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Self-sustained vocal fold vibration is possible with either or both of two mechanisms: (1) a mucosal wave propagating along the medial surface of the vocal folds and (2) a vocal tract that offers inertive reactance. A quantitative comparison shows the mucosal wave mechanism has a lower threshold pressure and a higher glottal efficiency, but the supraglottal inertance mechanism can assist in the oscillation and is effective in optimizing the two mechanisms. It is concluded that optimal parameters are a mucosal wave velocity on the order of 1 m/s and a diameter of the larynx canal (epilarynx tube) on the order of 0.8 cm.

Steady airflow resistances in semi-occluded airways as well as acoustic impedances in vocalization are quantified from the lungs to the lips. For clinical and voice training applications, the primary focus is on two airway conditions, an oral semi-occlusion and a semi-occlusion above the vocal folds. Laryngeal airflow resistance is divided into glottal airflow resistance and epilaryngeal airway resistance. Maximum aerodynamic power is transferred to the vocal tract if the glottal airflow resistance is reduced while the epilaryngeal airway resistance is increased. A semi-occlusion at the lips helps to set up this condition. For the acoustic power transfer, the epilaryngeal airway also serves to match the impedance of the source to the impedance of the vocal tract.

Objective Most type 1 thyroplasty implants and some common injectable materials are mechanically stiff. Placing them close to the supple vocal fold mucosa can potentially dampen vibration and adversely impact phonation, yet this effect has not been systematically investigated. This study aims to examine the effect of implant depth on vocal fold vibration and vocal output. Study design Computational simulation. Methods Voice production was simulated with a fiber-gel finite element computational model that incorporates a three-layer vocal fold composition (superficial lamina propria, vocal ligament, thyroarytenoid muscle). Implants of various depths were simulated, with a "deeper" or more medial implant positioned closer to the vocal fold mucosa and replacing more muscle elements. Trajectories of surface and within-tissue nodal points during vibration were produced. Outcome measures were the trajectory radii, fundamental frequency (F0 ), sound pressure level (SPL), and smoothed cepstral peak prominence (CPPS) as a function of implant depth. Results Amplitude of vibration at the vocal fold medial surface was reduced by an implant depth of as little as 14% of the total transverse vocal fold depth. Increase in F0 and decrease in CPPS were noted beyond 30% to 40% implant depth, and SPL decreased beyond 40% to 60% implant depth. Conclusions Commonly used implants can dampen vibration "from a distance," ie, even without being immediately adjacent to vocal fold mucosa. Since implants are typically placed at depths examined in this study, stiff implants likely have a negative vocal impact in a subset of patients. Softer materials may be preferable, especially in bilateral medialization procedures. Level of evidence N/A Laryngoscope, 130:2192-2198, 2020.

The effective depth of vocal fold vibration is self-regulated and generally not known a priori in vocalization. In this study, the effective depth was quantified systematically under various phonatory conditions using a fiber-gel finite element vocal fold model. The horizontal and vertical excursions of each finite element nodal point trajectory were recorded to compute trajectory areas. The extent of vibration was then studied based on the variation of trajectory radii as a function of depth in several coronal sections along the anterior-posterior direction. The results suggested that the vocal fold nodal trajectory excursions decrease systematically as a function of depth but are affected by the layered structure of the vocal folds. The effective depth of vibration was found to range between 15 and 55% of the total anatomical depth across all phonatory conditions. The nodal trajectories from the current study were compared qualitatively with the results from excised human hemi-larynx experiments published in Döllinger and Berry [(2006). J. Voice. 20(3), 401-413]. An estimate of the effective mass of a one-mass vocal fold model was also computed based on the effective depth of vibration observed in this study under various phonatory conditions.

Objective This investigation addressed the desirable source–airway interaction obtained with vocalization through a semi-occlusion at the mouth. The semi-occlusion was a flow-resistant tube of varying length and diameter. Method The methodology was strictly computational. Airway shapes resembling those obtained from magnetic resonance or computed tomography imaging were stylized. Supraglottal and subglottal acoustic impedances were calculated, from which inertagrams were plotted over a frequency range of 0–4000 Hz. The inertagrams predict which harmonics are likely to be strengthened. Results The combination of epilaryngeal airway narrowing and lengthening, a pharyngeal expansion, and an oral narrowing behind the tube produce the best overall inertagram for pitch glide exercises. This configuration supports harmonics of the source evenly over a range of 300–4000 Hz. Conclusions For clinical applications, theory predicts that the length of a tube or straw does not matter if the inner diameter is on the order of 3 mm or less. For wider open-ended tubes, greater length can compensate for the wider diameter for the beneficial inertance effect, but the desired steady pressure in the airways for vocal fold posturing cannot be maintained.

A fiber-gel vocal fold model is compared to a transversely isotropic stiffness model in terms of normal mode vibration. The fiber-gel finite element model (FG-FEM) consists of a series of gel slices, each with a two-dimensional finite element mesh, in a plane transverse to the tissue fibers. The gel slices are coupled with fibers under tension in the anterior-posterior dimension. No vibrational displacement in the fiber-length direction is allowed, resulting in a plane strain state. This is consistent with the assumption of transverse displacement of a simple string, offering a wide range of natural frequencies (well into the kHz region) with variable tension. For low frequencies, the results compare favorably with the natural frequencies of a transversely isotropic elastic stiffness model (TISM) in which the shear modulus in the longitudinal plane is used to approximate the effect of fiber tension. For high frequencies, however, the natural frequencies do not approach the string mode frequencies unless plane strain is imposed on the TISM model. The simplifying assumption of plane strain, as well as the use of analytical closed-form shape functions, allow for substantial savings in computational time, which is important in clinical and exploratory applications of the FG-FEM model.

Summary Purpose Speech has been hailed as unique to human evolution. Although the inventory of distinct sounds producible with vocal tract articulators is a great advantage in human oral communication, it is argued here that the larynx as a sound source in speech is limited in its range and capability because a low fundamental frequency is ideal for phonemic intelligibility and source-filter independence. Method Four existing data sets were combined to make an argument regarding exclusive use of the larynx for speech: (1) range of fundamental frequency, (2) laryngeal muscle activation, (3) vocal fold length in relation to sarcomere length of the major laryngeal muscles, and (4) vocal fold morphological development. Results Limited data support the notion that speech tends to produce a contracture of the larynx. The morphological design of the human vocal folds, like that of primates and other mammals, appears to be optimized for vocal communication over distances for which higher fundamental frequency, higher intensity, and fewer unvoiced segments are used. Conclusion The positive message is that raising one's voice to call, shout, or sing, or executing pitch glides to stretch the vocal folds, can counteract this trend toward a contracted state.

Mechanical stimulation of cell cultures has been shown be an effective means of enhancing ECM production. ECM produced from vocal fold fibroblast cultures has the potential for therapeutic use for vocal fold repair. However, current bioreactor designs generally fail to produce physiological relevant frequency and strain values. Here we present an approach for using commercial oscillatory rheometers and an elastic ring bilayer system to produce physiologically relevant strain values at frequencies in the range of 20 – 100HZ. We demonstrate the ability to target specific strain and frequency values by manipulating system parameters, and also show that it is possible to maintain high oscillatory strains for extended periods of time. Such a system could be used to mechanically stimulate cell cultures contained within gel carrier systems and has the potential to be extended to other applications requiring high strains at low frequencies.

Summary Source-filter interaction is a phenomenon in which acoustic airway pressures influence the glottal airflow at the source (level 1) and the vibration pattern of the vocal folds (level 2). This interaction is most significant when dominant source harmonics are near airway resonances. The influence of acoustic airway pressures on vocal fold vibration (level 2) was studied systematically by changing the supraglottal vocal tract length in human subjects with tube extensions. The subjects were asked to perform fundamental frequency (fo) glides while phonating through tubes of various lengths. An algorithm was developed using the quasi-open quotient extracted from the electroglottograph. Regions of sudden vocal fold vibration pattern change due to source-filter interaction were inferred from contact area changes. The algorithm correctly identified 89% of male and 84.8% of female quantal changes in contact pattern associated with interactions between source harmonics and formants during ascending glides. During the descending glides, the algorithm correctly identified 84% of male and 81.1% of female quantal changes in contact pattern. These results are in comparison with those obtained from the fo-based algorithm (Maxfield et al).

Hydration of vocal fold tissues is essential for self-sustained oscillation. Normal regulatory processes of liquid transport to and from the vocal folds would be expected through the autonomic systems, but the possibility exists that liquid movement may occur locally due to vibrational pressures. Such movement may cause regions of lower or higher concentrations of liquid viscosity and therewith changes in phonation threshold pressure. Hyaluronic acid, a glycosaminoglycan that attracts large quantities of free water, may be a key molecule for transporting or localizing liquids. Some preliminary experiments are reported in which attempts were made to move low-concentration HA liquids with vibration. None of the experiments was conclusive, but collectively they lay some groundwork for future explorations.

Intraglottal pressure is the driving force of vocal fold vibration. Theoretically, simultaneous quantification of glottal area and transglottal airflow allows the calculation of the intraglottal pressure waveform during a single vibration cycle. In this study, we show that, by combining photoglottography (transglottal light transmission) and airflow (Rothenberg mask) measurements during sustained vocal emissions in vivo, the intraglottal pressure wave can be approximated in a way similar to what has been done in models. The results confirm in vivo that the intraglottal pressure is systematically larger during the opening phase than during the closing phase, so that over one whole cycle, the driving force performs net positive work, accounting for sustained vocal fold motion. A component of this driving force asymmetry is related to vocal tract inertance, which also accounts for the skewing of the airflow waveform compared with the area waveform. Furthermore, the intraglottal pressure ratio (opening:closing) increases with voicing intensity, reaches a maximum around 76 dB, and significantly decreases at higher intensities. This rise and fall suggests that there is a range of intensity values in which, mechanically, a maximum of the driving force is imparted to the vocal fold mass. This finding could have implications for voice economy in professional speakers.

The traditional source-filter theory of voice production describes a linear relationship between the source (glottal flow pulse) and the filter (vocal tract). Such a linear relationship does not allow for nor explain how changes in the filter may impact the stability and regularity of the source. The objective of this experiment was to examine what effect unpredictable changes to vocal tract dimensions could have on fo stability and individual harmonic intensities in situations in which low frequency harmonics cross formants in a fundamental frequency glide. To determine these effects, eight human subjects (five male, three female) were recorded producing fo glides while their vocal tracts were artificially lengthened by a section of vinyl tubing inserted into the mouth. It was hypothesized that if the source and filter operated as a purely linear system, harmonic intensities would increase and decrease at nearly the same rates as they passed through a formant bandwidth, resulting in a relatively symmetric peak on an intensity-time contour. Additionally, fo stability should not be predictably perturbed by formant/harmonic crossings in a linear system. Acoustic analysis of these recordings, however, revealed that harmonic intensity peaks were asymmetric in 76% of cases, and that 85% of fo instabilities aligned with a crossing of one of the first four harmonics with the first three formants. These results provide further evidence that nonlinear dynamics in the source-filter relationship can impact fo stability as well as harmonic intensities as harmonics cross through formant bandwidths.

Vocal folds are used as sound sources in various species, but it is unknown how vocal fold morphologies are optimized for different acoustic objectives. Here we identify two main variables affecting range of vocal fold vibration frequency, namely vocal fold elongation and tissue fiber stress. A simple vibrating string model is used to predict fundamental frequency ranges across species of different vocal fold sizes. While average fundamental frequency is predominantly determined by vocal fold length (larynx size), range of fundamental frequency is facilitated by (1) laryngeal muscles that control elongation and by (2) nonlinearity in tissue fiber tension. One adaptation that would increase fundamental frequency range is greater freedom in joint rotation or gliding of two cartilages (thyroid and cricoid), so that vocal fold length change is maximized. Alternatively, tissue layers can develop to bear a disproportionate fiber tension (i.e., a ligament with high density collagen fibers), increasing the fundamental frequency range and thereby vocal versatility. The range of fundamental frequency across species is thus not simply one-dimensional, but can be conceptualized as the dependent variable in a multi-dimensional morphospace. In humans, this could allow for variations that could be clinically important for voice therapy and vocal fold repair. Alternative solutions could also have importance in vocal training for singing and other highly-skilled vocalizations., Author Summary Mammals, birds, and reptiles vocalize (make sounds with vocal cords). Various species, and individuals within the species, are identified by pitch, loudness, and other acoustic features they can build into a repertoire of rhythmic and melodic patterns. Range of pitch, or more precisely fundamental frequency, is required to produce a variety of patterns. Whereas the average fundamental frequency is predictable by body size, the range of fundamental frequency depends on two different factors. The first is a freedom of movement factor–how much vocal cord length change can be produced by muscles that rotate or glide cartilages in the larynx. The second is a molecular composition factor–how much collagen density can be produced in the vocal cord ligament. Development and evolution has not been uniform with regard to these factors, suggesting that alternative choices are available for growth, training, and repair.

The authors test the hypothesis that vocal fold morphology and biomechanical properties covary with species-specific vocal function. They investigate mule deer (Odocoileus hemionus) vocal folds, building on, and extending data on a related cervid, the Rocky Mountain elk (Cervus elaphus nelsoni). The mule deer, in contrast to the elk, is a species with relatively little vocal activity in adult animals. Mule deer and elk vocal folds show the typical three components of the mammalian vocal fold (epithelium, lamina propria and thyroarytenoid muscle). The vocal fold epithelium and the lamina propria were investigated in two sets of tensile tests. First, creep rupture tests demonstrated that ultimate stress in mule deer lamina propria is of the same magnitude as in elk. Second, cyclic loading tests revealed similar elastic moduli for the vocal fold epithelium in mule deer and elk. The elastic modulus of the lamina propria is also similar between the two species in the low-strain region, but differs at strains larger than 0.3. Sex differences in the stress–strain response, which have been reported for elk and human vocal folds, were not found for mule deer vocal folds. The laminae propriae in mule deer and elk vocal folds are comparatively large. In general, a thick and uniformly stiff lamina propria does not self-oscillate well, even when high subglottic pressure is applied. If the less stiff vocal fold seen in elk is associated with a differentiated lamina propria it would allow the vocal fold to vibrate at high tension and high subglottic pressure. The results of this study support the hypothesis that viscoelastic properties of vocal folds varies with function and vocal behavior. J. Morphol., 2010. © 2009 Wiley-Liss, Inc.

SUMMARY The vocal folds of male Rocky Mountain elk (Cervus elaphus nelsoni) are about 3 cm long. If fundamental frequency were to be predicted by a simple vibrating string formula, as is often done for the human larynx, such long vocal folds would bear enormous stress to produce the species-specific mating call with an average fundamental frequency of 1 kHz. Predictions would be closer to 50 Hz. Vocal fold histology revealed the presence of a large vocal ligament between the vocal fold epithelium and the thyroarytenoid muscle. In tensile tests, the stress–strain response of vocal fold epithelium and the vocal ligament were determined. Elasticity of both tissue structures reached quantitative values similar to human tissue. It seems unlikely that the longitudinal stress in elk vocal folds can exceed that in human vocal folds by an order of magnitude to overcome the drop in fundamental frequency due to a 3:1 increase in vocal fold length. Alternative hypotheses of how the elk produces high fundamental frequency utterances,despite its very long vocal fold, include a reduced effective vocal fold length in vibration, either due to bending properties along the vocal fold, or by actively moving the boundary point with muscle stiffening. The relationships between an individual's average fundamental frequency, vocal fold length and body size are discussed.

A theory of interaction between the source of sound in phonation and the vocal tract filter is developed. The degree of interaction is controlled by the cross-sectional area of the laryngeal vestibule (epilarynx tube), which raises the inertive reactance of the supraglottal vocal tract. Both subglottal and supraglottal reactances can enhance the driving pressures of the vocal folds and the glottal flow, thereby increasing the energy level at the source. The theory predicts that instabilities in vibration modes may occur when harmonics pass through formants during pitch or vowel changes. Unlike in most musical instruments (e.g., woodwinds and brasses), a stable harmonic source spectrum is not obtained by tuning harmonics to vocal tract resonances, but rather by placing harmonics into favorable reactance regions. This allows for positive reinforcement of the harmonics by supraglottal inertive reactance (and to a lesser degree by subglottal compliant reactance) without the risk of instability. The traditional linear source–filter theory is encumbered with possible inconsistencies in the glottal flow spectrum, which is shown to be influenced by interaction. In addition, the linear theory does not predict bifurcations in the dynamical behavior of vocal fold vibration due to acoustic loading by the vocal tract.

Nonlinear source-filter coupling has been demonstrated in computer simulations, in excised larynx experiments, and in physical models, but not in a consistent and unequivocal way in natural human phonations. Eighteen subjects (nine adult males and nine adult females) performed three vocal exercises that represented a combination of various fundamental frequency and formant glides. The goal of this study was to pinpoint the proportion of source instabilities that are due to nonlinear source-tract coupling. It was hypothesized that vocal fold vibration is maximally destabilized when F(0) crosses F(1), where the acoustic load changes dramatically. A companion paper provides the theoretical underpinnings. Expected manifestations of a source-filter interaction were sudden frequency jumps, subharmonic generation, or chaotic vocal fold vibrations that coincide with F(0)-F(1) crossovers. Results indicated that the bifurcations occur more often in phonations with F(0)-F(1) crossovers, suggesting that nonlinear source-filter coupling is partly responsible for source instabilities. Furthermore it was observed that male subjects show more bifurcations in phonations with F(0)-F(1) crossovers, presumably because in normal speech they are less likely to encounter these crossovers as much as females and hence have less practice in suppressing unwanted instabilities.

The nonlinear viscoelastic passive properties of three canine intrinsic laryngeal muscles, the lateral cricoarytenoid (LCA), the posterior cricoarytenoid (PCA), and the interarytenoid (IA), were fit to the parameters of a modified Kelvin model. These properties were compared with those of the thyroarytenoid (TA) and cricothyroid (CT) muscles, as well as previously unpublished viscoelastic characteristics of the human vocal ligament. Passive parameters of the modified Kelvin model were summarized for the vocal ligament, mucosa, and all five laryngeal muscles. Results suggest that the LCA, PCA, and IA muscles are functionally different from the TA and CT muscles in their load-bearing capacity. Furthermore, the LCA, PCA, and IA have a much larger stress-strain hysteresis effect than has been previously reported for the TA and CT or the vocal ligament. The variation in this effect suggests that the connective tissue within the TA and CT muscles is somehow similar to the vocal ligament but different from the LCA, PCA, or IA muscles. Further demonstrating the potential significance of grouping tissues in the laryngeal system by functional groups in the laryngeal system was the unique finding that, over their working elongation range, the LCA and PCA were nearly as exponentially stiff as the vocal ligament. This paper was written in conjunction with an online technical report ( http://www.ncvs.org/ncvs/library/tech ) in which comprehensive muscle data and sensitivity analysis, as well as downloadable data files and computer scripts, are made available.

The forces and torques governing effective two-dimensional (2D) translation and rotation of the laryngeal cartilages (cricoid, thyroid, and arytenoids) are quantified on the basis of more complex three-dimensional movement. The motions between these cartilages define the elongation and adduction (collectively referred to as posturing) of the vocal folds. Activations of the five intrinsic laryngeal muscles, the cricothyroid, thyroarytenoid, lateral cricoarytenoid, posterior cricoarytenoid, and interarytenoid are programmed as inputs, in isolation and in combination, to produce the dynamics of 2D posturing. Parameters for the muscles are maximum active stress, passive stress, activation time, contraction time, and maximum shortening velocity. The model accepts measured electromyographic signals as inputs. A repeated adductory-abductory gesture in the form /hi-hi-hi-hi-hi/ is modeled with electromyographic inputs. Movement and acoustic outputs are compared between simulation and measurement.

Voiced obstruents and phonation into tubes are widely used as vocal exercises. They increase the inertive reactance of the vocal tract in the 200-1000 Hz range and thereby reinforce vocal fold vibration. But the effect is strong only when the epilarynx tube is also narrowed. The present study focused on the effects of a 'resonance tube' (27 cm in length, 0.5 cm2 cross-sectional area, hard walls) on vocal tract reactance and the accompanying economy of voice production (defined as maximum flow declination rate (MFDR), divided by maximum area declination rate (MADR)). The vowel /u/ and phonation into the tube were simulated with a computer model. Three values were given to the cross-sectional area of the epilarynx tube (0.2 cm2, 0.5 cm2, and 1.6 cm2), which is at the opposite end of the vocal tract from the artificial 'resonance tube'. The degree of glottal adduction was varied in order to find the economy maximum for each epilarynx tube setting. Results showed that the 'resonance tube' lowered F1 from 300 Hz to 150 Hz and doubled the vocal tract inertive reactance at F0=100 Hz. The largest economy with the 'resonance tube' was obtained when the epilarynx tube was narrowed (relative to the rest of the vocal tract) and sufficiently tight adduction was used. Most importantly, the intraoral acoustic pressure (calculated at 0.8 cm behind the lips) was tripled with the tube. The results suggest that by optimizing the vibratory sensations in the face that are attributed to increased intraoral acoustic pressure, phonation into a tube may assist a trainee in finding an optimal glottal and epilaryngeal setting for the greatest vocal economy.

To test the hypothesis that subligamental cordectomy produces superior acoustic outcome than subepithelial cordectomy for early (T1-2) glottic cancer that requires complete removal of the superficial lamina propria but does not involve the vocal ligament.Computer simulation.A computational tool for vocal fold surgical planning and simulation (the National Center for Voice and Speech Phonosurgery Optimizer-Simulator) was used to evaluate the acoustic output of alternative vocal fold morphologies. Four morphologies were simulated: normal, subepithelial cordectomy, subligamental cordectomy, and transligamental cordectomy (partial ligament resection). The primary outcome measure was the range of fundamental frequency (F0 ) and sound pressure level (SPL). A more restricted F0 -SPL range was considered less favorable because of reduced acoustic possibilities given the same range of driving subglottic pressure and identical vocal fold posturing.Subligamental cordectomy generated solutions covering an F0 -SPL range 82% of normal for a rectangular vocal fold. In contrast, transligamental and subepithelial cordectomies produced significantly smaller F0 -SPL ranges, 57% and 19% of normal, respectively.This study illustrates the use of the Phonosurgery Optimizer-Simulator to test a specific hypothesis regarding the merits of two surgical alternatives. These simulation results provide theoretical support for vocal ligament excision with maximum muscle preservation when superficial lamina propria resection is necessary but the vocal ligament can be spared on oncological grounds. The resection of more tissue may paradoxically allow the eventual recovery of a better speaking voice, assuming glottal width is restored. Application of this conclusion to surgical practice will require confirmatory clinical data.N/A.

The human vocal folds are a complex layering of cells and extracellular matrix. Vocal fold extracellular matrix uniquely contributes to the biomechanical viscoelasticity required for human phonation. We investigated the adhesion of vocal fold stellate cells, a novel cell type first cultured by our laboratory, and fibroblasts to eight vocal fold extracellular matrix components: elastin, decorin, fibronectin, hyaluronic acid, laminin and collagen types I, III and IV. Our data demonstrate that these cells adhere differentially to said substrates at 5 to 120 min. Cells were treated with hyaluronidase and Y-27632, a p160ROCK-specific inhibitor, to test the role of pericellular hyaluronan and Rho-ROCK activation in early and mature adhesion. Reduced adhesion resulted; greater inhibition of fibroblast adhesion was observed. We modulated the fibronectin affinity exhibited by both cell types using Nimesulide, an inhibitor of fibronectin integrin receptors alpha5beta1 and alphavbeta3. Our results are important in understanding vocal fold pathologies, wound healing, scarring, and in developing an accurate organotypic model of the vocal folds.

Analytical and computer simulation studies have shown that the acoustic impedance of the vocal tract as well as the viscoelastic properties of vocal foldtissues are critical for determining the dynamics and the energy transfer mechanism of vocal fold oscillation. In the present study, a linear, small-amplitude oscillation theory was revised by taking into account the propagation of a mucosal wave and the inertive reactance (inertance) of the supraglottal vocal tract as the major energy transfer mechanisms for flow-induced self-oscillation of the vocal fold. Specifically, analytical results predicted that phonation threshold pressure ( P th ) increases with the viscous shear properties of the vocal fold, but decreases with vocal tract inertance. This theory was empirically tested using a physical model of the larynx, where biological materials (fat, hyaluronic acid, and fibronectin) were implanted into the vocal fold cover to investigate the effect of vocal foldtissueviscoelasticity on P th . A uniform-tube supraglottal vocal tract was also introduced to examine the effect of vocal tract inertance on P th . Results showed that P th decreased with the inertive impedance of the vocal tract and increased with the viscous shear modulus ( G ″ ) or dynamic viscosity ( η ′ ) of the vocal fold cover, consistent with theoretical predictions. These findings supported the potential biomechanical benefits of hyaluronic acid as a surgical bioimplant for repairing voice disorders involving the superficial layer of the lamina propria, such as scarring, sulcus vocalis, atrophy, and Reinke’s edema.

Purpose Voice therapy with a semi-occluded vocal tract has a long history. The use of lip trills, tongue trills, bilabial fricatives, humming, and phonation into tubes or straws has been hailed by clinicians, singing teachers, and voice coaches as efficacious for training and rehabilitation. Little has been done, however, to provide the scientific underpinnings. The purpose of the study was to investigate the underlying physical principles behind the training and therapy approaches that use semi-occluded vocal tract shapes. Method Computer simulation, with a self-oscillating vocal fold model and a 44 section vocal tract, was used to elucidate source–filter interactions for lip and epilarynx tube semi-occlusions. Results A semi-occlusion in the front of the vocal tract (at the lips) heightens source–tract interaction by raising the mean supraglottal and intraglottal pressures. Impedance matching by vocal fold adduction and epilarynx tube narrowing can then make the voice more efficient and more economic (in terms of tissue collision). Conclusion The efficacious effects of a lip semi-occlusion can also be realized for nonoccluded vocal tracts by a combination of vocal fold adduction and epilarynx tube adjustments. It is reasoned that therapy approaches are designed to match the glottal impedance to the input impedance of the vocal tract.

Active and passive characteristics of the canine adductor- abductor muscles were investigated through a series of experiments conducted in vitro. Samples of canine posterior cricoarytenoid muscle (PCA), lateral cricoarytenoid muscle (LCA), and interarytenoid muscle (IA) were dissected from dog larynges excised a few minutes before death and kept in Krebs-Ringer solution at a temperature of 37 degrees C +/- 1 degree C and a pH of 7.4 +/- 0.05. Active twitch and tetanic force was obtained in an isometric condition by applying field stimulation to the muscle samples through a pair of parallel-plate platinum electrodes. Force and elongation of the samples were obtained electronically with a dual-servo system (ergometer). The results indicate that the twitch contraction times of the three muscles are very similar, with the average of 32 +/- 1.9 ms for PCA, 29 +/- 1.6 ms for LCA, and 32 +/- 2.4 ms for IA across all elongations. Thus, PCA, LCA, and IA muscles are all faster than the cricothyroid (CT) muscles but slower than the thyroarytenoid (TA) muscles. The tetanic force response times of these muscles are also similar, with a maximum rate of force increase of 0.14 N/ms.

An interactive source-filter system, consisting of a three-mass body-cover model of the vocal folds and a wave reflection model of the vocal tract, was used to test the dependence of vocal fold vibration on the vocal tract. The degree of interaction is governed by the epilarynx tube, which raises the vocal tract impedance to match the impedance of the glottis. The key component of the impedance is inertive reactance. Whenever there is inertive reactance, the vocal tract assists the vocal folds in vibration. The amplitude of vibration and the glottal flow can more than double, and the oral radiated power can increase up to 10 dB. As F0 approaches F1, the first formant frequency, the interactive source-filter system loses its advantage (because inertive reactance changes to compliant reactance) and the noninteractive system produces greater vocal output. Thus, from a voice training and control standpoint, there may be reasons to operate the system in either interactive and noninteractive modes. The harmonics 2F0 and 3F0 can also benefit from being positioned slightly below F1.

A three-dimensional biomechanical model of tissue deformation was developed to simulate dynamic vocal fold abduction and adduction. The model was made of 1721 nearly incompressible finite elements. The cricoarytenoid joint was modeled as a rocking-sliding motion, similar to two concentric cylinders. The vocal ligament and the thyroarytenoid muscle's fiber characteristics were implemented as a fiber-gel composite made of an isotropic ground substance imbedded with fibers. These fibers had contractile and/or passive nonlinear stress-strain characteristics. The verification of the model was made by comparing the range and speed of motion to published vocal fold kinematic data. The model simulated abduction to a maximum glottal angle of about 31 degrees. Using the posterior-cricoarytenoid muscle, the model produced an angular abduction speed of 405 degrees per second. The system mechanics seemed to favor abduction over adduction in both peak speed and response time, even when all intrinsic muscle properties were kept identical. The model also verified the notion that the vocalis and muscularis portions of the thyroarytenoid muscle play significantly different roles in posturing, with the muscularis portion having the larger effect on arytenoid movement. Other insights into the mechanisms of abduction/adduction were given.

An experimental method for quantifying the amount of voicing over time is described in a tutorial manner. A new procedure for obtaining calibrated sound pressure levels (SPL) of speech from a head-mounted microphone is offered. An algorithm for voicing detection (kv) and fundamental frequency (F0) extraction from an electroglottographic signal is described. The extracted values of SPL, F0, and kv are used to derive five vocal doses: the time dose (total voicing time), the cycle dose (total number of vocal fold oscillatory cycles), the distance dose (total distance travelled by the vocal folds in an oscillatory path), the energy dissipation dose (total amount of heat energy dissipated in the vocal folds) and the radiated energy dose (total acoustic energy radiated from the mouth). The doses measure the vocal load and can be used for studying the effects of vocal fold tissue exposure to vibration.

It is common practice in laryngeal research laboratories to store excised larynges and vocal fold tissue specimens frozen, presumably to preserve viability and structural integrity of the specimens for physiologic and biomechanical experiments. However, little is known about the biomechanical effects of postmortem changes and frozen storage in vocal fold tissues. This study attempted to quantify the effects of postmortem changes and freezing on the viscoelastic shear properties of the canine vocal fold mucosa. Sixteen larynges were excised from adult dogs immediately postmortem in a viable state. Using a torsional rheometer, the complex shear modulus (G*) of the mucosal tissue from one vocal fold of each larynx was measured as a function of frequency (0.01–15 Hz) by linear small-amplitude oscillation experiments. Measurement was repeated for ten mucosal specimens after 24 h of postmortem storage in saline solution at room temperature. Eleven of the 16 larynges were frozen and stored at −20°C, six of them at a slow rate of cooling (storage in a regular freezer) and five others by quick freezing (chilling by liquid nitrogen prior to frozen storage). The larynges were thawed slowly overnight after one month and the viscoelastic shear properties of the contralateral vocal fold mucosa were measured. Results showed that the elastic shear modulus (G′) and dynamic viscosity (η ′) of the vocal fold mucosa did not seem to change significantly after 24 h of storage in saline at room temperature, nor after one month of frozen storage following quick freezing, whereas both G′ and η′ decreased significantly for tissues that were slowly frozen. These findings supported the feasibility of using quick freezing to preserve laryngeal tissues for in vitro biomechanical testing, for excised larynx experiments, and for tissue engineering applications. © 2003 Biomedical Engineering Society.

Vowel selection is important in differentiating between singing styles. The timbre of the vocal instrument, which is related to its frequency spectrum, is governed by both the glottal sound source and the vowel choices made by singers. Consequently, the ability to modify the vowel space is a measure of how successfully a singer can maintain a desired timbre across a range of pitches. Formant range profiles were produced as a means of quantifying this ability. Seventy-seven subjects (including trained and untrained vocalists) participated, producing vowels with three intended mouth shapes: (1) neutral or speech-like, (2) megaphone-shaped (wide open mouth), and (3) inverted-megaphone-shaped (widened oropharynx with moderate mouth opening). The first and second formant frequencies (F1 and F2) were estimated with fry phonation for each shape and values were plotted in F1-F2 space. By taking four vowels of a quadrangle /i, ae, a, u/, the resulting area was quantified in kHz2 (kHz squared) as a measure of the subject's ability to modify their vocal tract for spectral differences.

The origin of vocal registers has generally been attributed to differential activation of cricothyroid and thyroarytenoid muscles in the larynx. Register shifts, however, have also been shown to be affected by glottal pressures exerted on vocal fold surfaces, which can change with loudness, pitch, and vowel. Here it is shown computationally and with empirical data that intraglottal pressures can change abruptly when glottal adductory geometry is changed relatively smoothly from convergent to divergent. An intermediate shape between large convergence and large divergence, namely, a nearly rectangular glottal shape with almost parallel vocal fold surfaces, is associated with mixed registration. It can be less stable than either of the highly angular shapes unless transglottal pressure is reduced and upper stiffness of vocal fold tissues is balanced with lower stiffness. This intermediate state of adduction is desirable because it leads to a low phonation threshold pressure with moderate vocal fold collision. Achieving mixed registration consistently across wide ranges of F0, lung pressure, and vocal tract shapes appears to be a balancing act of coordinating laryngeal muscle activation with vocal tract pressures. Surprisingly, a large transglottal pressure is not facilitative in this process, exacerbating the bi-stable condition and the associated register contrast.

Morphological design and the relationship between form and function have great influence on the functionality of a biological organ. However, the simultaneous investigation of morphological diversity and function is difficult in complex natural systems. We have developed a multiobjective optimization (MOO) approach in association with cluster analysis to study the form-function relation in vocal folds. An evolutionary algorithm (NSGA-II) was used to integrate MOO with an existing finite element model of the laryngeal sound source. Vocal fold morphology parameters served as decision variables and acoustic requirements (fundamental frequency, sound pressure level) as objective functions. A two-layer and a three-layer vocal fold configuration were explored to produce the targeted acoustic requirements. The mutation and crossover parameters of the NSGA-II algorithm were chosen to maximize a hypervolume indicator. The results were expressed using cluster analysis and were validated against a brute force method. Results from the MOO and the brute force approaches were comparable. The MOO approach demonstrated greater resolution in the exploration of the morphological space. In association with cluster analysis, MOO can efficiently explore vocal fold functional morphology.

Objective: This study examined the influence of hyaluronic acid (HA) on the biomechanical properties of the human vocal fold cover (the superficial layer of the lamina propria). Study design: Vocal fold tissues were freshly excised from 5 adult male cadavers and were treated with bovine testicular hyaluronidase to selectively remove HA from the lamina propria extracellular matrix (ECM). Linear viscoelastic shear properties (elastic shear modulus and dynamic viscosity) of the tissue samples before and after enzymatic treatment were quantified as a function of frequency (0.01 to 15 Hz) by a parallel-plate rotational rheometer at 37°C. Results: On removing HA from the vocal fold ECM, the elastic shear modulus (G′ ) or stiffness of the vocal fold cover decreased by an average of around 35%, while the dynamic viscosity (η′) increased by 70% at higher frequencies (>1 Hz). Conclusion: The results suggested that HA plays an important role in determining the biomechanical properties of the vocal fold cover. As a highly hydrated glycosaminoglycan in the vocal fold ECM, it likely contributes to the maintenance of an optimal tissue viscosity that may facilitate phonation, and an optimal tissue stiffness that may be important for vocal fundamental frequency control. Significance: HA has been proposed as a potential bioimplant for the surgical repair of vocal fold ECM defects (eg, vocal fold scarring and sulcus vocalis). Our results suggested that such clinical use may be potentially optimal for voice production from a biomechanical perspective. (Otolaryngol Head Neck Surg 2001;124:607-14.)

The relation between subglottal pressure ( P s ) and fundamental frequency ( F 0 ) in phonation was investigated with an in vivo canine model. Direct muscle stimulation was used in addition to brain stimulation. This allowed the P s - F 0 slope to be quantified in terms of cricothyroid muscle activity. Results showed that, for ranges of 0–2 mA constant current stimulation of the cricothyroid muscle, the P s - F 0 slope ranged from 10 Hz/kPa to 60 Hz/kPa. These results were compared to similar slopes obtained in a previous study on excised larynges in which the vocal fold length was varied instead of cricothyroid activation. A physical interpretation of the P s - F 0 slope is that the amplitude-to-length ratio of the vocal folds decreases with CT activity, resulting in a smaller time-varying stiffness. In other words, there is less dependence of F 0 on amplitude of vibration when the vocal folds are long instead of short.

A finite-element model of the vocal fold is developed from basic laws of continuum mechanics to obtain the oscillatory characteristics of the vocal folds. The model is capable of accommodating inhomogeneous, anisotropic material properties and irregular geometry of the boundaries. It has provisions for asymmetry across the midplane, both from the geometric and tension point of view, which enables one to simulate certain kinds of voice disorders due to vocal-fold paralysis. It employs the measured viscoelastic properties of the vocal-fold tissues. The detailed construction of the matrix differential equations of motion is presented followed by the solution scheme. Finally, typical results are presented and validated using an eigenvalue method and a commercial finite-element package (ABAQUS).

Direct observations of nonstationary asymmetric vocal-fold oscillations are reported. Complex time series of the left and the right vocal-fold vibrations are extracted from digital high-speed image sequences separately. The dynamics of the corresponding high-speed glottograms reveals transitions between low-dimensional attractors such as subharmonic and quasiperiodic oscillations. The spectral components of either oscillation are given by positive linear combinations of two fundamental frequencies. Their ratio is determined from the high-speed sequences and is used as a parameter of laryngeal asymmetry in model calculations. The parameters of a simplified asymmetric two-mass model of the larynx are preset by using experimental data. Its bifurcation structure is explored in order to fit simulations to the observed time series. Appropriate parameter settings allow the reproduction of time series and differentiated amplitude contours with quantitative agreement. In particular, several phase-locked episodes ranging from 4:5 to 2:3 rhythms are generated realistically with the model.

The biomechanics of vocal fold abduction and adduction during phonation, respiration, and airway protection are not completely understood. Specifically, the rotational and translational forces on the arytenoid cartilages that result from intrinsic laryngeal muscle contraction have not been fully described. Anatomic data on the lines of action and moment arms for the intrinsic laryngeal muscles are also lacking. This study was conducted to quantify the 3-dimensional orientations and the relative cross-sectional areas of the intrinsic abductor and adductor musculature of the canine larynx. Eight canine larynges were used to evaluate the 3 muscles primarily responsible for vocal fold abduction and adduction: the posterior cricoarytenoid, the lateral cricoarytenoid, and the interarytenoid muscles. Each muscle was exposed and divided into discrete fiber bundles whose coordinate positions were digitized in 3-dimensional space. The mass, length, relative cross-sectional area, and angle of orientation for each muscle bundle were obtained to allow for the calculations of average lines of action and moment arms for each muscle. This mapping of the canine laryngeal abductor and adductor musculature provides important anatomic data for use in laryngeal biomechanical modeling. These data may also be useful in surgical procedures such as arytenoid adduction.

Treatment of challenging laryngeal disorders, such as lamina propria loss or neuromuscular dysfunction, may require novel approaches and techniques. This paper discusses an evolution of experimental techniques for treatment of lamina propria loss and use of the minithyrotomy. These techniques have been used for surgical access for lamina propria substitution, as well as placement of stimulating electrodes. The minithyrotomy is tolerated well by patients, provides access for microscopic instruments with the surgeon's hand close to the tissue of interest, avoids intralaryngeal mucosal incisions, and lines up the direction of dissection in an anterior-to-posterior orientation. This orientation is favorable for particular situations herein discussed. We present anatomic and physiologic concepts relevant to the surgical treatment of lamina propria dysfunction, as well as presenting our clinical experience. This paper is not intended to state how these difficult problems should be handled, but rather, to present our experience in techniques that may prove useful through further development.

Magnetic resonance imaging (MRI) was used to acquire vocal tract shapes of ten vowels /i, I, [symbol: see text] a, [symbol: see text], o, [symbol: see text] u/ and two liquid approximants /3[symbol: see text], 1/ for a 27-year-old adult female. These images were complemented with additional images acquired with electron beam computed tomography (CT) of /i/ and /a/. Each 3-D shape was condensed into a set of cross-sectional areas of oblique sections perpendicular to the centerline of the vocal tract's long axis, resulting in an "area function." Formant frequencies computed for each area function showed reasonable similarity to those determined from the natural (recorded) speech of the imaged subject, but differences suggest that some of the imaged vocal tract shapes were articulated differently during imaging than during recording of natural speech, and also that imaging procedures may have compromised some accuracy for a few shapes. The formant calculations also confirmed the significant effect that the piriform sinus can have on lowering the formant frequencies. A comparison is made between area functions derived using both MRI and CT methods for the vowels /i/ and /a/. Additionally, the area functions reported in this study are compared with those from two previous studies and demonstrate general similarities in shape but also obvious differences that can be attributed to anatomical differences of the imaged subjects and to differences in imaging techniques and image processing methods.

Vocal fold vibration depends critically on the viscoelasticity of vocal fold tissues. For instance, phonation threshold pressure, a measure of the "ease" of phonation, has been shown to be directly related to the viscosity of the vibrating mucosa. Various implantable biomaterials have been used in vocal fold augmentation surgery, with implantation sites sometimes close to or inside the mucosa. Yet their viscosities or other mechanical properties are seldom known. This study attempts to provide data on viscosities of commonly used phonosurgical biomaterials. Using a parallel-plate rotational rheometer, oscillatory shear experiments were performed on implantable polytetrafluoroethylene (Teflon or Polytef; Mentor Inc., Hingham, MA), collagen (Zyderm; Collagen Corp., Palo Alto, CA), glutaraldehyde crosslinked (GAX) collagen (Phonagel or Zyplast; Collagen Corp.), absorbable gelatin (Gelfoam; Upjohn Co., Kalamazoo, MI), and human abdominal subcutaneous fat. Samples of human vocal fold mucosal tissues were also tested. Under sinusoidal oscillatory shear at 10 Hz and at 37 degrees C, the dynamic viscosity was 116 Pascal-seconds (Pa-s) for polytetrafluoroethylene, 21 Pa-s for gelatin, 8-13 Pa-s for the two types of collagen, 3 Pa-s for fat, and 1 to 3 Pa-s for vocal fold mucosa. Results extrapolated to 100 Hz also show similar differences among the biomaterials, but all values are an order of magnitude lower because of the typical inverse frequency relation (shear thinning effect) for polymeric and biologic materials. The data suggest that the use of fat for vocal fold augmentation may be more conducive to the "ease" of phonation because of its relatively low viscosity, which is closest to physiologic levels. This implication is probably the most relevant in predicting initial outcome of the postoperative voice before there is any significant assimilation (e.g., resorption and fibrosis) of the implanted biomaterial.

An experiment with excised larynges was undertaken to investigate the interaction between acoustic pressures in a pseudotrachea and the amplitude of vibration of the vocal folds. Pressure was measured beneath the vocal folds at three specific moments of the vibratory cycle: (a) when the superior margin of the vocal folds began to separate, (b) when the vocal folds were maximally apart, and (c) when the inferior margin of the vocal folds began to touch. Results indicate that in half the larynges investigated, the maximum amplitude of vibration increased as a function of: (a) increased positive pressure at the moment of opening, and (b) reduced subglottal pressure when the vocal folds were maximally apart. The implications of these experiments regarding involuntary register transitions related to trachea resonance are discussed in light of a previously proposed register theory.

Summary The time courses of vocal fold elongation and contraction have beenmeasured as a function of intrinsic laryngeal muscle activity. The superior and recurrent laryngeal nerves of anesthetized canines were stimulated supramaximally (on-off in all combinations) while the vocal folds were surgically exposed and illuminated for conventional and higher speed (300 frames per second) video recording. Microsutures were placed on various points on the vocal folds to measure elongation and contraction. Vocal fold strain, defined as elongation divided by rest length, ranged from −17% to +45%. The typical time constant for exponential increase or decrease in strain was about 30 ms. This reflects primarily the intrinsic muscle activation times rather than a passive (inertial or viscoelastic) response of cricothyroid joint rotation or translation.

This paper reports results of further experimentation on a previously developed physical model of the vocal-fold mucosa [Titze et al., J. Acoust. Soc. Am. 97, 3080-3084 (1995)]. The effects of vocal-fold thickness, epithelial membrane thickness, and prephonatory glottal geometry on phonation threshold pressure were studied. Phonation threshold pressures in the range of 0.13 to 0.34 kPa were observed for an 11-mm-thick vocal fold with a 70-micron-thick "epithelial" membrane for different "mucosal" fluid viscosities. Higher threshold pressure was always obtained for thinner vocal folds and thicker membranes. In another set of experiments, lowest offset threshold pressure was obtained for a rectangular or a near-rectangular prephonatory glottis (with a glottal convergence angle within about +/- 3 degrees). It ranged from 0.07 to 0.23 kPa for different glottal half-widths between 2.0 and 6.0 mm. The threshold for more convergent or divergent glottal geometries was consistently higher. This finding only partially agrees with previous analytical work which predicts a lowest threshold for a divergent glottis. The discrepancy between theory and data is likely to be associated with flow separation from a divergent glottis.

The Ritz method is used to calculate eigenmodes and eigenfrequencies in a continuum model of the vocal folds. The investigation represents a rectification and extension of previous studies, emphasizing the indispensability of utilizing natural boundary conditions when computing the characteristic modes of a system. Concurring with previous assertions, two of the lower-order eigenmodes are theorized to play a major role in facilitating self-oscillation of the folds during phonation. One mode, related to vertical phasing, is shown to have a more direct control over glottal convergence/divergence than indicated in previous calculations. Unlike lumped element models, the continuum model predicts that the eigenfrequencies of the two modes are closely spaced over an extensive range of tissue sizes and stiffnesses. This finding may help explain why the two modes entrain so naturally over a wide range of phonatory adjustments in human phonation.

Bifurcation analysis is applied to vocal fold vibration in excised larynx experiments. In particular, two‐dimensional bifurcation diagrams are generated in a parameter plane spanned by subglottal pressure and asymmetry of vocal fold adduction or elongation. Various phonatory regimes are observed, including single vocal fold oscillations. Selected spectra demonstrate a correspondence between the observed phonatory regimes and vocal registers noted in the literature. Many instabilities or bifurcations are noted in the regions of coexistence, i.e., the regions where the phonatory regimes overlap. Bifurcations are illustrated with spectrograms and fundamental frequency contours. Where possible, results from these studies are related to clinical observations. [This research was supported by Grant No. P60 DC00976 from the National Institute on Deafness and Other Communication Disorders.]

The vocal fold mucosa, which consists of the epithelium and the superficial layer of the lamina propria, has been modeled by a fluid encapsulated in a silicone membrane. The artificial mucosa was attached to a rigid (metal) vocal fold body and introduced into an airflow channel, creating a rectangular glottis. Flow-induced oscillation of the mucosa was achieved at various subglottal pressures and glottal diameters. Phonation threshold pressure, the parameter of interest, was lowest (on the order of 0.4 kPa) for glottal diameters between 0.0 and 0.1 mm and for fluids with the lowest viscosity. There was a consistent hysteresis effect; that is, phonation threshold pressure was always lower for oscillation offset than onset.

A group of 22 voice professionals engaged in vigorous debate about symbolic notation and definitions in voice acoustics for a period of about 2 years. The group included singing teachers, speech-language pathologists, and voice scientists from the United States, Europe, and Australia. The first recommendation was regarding the symbol for fundamental frequency. The symbol fo was agreed upon, written with a lower case f and a subscript “o,” not “zero.” The reason given was that a “zero” frequency does not fit into the harmonic series of the sound source. The fundamental frequency is the first harmonic, not the zeroth harmonic. The subscript “o” was appealing because it could signify “oscillation.” The second recommendation was to write all harmonics as multiples of fo, namely fo, 2 fo, 3 fo. . . . n fo. This recommendation makes future use of the symbol h or H totally superfluous. Consensus was somewhat difficult to reach on this issue because a significant number of papers and textbooks have been written with h and H labels for harmonics. In conjunction with the above frequency symbols, the amplitudes of harmonics are written as A1, A2, A3. . . . .An. If they are converted to decibels, the relative decibel levels of the harmonics are written as L1, L2, L3. . . . .Ln. With regard to vocal tract resonance, much debate ensued about keeping a distinction between formants and resonances. Based

Several authors have recently demonstrated the intimate relationship between nonlinear dynamics and observations in vocal fold vibration (Herzel, 1993; Mende, Herzel, & Wermke, 1990; Titze, Baken, & Herzel, 1993). The aim of this paper is to analyze vocal disorders from a nonlinear dynamics point of view. Basic concepts and analysis techniques from nonlinear dynamics are reviewed and related to voice. The voices of several patients with vocal disorders are analyzed using traditional voice analysis techniques and methods from nonlinear dynamics. The two methods are shown to complement each other in many ways. Likely physiological mechanisms of the observed nonlinear phenomena are presented, and it is shown how much of the terminology in the literature describing rough voice can be unified within the framework of nonlinear dynamics.

Mechanical stress is always encountered in phonation. This includes tensile stress, shear stress, impact stress during collision, maximum active contractile stress in laryngeal muscles, inertial stress, and aerodynamic stress (pressure). Order of magnitude calculations reveal that tensile stress can reach the greatest value (near 1.0 MPa), contractile stress is next in size (near 100 kPa), and aerodynamic stress is relatively small (1-10 kPa). Inertial stress and impact stress are greater than aerodynamic stress, but less than contractile stress. Excessive collision and acceleration may be responsible for the greatest tissue damage, even though they do not account for the greatest stresses. This is because they act perpendicularly to the direction of tissue load-bearing fibers and are applied directly to mucosal tissue.

A submucosal fat autograft was implanted within the cover of injured vocal folds of 5 dogs. The implant occurred 6 weeks after unilateral mucosal excision had been performed. Three months postoperatively the larynges of these animals were excised and their phonation was compared to that of normal dog larynges and to other larynges with mucosal excision (but without fat grafting). Radiated acoustic pressure from the artificially driven larynges was recorded and digitized at 20 kHz with 16-bit resolution. Amplitude and fundamental frequency perturbations were extracted from a segment of phonation to assess the stability of the acoustic signals from the 3 groups. It was found that fat augmentation after mucosal excision reduced amplitude and frequency perturbation measures. There was no significant difference between fat-augmented and normal vocal folds. The acoustic measures were also positively correlated with phonation threshold and phonation efficiency measures reported earlier. The results suggest that submucosal fat autograft implantation within an injured vocal fold cover can restore not only the “ease” of phonation, but also the stability of phonation, which is a component of vocal quality.