16 to 85 years. Patients underwent evaluation of their voice directly before and after hemodialysis using the Kay Elemetric VISI Pitch (Model 330; Kay Elemetric Corporation, Lincoln Park, New Jersey). The vocal acoustic parameters studied include habitual pitch, pitch range, relative average perturbation, shimmer, noise-to-harmonic ratio, voice turbulence index, maximum phonation time, and voice energy. The data were analyzed using the paired t-test for the total sample and the nonparametric test for the female and male subgroups. The total sample analysis showed a statistically significant increase in the habitual pitch after the hemodialyis (p < 0.05), with a borderline increase in the pitch range and maximum phonation time (p < 0.10). In the female group, there was a statistically significant increase in the habitual pitch and a borderline increase in the relative average perturbation. In the male group, there was a significant increase in the habitual pitch with a borderline increase in maximum phonation time. Discussion of the after-mentioned results is presented.     

Model-based classification of nonstationary vocal fold vibrations

Classification of vocal fold vibrations is an essential task of the objective assessment of voice disorders. For historical reasons, the conventional clinical examination of vocal fold vibrations is done during stationary, sustained phonation. However, the conclusions drawn from a stationary phonation are restricted to the observed steady-state vocal fold vibrations and cannot be generalized to voice mechanisms during running speech. This study addresses the approach of classifying real-time recordings of vocal fold oscillations during a nonstationary phonation paradigm in the form of a pitch raise. The classification is based on asymmetry measures derived from a time-dependent biomechanical two-mass model of the vocal folds which is adapted to observed vocal fold motion curves with an optimization procedure. After verification of the algorithm performance the method was applied to clinical problems. Recordings of ten subjects with normal voice and ten dysphonic subjects have been evaluated during stationary as well as nonstationary phonation. In the case of nonstationary phonation the model-based classification into "normal" and "dysphonic" succeeds in all cases, while it fails in the case of sustained phonation. The nonstationary vocal fold vibrations contain additional information about vocal fold irregularities, which are needed for an objective interpretation and classification of voice disorders.     

Spectral- and Cepstral-Based Measures During Continuous Speech: Capacity to Distinguish Dysphonia and Consistency Within a Speaker

Spectral- and cepstral-based acoustic measures are preferable to time-based measures for accurately representing dysphonic voices during continuous speech. Although these measures show promising relationships to perceptual voice quality ratings, less is known regarding their ability to differentiate normal from dysphonic voice during continuous speech and the consistency of these measures across multiple utterances by the same speaker. The purpose of this study was to determine whether spectral moments of the long-term average spectrum (LTAS) (spectral mean, standard deviation, skewness, and kurtosis) and cepstral peak prominence measures were significantly different for speakers with and without voice disorders when assessed during continuous speech. The consistency of these measures within a speaker across utterances was also addressed. Continuous speech samples from 27 subjects without voice disorders and 27 subjects with mixed voice disorders were acoustically analyzed. In addition, voice samples were perceptually rated for overall severity. Acoustic analyses were performed on three continuous speech stimuli from a reading passage: two full sentences and one constituent phrase. Significant between-group differences were found for both cepstral measures and three LTAS measures (P < 0.001): spectral mean, skewness, and kurtosis. These five measures also showed moderate to strong correlations to overall voice severity. Furthermore, high degrees of within-speaker consistency (correlation coefficients ≥0.89) across utterances with varying length and phonemic content were evidenced for both subject groups.