Endolaryngeal changes during high-intensity phonation videolaryngoscopic observations

Describing the Acoustic and Vocal Production Characteristics of the Irrintzi: Feasibility of Its Use for the Treatment of Voice Disorders

PURPOSE

The aims of this study were to analyze and characterize the irrintzi (a folkloric shout emitted in a single breath used by the Basque people) acoustically and to describe the mechanism by which it is emitted.

METHOD

Thirty-six sound samples of 12 female volunteers were analyzed. Acoustic analysis included primarily fundamental frequency (f _o), spectral analysis in the time domain with a narrowband filter, and the use of linear predictive coding (LPC). Laryngeal and pharyngeal movements while emitting an irrintzi were studied by fiberoptic nasal endoscopy. Postural and mandible movements were observed and video recorded. Movements of the larynx and the vocal tract were also studied by lateral pharyngo-laryngeal radioscopy.

RESULTS

The central part of an irrintzi spectrogram contains a peculiar, repeated M-shaped motif unseen in the spectrogram of any other human vocal emission, and intensity was over 90 dB SPL in all cases. f _o was very high (1487 Hz) especially at the end of the irrintzi. Fiberoptic nasal endoscopy consistently revealed considerable elevation of the glottis, with the larynx swinging forward and retraction of the ventricular bands. Lateral radioscopy showed a very high larynx and a high tongue dorsum.

CONCLUSIONS

The irrintzi is a sound emitted in a single breath and characterized by its shrillness and loudness, qualities that make it audible in noisy environments and over large distances and the vocal technique observed when it is produced can be explained by the Estill voice model (Steinhauer et al., 2017). The use of this technique may help in the treatment of voice disorders and improve efficiency in singers, teachers, actors, and people who use their voice at high volume or at high frequency.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20779405.

The Nasal Musculature as a Control Panel for Singing-Why Classical Singers Use a Special Facial Expression?

OBJECTIVES

This study aimed to explain the possible reason why classical singers seem to spread their nostrils and raise their cheeks before starting to sing.

STUDY DESIGN

This is an experimental study.

METHODS

Five subjects (three classical singers, two nonsingers) were investigated with nasofiberoscopy holding their breath after inhalation. The subjects were instructed to have a neutral expression first and then to take the singers' expression characterized by nostril flaring. In case of nonsingers, the special expression was rehearsed beforehand, guided by a classical singer. The following measurements were made: (1) height of soft palate, (2) area of the hypopharynx, (3) area of the epilaryngeal tube inlet (Aditus laryngis), and (4) dimensions of the (visible) glottis (length, width, and length-to-width ratio).

RESULTS

All subjects raised the palate and widened the pharyngeal inlet, epilaryngeal inlet, and the glottis during "singer's expression."

CONCLUSIONS

The results suggest that classical singers may take advantage of breathing- and smelling-related connections between nasal and facial muscles and the larynx to avoid a hard glottal attack and pressed phonation and possibly also to assist the production of mixed register (head voice), characterized by a relatively low adduction between the vocal folds.

Are Instructions to Manipulate Specific Parameters of Laryngeal Function Associated with Auditory-Perceptual Ratings of Voice Quality in Nondisordered Speakers?

OBJECTIVES/HYPOTHESIS

This preliminary study investigated whether auditory-perceptual judgments of voice quality by experienced speech language pathologists were associated with instructions given to speakers to manipulate specific laryngeal postures.

STUDY DESIGN

Experimental, within-subject design.

METHODS

Nine speakers were instructed and trained to manipulate three vocal parameters implicated in functional voice disorders-false vocal fold constriction, vocal fold mass, and larynx height-while reading a standard passage. Experienced judges rated these standard passages in terms of the widely used perceptual voice qualities breathiness, roughness, vocal strain, glottal fry, tone onset, tone color, loudness, and pitch.

RESULTS

Between-subject factorial analysis of variance, controlling for judge unreliability, revealed some evidence that perceptual judgments are strongly associated with underlying laryngeal muscle activity that can then serve clinical planning of goals for intervention. Eta² effect sizes were large for all dependent measures, ranging from 0.39 for pitch to 0.77 for strained.

CONCLUSIONS

Although these results are encouraging, they were obtained under ideal conditions. Further research is warranted.

Nonspeech Oral Movements and Oral Motor Disorders: A Narrative Review

PURPOSE

Speech and other oral functions such as swallowing have been compared and contrasted with oral behaviors variously labeled quasispeech, paraspeech, speechlike, and nonspeech, all of which overlap to some degree in neural control, muscles deployed, and movements performed. Efforts to understand the relationships among these behaviors are hindered by the lack of explicit and widely accepted definitions. This review article offers definitions and taxonomies for nonspeech oral movements and for diverse speaking tasks, both overt and covert.

METHOD

Review of the literature included searches of Medline, Google Scholar, HighWire Press, and various online sources. Search terms pertained to speech, quasispeech, paraspeech, speechlike, and nonspeech oral movements. Searches also were carried out for associated terms in oral biology, craniofacial physiology, and motor control.

RESULTS AND CONCLUSIONS

Nonspeech movements have a broad spectrum of clinical applications, including developmental speech and language disorders, motor speech disorders, feeding and swallowing difficulties, obstructive sleep apnea syndrome, trismus, and tardive stereotypies. The role and benefit of nonspeech oral movements are controversial in many oral motor disorders. It is argued that the clinical value of these movements can be elucidated through careful definitions and task descriptions such as those proposed in this review article.

Differentiated vocal tract control and the reliability of interpretations of nasendoscopic assessment

Training specific vocal techniques can be effective in treating nonorganic dysphonias. Evaluation of vocal function in these studies has included auditory-perceptual assessment, aerodynamic measurement, acoustic analysis, self-report, and visual inspection of the larynx. Reliability of judgments made using visual rating tools for nasendoscopic and videostroboscopic visualization of the larynx when diagnosing vocal function and disorder has been the focus of previous research. However, detailed analysis of factors that affect reliability and consistency of perceptual ratings of laryngoscopic footage has not been investigated in voice therapy outcome studies. This study evaluated clinicians' judgments of the effectiveness of training differentiated vocal tract control of false vocal fold activity (FVFA), true vocal fold mass (TVFM) and larynx height (LH). A within-subject, experimental design was used to assess participants' mastery in manipulating FVFA, TVFM, and LH assessed via laryngoscopic visualization of the larynx. Three experienced speech pathologists rated the nasendoscopy footage with accompanying acoustic recordings of 12 speakers. Intrajudge consistency, interjudge reliability, and interjudge agreement of perceptual ratings were investigated. Twelve vocally trained unimpaired speakers used differentiated biomechanical manipulation of various laryngeal muscles to produce eight specific vocal qualities each. These manipulated vocal qualities were rated by three experienced voice clinicians who demonstrated higher levels of intrajudge consistency and interjudge agreement when identifying rather than quantifying the degree of a voice quality based on their visual and auditory perceptions of the different vocal features. The findings suggest that unimpaired speakers can be trained successfully to manipulate and change individual biomechanical aspects of their vocal functions as demonstrated by the visual- and auditory-perceptual judgments of expert voice clinicians. These judgments are vulnerable to issues of reliability and suggests that judges used auditory-perceptual judgments when interpreting laryngoscopic footage, particularly when the view of laryngeal features is compromised.