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

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

The biomechanics of the medialization laryngoplasty(thyroplasty type 1) in an ex vivo canine model

The biomechanics of medialization laryngoplasty are not well understood. An excised canine larynx model was used to test the effects of various sized silicon implants. The vocal fold length, position, and tension were measured. Medialization laryngoplasty did not affect vocal fold length. At the mid-membranous vocal fold, larger shims resulted in greater medialization and tension. Medialization laryngoplasty neither medialized nor stiffened the vocal process to resist lateralizing forces. We conclude that medialization laryngoplasty provides bulk and support for defects of the membranous region of the vocal fold, but does not appear to close a posterior glottal gap. The selection of a surgical procedure to treat glottal incompetence should take into account the unique biomechanical properties of the anterior (membranous vocal folds) and posterior (cartilaginous portion) glottis.     

Standardized laryngeal videostroboscopic rating: Differences between untrained and trained male and female subjects, and effects of varying sound intensity, fundamental frequency, and age

To determine the influence of the factors gender, vocal training, sound intensity, pitch, and aging on vocal function, videolaryngostroboscopic images of 214 subjects, subdivided according to gender and status of vocal training, were evaluated by three judges with standardized rating scales, comprising aspects of laryngeal appearance (larynx/pharynx ratio; epiglottal shape; asymmetry arytenoid region; compensatory adjustments; thickness, width, length, and elasticity of vocal folds) and glottal functioning (amplitudes of excursion; duration, percentage, and type of vocal fold closure; phase differences; location of glottal chink). The video registrations were made while the subjects performed a set of phonatory tasks, comprising the utterance of the vowel /i/ at three levels of both fundamental frequency and sound intensity. Analysis of the rating scales showed generally sufficient agreement among judges. With the exception of more frequently observed complete closure and lateral phase differences of vocal fold excursions in trained subjects, no further differences were established between untrained and trained subjects. With an α level of p = 0.005, men differed from women with respect to laryngeal appearance (larynx/pharynx ratio, compensatory adjustments, and the presence of omega and deviant-shaped epiglottises), and their vocal folds were rated thicker in the vertical dimension, smaller in the lateral dimension, longer, and more tense, with smaller amplitudes of excursion during vibration. Glottal closure in male subjects was rated more complete, but briefer in duration. Significant effects of the factors pitch, sound intensity, and age on vocal fold appearance and glottal functioning were ascertained. Awareness of the influence of these factors, as well as the factor gender, on the rated scales is essential for an adequate evaluation of laryngostroboscopic images.     

Two-dimensional model of vocal fold vibration for sound synthesis of voice and soprano singing

Voiced sounds were simulated with a computer model of the vocal fold composed of a single mass vibrating both parallel and perpendicular to the airflow. Similarities with the two-mass model are found in the amplitudes of the glottal area and the glottal volume flow velocity, the variation in the volume flow waveform with the vocal tract shape, and the dependence of the oscillation amplitude upon the average opening area of the glottis, among other similar features. A few dissimilarities are also found in the more symmetric glottal and volume flow waveforms in the rising and falling phases. The major improvement of the present model over the two-mass model is that it yields a smooth transition between oscillations with an inductive load and a capacitive load of the vocal tract with no sudden jumps in the vibration frequency. Self-excitation is possible both below and above the first formant frequency of the vocal tract. By taking advantage of the wider continuous frequency range, the two-dimensional model can successfully be applied to the sound synthesis of a high-pitched soprano singing, where the fundamental frequency sometimes exceeds the first formant frequency.     

Simulation of vocal fold impact pressures with a self-oscillating finite-element model

Vocal fold impact pressures were studied using a self-oscillating finite-element model capable of simulating vocal fold vibration and airflow. The calculated airflow pressure is applied on the vocal fold as the driving force. The airflow region is then adjusted according to the calculated vocal fold displacement. The interaction between airflow and the vocal folds produces a self-oscillating solution. Lung pressures between 0.2 and 2.5 kPa were used to drive this self-oscillating model. The spatial distribution of the impact pressure was studied. Studies revealed that the tissue collision during phonation produces a very large impact pressure which correlates with the lung pressure and glottal width. Larger lung pressure and a narrower glottal width increase the impact pressure. The impact pressure was found to be roughly the square root of lung pressure. In the inferior-superior direction, the maximum impact pressure is related to the narrowest glottis. In the anterior-posteriorfirection, the greatest impact pressure appears at the midpoint of the vocal fold. The match between our numerical simulations and clinical observations suggests that this self-oscillating finite-element model might be valuable for predicting mechanical trauma of the vocal folds.     

Flow visualization and pressure distributions in a model of the glottis with a symmetric and oblique divergent angle of 10 degrees

Modeling the human larynx can provide insights into the nature of the flow and pressures within the glottis. In this study, the intraglottal pressures and glottal jet flow were studied for a divergent glottis that was symmetric for one case and oblique for another. A Plexiglas model of the larynx (7.5 times life size) with interchangeable vocal folds was used. Each vocal fold had at least 11 pressure taps. The minimal glottal diameter was held constant at 0.04 cm. The glottis had an included divergent angle of 10 degrees. In one case the glottis was symmetric. In the other case, the glottis had an obliquity of 15 degrees. For each geometry, transglottal pressure drops of 3, 5, 10, and 15 cm H2O were used. Pressure distribution results, suggesting significantly different cross-channel pressures at glottal entry for the oblique case, replicate the data in another study by Scherer et al. [J. Acoust. Soc. Am. 109, 1616-1630 (2001b)]. Flow visualization using a LASER sheet and seeded airflow indicated separated flow inside the glottis. Separation points did not appear to change with flow for the symmetric glottis, but for the oblique glottis moved upstream on the divergent glottal wall as flow rate increased. The outgoing glottal jet was skewed off-axis for both the symmetric and oblique cases. The laser sheet showed asymmetric circulating regions in the downstream region. The length of the laminar core of the glottal jet was less than approximately 0.6 cm, and decreased in length as flow increased. The results suggest that the glottal obliquity studied here creates significantly different driving forces on the two sides of the glottis (especially at the entrance to the glottis), and that the skewed glottal jet characteristics need to be taken into consideration for modeling and aeroacoustic purposes.     

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.     

The effect of glottal angle on intraglottal pressure

Intraglottal pressure distributions depend upon glottal shape, size, and diameter. This study reports the effects of varying glottal angle on intraglottal and transglottal pressures using a three-dimensional Plexiglas model with a glottis having nine symmetric glottal angles and a constant minimal glottal diameter of 0.06 cm. The empirical data were supported by computational results using FLUENT. The results suggested that (1) the greater the convergent glottal angle, the greater outward driving forces (higher intraglottal pressures) on the vocal folds; (2) flow resistance was greatest for the uniform glottis, and least for the 10 degrees divergent glottis; (3) the greatest negative pressure in the glottis and therefore the greatest pressure recovery for diverging glottal shapes occurred for an angle of 10 degrees; (4) the smaller the convergent angle, the greater the flow resistance; (5) FLUENT was highly accurate in predicting the empirical pressures of this model; (6) flow separation locations (given by FLUENT) for the divergent glottis moved upstream for larger flows and larger glottal angles. The results suggest that phonatory efficiency related to aerodynamics may be enhanced with vocal fold oscillations that include large convergent angles during glottal opening and small (5 degrees - 10 degrees) divergent angles during glottal closing.     

Unilateral cricothyroid contraction and glottic configuration

It is frequently stated that unilateral cricothyroid muscle (CT) paralysis can be diagnosed by physical examination, noting rotation of the glottis, and shortening and vertical displacement of the ipsilateral vocal fold. These signs, however, are inconsistently observed, and there is considerable controversy regarding the direction of glottic rotation. To determine the effects of CT contraction on three-dimensional glottic configuration, we performed computerized tomography on cadaver larynges before and after simulated CT contraction. Radiopaque makers were used to compute distances. Unilateral CT contraction equally increased the length of both membranous vocal folds, and rotated the posterior glottis less than 1 mm. CT contraction neither adducted the vocal processes, nor significantly their altered vertical level. These results suggest that unilateral CT paralysis cannot be diagnosed on the basis of any clinically apparent change in glottal configuration.     

Theoretical assessment of unsteady aerodynamic effects in phonation

This paper ranks the importance of unsteady aerodynamic mechanisms in glottal flow. Particular emphasis is given to separation point motion, acceleration of glottal airflow by vocal fold motion, and viscous blockage. How nondimensional parameters such as the Reynolds, Strouhal, and Womersley numbers help in this ranking is also addressed. An equation of motion is derived which includes terms explicitly describing the effects of interest, assuming (1) a symmetrical glottis, (2) zero pressure recovery downstream of the vocal folds, and (3) a quasisteady glottal jet. Estimating the order of magnitude of the terms in this equation, it is shown that the flow is characterized by two temporal regimes: (1) a flow initiation/shutoff regime where local unsteady acceleration and wall motion dominate, and (2) a "quasisteady" regime where the flow is dominated by convective acceleration. In the latter case, separation point motion and viscous blockage are shown to be out of phase with motion of the vocal folds, thereby impacting the shape of the glottal volume flow waveform. The analysis suggests that glottal flow may be considered quasisteady only insofar as traditional assumptions concerning glottal jet behavior can be confirmed.     

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.     

A theoretical study of the effects of various laryngeal configurations on the acoustics of phonation.

Simulation of glottal volume flow and vocal fold tissue movement was accomplished by numerical solution of a time-dependent boundary value problem, in which nonuniform, orthotropic, linear, incompressible vocal fold tissue media were surrounded by irregularly shaped boundaries, which were either fixed or subject to aerodynamic stresses. Spatial nonuniformity of the tissues was of the layered type, including a mucosal layer, a ligamental layer, and muscular layers. Orthotropy was required to stabilized the vocal folds longitudinally and to accomodate large variations in muscular stress. Incompressibility and vertical motions at the golttis played an important role in producing and sustaining phonation. A nominal configuration for male fundamental speaking pitches was selected, and the regulation of fundamental frequency, intensity, average volume flow, and vocal efficiency was investigated in terms of variations around this nominal configuration. Parameters which were varied consisted of geometrical factors such as length, thickness, and depth, factors for shaping the glottis, as well as tissue elasticities, tissue viscosities, and subglottal pressure. Since nonlinear stress-strain properties were not included, subglottal pressure did not produce a pronounced effect upon fundamental frequency under these somewhat edealized conditions F0 rasing correlated strongly with increased tension in the ligament, and somewhat with increasing tension in the vocalis. F0 lowering correlated with increase in vocal fold length when the tensions were held constant, but not with increase in vocal fold thickness. Vocal intensity and efficiency are shown to have local maxima as the configurational parameters are varied one at a time. It appears that oral acoustic power output and vocal efficiency can be maximized by proper adjustments of longitudinal tension of nonmuscular (mucosal and ligamental) tissue layers in relation to muscular layers. Quantitative verification of the "body-cover" theory is therefore suggested, and several further implications with regard to control of the human larynx are considered.     

Intraglottal pressure profiles for a symmetric and oblique glottis with a divergence angle of 10 degrees

Human phonation does not always involve symmetric motions of the two vocal folds. Asymmetric motions can create slanted or oblique glottal angles. This study reports intraglottal pressure profiles for a Plexiglas model of the larynx with a glottis having a 10-degree divergence angle and either a symmetric orientation or an oblique angle of 15 degrees. For the oblique glottis, one side was divergent and the other convergent. The vocal fold surfaces had 14 pressure taps. The minimal glottal diameter was held constant at 0.04 cm. Results indicated that for either the symmetric or oblique case, the pressure profiles were different on the two sides of the glottis except for the symmetric geometry for a transglottal pressure of 3 cm H2O. For the symmetric case, flow separation created lower pressures on the side where the flow stayed attached to the wall, and the largest pressure differences between the two sides of the channel were 5%-6% of the transglottal pressure. For the oblique case, pressures were lower on the divergent glottal side near the glottal entry and exit, and the cross-channel pressures at the glottis entrance differed by 27% of the transglottal pressure. The empirical pressure distributions were supported by computational results. The observed aerodynamic asymmetries could be a factor contributing to normal jitter values and differences in vocal fold phasing.     

Aerodynamic and acoustic characteristics of the adult AfricanAmerican voice

Laryngeal aerodynamic and acoustic characteristics of African American voice production were examined from vowel samples produced by ten adult female and ten adult male speakers. The data were compared with that for a control group consisting of ten adult female and ten adult male White speakers, matched for age, height, and weight. All measures were analyzed using Cspeech 4.0. Aerodynamic measurements, extracted from a glottal airflow waveform, included maximum flow declination rate, alternating glottal airflow, minimum glottal airflow, and airflow open quotient. Acoustic measures included fundamental frequency and sound pressure level. No significant mean differences between the African American and White speakers were found, except for maximum-flow declination rate. The White speakers produced significantly higher declination rates than the African American speakers. The factor of sex for the African American speakers was statistically significant for the measures of maximum-flow declination rate, alternating glottal airflow, open quotient, and fundamental frequency, consistent with the functioning of the White speakers. The results suggest that during vowel production, where the vocal tract is in a fairly static position, acoustic and aerodynamic characteristics for African American and White Speakers are comparable.     

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.     

Flow separation in a computational oscillating vocal fold model

A finite-volume computational model that solves the time-dependent glottal airflow within a forced-oscillation model of the glottis was employed to study glottal flow separation. Tracheal input velocity was independently controlled with a sinusoidally varying parabolic velocity profile. Control parameters included flow rate (Reynolds number), oscillation frequency and amplitude of the vocal folds, and the phase difference between the superior and inferior glottal margins. Results for static divergent glottal shapes suggest that velocity increase caused glottal separation to move downstream, but reduction in velocity increase and velocity decrease moved the separation upstream. At the fixed frequency, an increase of amplitude of the glottal walls moved the separation further downstream during glottal closing. Increase of Reynolds number caused the flow separation to move upstream in the glottis. The flow separation cross-sectional ratio ranged from approximately 1.1 to 1.9 (average of 1.47) for the divergent shapes. Results suggest that there may be a strong interaction of rate of change of airflow, inertia, and wall movement. Flow separation appeared to be "delayed" during the vibratory cycle, leading to movement of the separation point upstream of the glottal end only after a significant divergent angle was reached, and to persist upstream into the convergent phase of the cycle.     

Influence of glottal closure configuration on vocal efficacy in young normal-speaking women

Posterior closure insufficiency of the glottis is often mentioned in connection with permanent voice disorders. Recently published studies have revealed that an incomplete closure of the glottis can be found also in normal-speaking voices, especially in women. However, the effect of glottal closure configuration on vocal efficacy is not sufficiently clarified. The purpose of this study was to determine the effect of glottal closure configuration on singing and speaking voice characteristics. Overall, 520 young female normal-speaking subjects were examined by videostroboscopy for different phonation conditions in the combination of soft, loud, low, and/or high phonation and by voice range profile measurements. According to the videostroboscopic analysis, the subjects were subdivided into four groups: complete closure of the vocal folds already in soft phonation (group 1), closure of the vocal fold with increasing intensity (group 2), persistent closure insufficiencies despite increasing intensity (group 3), and hourglass-shaped closure in subjects with vocal nodules (group 4). Subjects in which the glottal closure could not be evaluated sufficiently were subclassified into group 5 (missing values).

Selected criteria of the singing and speaking voice were evaluated and statistically processed according to the mentioned subclassification. Group 1 reached significantly the highest sound pressure levels (SPL_max) for the singing voice as well as for the shouting voice. Group 3 showed a limited capacity to increase the intensity of the singing and speaking voice. The results gathered in this study objectify the relationship of insufficient glottal closure and reduced vocal capabilities. As long as no conclusive data on long-term consequences of insufficient glottal closure are available, a prophylactic improvement of the laryngeal situation especially in female professional voice users by voice therapy should be recommended.     

A Novel Treatment for Hypophonic Voice: Twang Therapy

A hypophonic voice, characterized perceptually as weak and breathy, is associated with voice disorders such as vocal fold atrophy and unilateral vocal fold paralysis. Although voice therapy programs for hypophonia typically address the vocal folds or the sound source, twang voice quality was examined in this study as an alternative technique for increasing vocal power by altering the epilarynx or the sound filter. OBJECTIVE: This study investigated the effect of twang production on physiologic, acoustic, and perceived voice handicap measures in speakers with hypophonia. DESIGN/METHODS: This prospective pilot study compared the vocal outcomes of six participants with hypophonia at pre- and posttreatment time points. Outcome measures included mean airflow rate, intensity in dB sound pressure level (SPL), maximum phonation time, and self-report of voice handicap. RESULTS: All subjects improved in at least three of the four vocal outcome measures. Wilcoxon signed-rank test of paired differences revealed significant differences between pre- and posttherapy group means for airflow rate, SPL, and Voice Handicap Index scores. CONCLUSION: The twang voice quality as a manipulation of the sound filter offers a clinical complement to traditional voice therapies that primarily address the sound source.