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.     

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.     

Average speaking fundamental frequency in soprano singers with and without symptoms of vocal attrition

Nineteen trained soprano singers aged 18–30 years vocalized tasks designed to assess average speaking fundamental frequency (SFF) during spontaneous speaking and reading. Vocal range and perceptual characteristics while singing with low intensity and high frequency were also assessed, and subjects completed a survey of vocal habits/symptoms. Recorded signals were digitized prior to being analyzed for SFF using the Kay Computerized Speech Lab program. Subjects were assigned to a normal voice or impaired voice group based on ratings of perceptual tasks and survey results. Data analysis showed group differences in mean SFF, no differences in vocal range, higher mean SFF values for reading than speaking, and 58% ability to perceive speaking in low pitch. The role of speaking in too low pitch as causal for vocal symptoms and need for voice classification differentiation in vocal performance studies are discussed.     

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.     

The effects of preventive vocal hygiene education on the vocal hygiene habits and perceptual vocal characteristics of training singers

The purpose of the present study was to determine the effects of vocal hygiene education on the vocal hygiene behaviors and perceptual vocal characteristics of untrained singers. Eleven adult untrained singers served as subjects. They attended four 1-hour class sessions on vocal hygiene, including anatomy and physiology of the phonatory mechanism, vocally abusive behaviors, voice disorders commonly seen in singers, and measures to prevent voice disorders. Pre- and postinstruction surveys were used to record subjects' vocal abuses and their perceptions of their speaking and singing voice. They also rated their perceived value of vocal hygiene education. Results revealed minimal changes in vocal hygiene behaviors and perceptual voice characteristics. The subjects did report a high degree of benefit and learning, however.     

Reflux and vocal disorders in singers with bulimia

Dysphonia associated with bulimia has been described in the literature associated with vocal fold edema and polypoid changes. Laryngopharyngeal reflux (LPR) has been documented to cause reflux vocal fold pathology including edema and polypoid changes. We studied eight singers with bulimia and documented vocal fold pathology, including edema, posterior commissure hypertrophy, ventricular obliteration, and telangiectasia. Reflux was demonstrated in all eight. The results of this study showed that LPR may be a contributing factor to vocal disorders in singers with bulimia.     

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.     

Vocal fold microsurgery in singers

Some singers with benign vocal fold mucosal lesions remain unacceptably impaired vocally in spite of compliance with a regimen of medical treatment and voice therapy lasting several months—or even years. I present here my experience with 62 singers who, because of this predicament, chose to undergo vocal fold microsurgery. This series is the second largest reported to date in English literature. Procedures are presented which were used for patient selection, education, and vocal retraining, as well as for surgery itself and postoperative care. Results reported here include (a) comparison of my auditory-perceptual ratings of singing voice impairment before and after surgery, (b) preoperative versus postoperative videostroboscopic findings, (c) postoperative rate of return to public singing, and (d) postoperative patient questionnaires which sought to uncover patient/singer perceptions of the results of vocal fold surgery. Excellent results were achieved overall with a very low incidence of untoward results, and no complications were encountered.     

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.     

Voice handicap index change following treatment of voice disorders

Outcome measurements of voice disorders is an important new area for both the evaluation of voice-disordered patients and evaluation of treatment efficacy. The Voice Handicap Index (VHI) measures the patient's perception of the impact of his or her voice-disorder. The VHI was used in this study to measure the changes of the patient's perception following treatment for four different voice disorders. The VHI showed a significant change following treatment for unilateral vocal fold paralysis, vocal cyst/polyp, and muscle tension dysphonia. Results of this paper indicate that the VHI is a useful instrument to monitor the treatment efficacy for voice disorders.     

Self-reported voice problems among three groups of professional singers

A vocal health questionnaire was administered to three groups of professional singers and a “friendship-matched” group of nonsingers in Melbourne, Australia. The responses of 79 opera, 57 musical theatre and 31 contemporary (excluding rock) singers and 86 nonsingers were analysed. The questionnaire solicited information regarding biographical data speaking and singing voice-use behaviours, and vocal health over the previous 12 months in terms of experiences of vocal impairment, vocal disability, and handicap. Significant differences between singers and nonsingers in the prevalence and nature of voice problems were reported. Of the singers, 44% reported one or more occurrences of a diagnosed vocal condition compared to 21% of nonsingers and 69% of singers experienced vocal disability compared to only 41% of nonsingers, over the previous 12 months. In contrast, no significant differences were found between the three different styles of singers in their experience of vocal impairment, disability or handicap.     

Glottic Characteristics and Voice Complaint in the Elderly

This study evaluated the relationship between voice complaint and deviant vocal fold status with special regard to presbylarynx, in patients aged more than 60 years, with pharyngeal-laryngeal complaint. The material consisted of clinical histories and images obtained by laryngoscopies from protocols from the Larynx Institute-INLAR, Sao Paulo, Brazil, of 210 patients, 88 men and 122 women, aged more than 60 years, who had sought otorhinolaryngologic treatment. Indicative glottic characteristics of the presbylarynx, such as vocal fold bowing, prominence of vocal processes, and spindle-shaped glottic chink, were analyzed. The increase in mass, leukoplakia, and other vocal fold alterations, distinct from these two, grouped as miscellaneous, as well as the presence or absence of voice complaint were also analyzed. Vocal fold bowing, prominence of vocal processes, and spindle-shaped glottic chink showed a strong correlation among each other. The presence of presbylarynx was accompanied by less voice complaint than the presence of vocal fold mucosa alterations, which in turn are more common where an absence of presbylarynx exists.     

Voice source characteristics in six premier country singers

Voice source characteristics as derived from inverse filtering were analyzed in 6 country singers' speech and singing. Results showed that the closed quotient varied systematically with vocal loudness, and that glottal compliance (the ratio between transglottal AC volume displacement and subglottal pressure) decreased with increases in fundamental frequency but remained unaffected by vocal loudness. No striking differences were found in source characteristics between speech and singing within subjects. The degree of phonatory press, as judged by a panel of 19 expert listeners, appeared related to the range in which the singer was singing and to the sound pressure level gain from a doubling of subglottal pressure.     

Documenting laryngeal change following prolonged loud reading: A videostroboscopic study

This study investigated the effects of prolonged loud reading on trained and untrained subjects. Subjects were eight young women singers, and eight young women with limited musical experience. Each subject underwent videostroboscopic examination prior to and following 1 h of prolonged loud reading. The pretest and posttest videotaped samples were randomized and presented to three experienced judges, who evaluated various aspects of laryngeal appearance and vibratory characteristics. Analyses of group data revealed that untrained subjects showed a small but significant increase in amplitude of vocal fold excursion following the experimental task. No significant differences were noted in the trained singer group. When individual variation was analyzed, it was found that most subjects did not show many changes from pretest to posttest. It was concluded that a l-h loud-reading task was not sufficient to induce notable laryngeal alterations     

Thyroplasty revisions: frequency and predictive factors

Thyroplasty is the most commonly performed type of laryngeal framework surgery, and the surgical indications are gradually being expanded. Although many reports have described thyroplasty results and rates of success, no study has attempted to determine predictors of the need for revisions or other secondary surgical procedures. METHODS: Retrospective review of 118 primary thyroplasty procedures performed on 96 patients. Secondary surgical procedures were divided into planned second-stage procedures (all fat implantation due to scarring), touchup procedures (primarily fat or collagen injections to close localized glottic gaps), and thyroplasty revisions (for implant extrusion or slippage). Statistical analysis was performed via the chi-squared technique with p < 0.05 considered significant. RESULTS: 96 patients underwent thyroplasty, 58 for vocal fold paresis or paralysis and 38 for other indications. Thirty-two (33%) patients underwent secondary surgical procedures, including 4 planned second stage procedures, and 6 patients with progression of their underlying disease. Thirty-two secondary procedures were performed in the other 22 patients. Professional singers were found to be more likely to require touchup or planned second-stage procedures (p = 0.029). Patients with abnormal preoperative noise-toharmonic ratios were more likely to undergo secondary surgeries (p = 0.039). Maximum phonation time was not associated with need for secondary surgery. Implant material did not influence revision rates. CONCLUSIONS: Professional singers and those patients with severe voice disorders (as measured by more abnormal noise-to-harmonic ratios) are more likely to undergo secondary surgical procedures. The choice of implant material does not affect need for secondary surgical procedures.