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In current voice research, there is a growing interest in semi-occluded vocal tract exercises and their contribution to an increased vocal efficiency. However, there are only few studies on the lasting effects.Eight vocally healthy subjects were asked to sustain a phonation at a comfortable loudness on the vowel /i/, with a Fundamental Frequency of 250 Hz (females) or 125 Hz (males). During phonation the subjects were simultaneously recorded with transnasal High Speed Videoendoscopy (HSV, 20,000fps), electroglottography, and audio signals. The subjects then performed a water resistance therapy (WRT) for 10 min (tube: 30 cm length, 5 cm below water surface, diameter 9 mm). Repeated measurements of sustained phonation were performed 0, 5, 10, 20, and 30 min after exercising. From the HSV material the Glottal Area Waveform (GAW) was segmented and GAW parameters were computed.There were strong inter-individual differences concerning the changes of different measures over time after WRT. In general, directly after WRT there was a lowering of the GAW derived Period Perturbation Quotient, a lowering of the Closing Quotient and an increase of the Sound Pressure Level (SPL) in comparison to the pre-intervention measurement. However, only 5 min post WRT there was no longer a clear difference compared to baseline results before WRT. Other values such as Open Quotients exhibited no evident changes by WRT at any timepoint.WRT showed strong inter-individual effects concerning the changes in the evaluated measures post-intervention. General tendencies of some measures directly after the intervention showed a brief effect of only a few minutes.

Resonance-strategies with respect to vocal registers, i.e., frequency-ranges of uniform, demarcated voice quality, for the highest part of the female voice are still not completely understood. The first and second vocal tract resonances usually determine vowels. If the fundamental frequency exceeds the vowel-shaping resonance frequencies of speech, vocal tract resonances are tuned to voice source partials. It has not yet been clarified if such tuning is applicable for the entire voice-range, particularly for the top pitches. We investigated professional sopranos who regularly sing pitches above C6 (1047 Hz). Dynamic three-dimensional (3D) magnetic resonance imaging was used to calculate resonances for pitches from C5 (523 Hz) to C7 (2093 Hz) with different vowel configurations ([a:], [i:], [u:]), and different contexts (scales or octave jumps). A spectral analysis and an acoustic analysis of 3D-printed vocal tract models were conducted. The results suggest that there is no exclusive register-defining resonance-strategy. The intersection of fundamental frequency and first vocal tract resonance was not found to necessarily indicate a register shift. The articulators and the vocal tract resonances were either kept without significant adjustments, or the fR1:fo-tuning, wherein the first vocal tract resonance enhances the fundamental frequency, was applied until F6 (1396 Hz). An fR2:fo-tuning was not observed.

Breath control is an important factor for singing voice production, but pedagogic descriptions of how a beneficial movement pattern should be performed vary widely and the underlying physiological processes are not understood in detail. Differences in respiratory movements during singing might be related to the sex of the singer. To study sex-related differences in respiratory kinematics during phonation, 12 singers (six male and six female) trained in the Western classical singing tradition were imaged with dynamic magnetic resonance imaging. Singers were asked to sustain phonation at five different pitches and loudness conditions, and cross-sectional images of the lung were acquired. In each dynamic image frame the distances between anatomical landmarks were measured to quantify the movements of the respiratory apparatus. No major difference between male and female singers was found for the general respiratory kinematics of the thorax and the diaphragm during sustained phonation. However when compared to sole breathing, male singers significantly increased their thoracic movements for singing. This behavior could not be observed in female singers. The presented data support the hypothesis that professional singers follow sex-specific breathing strategies. This finding may be important in a pedagogical context where the biological sex of singer and student differ and should be further investigated in a larger cohort.

Respiratory kinematics are important for the regulation of voice production. Dynamic MRI is an excellent tool to study respiratory motion providing high-resolution cross-sectional images. Unfortunately, in clinical MRI systems images can only be acquired in a horizontal subject position, which does not take into account gravitational effects on the respiratory apparatus. To study the effect of body posture on respiratory kinematics during phonation, 8 singers were examined both in an open-configuration MRI with a rotatable gantry and a conventional horizontal MRI system. During dynamic MRI the subjects sang sustained tones at different pitches in both supine and upright body positions. Sagittal images of the respiratory system were obtained at 1–3 images per second, from which 6 anatomically defined distances were extracted to characterize its movements in the anterior, medium and posterior section of the diaphragm as well as the rip cage (diameter at the height of the 3rd and 5th rip) and the anterior–posterior position of the diaphragm cupola. Regardless of body position, singers maintained their general principles of respiratory kinematics with combined diaphragm and thorax muscle activation for breath support. This was achieved by expanding their chest an additional 20% during inspiration when singing in the supine position but not for sole breathing. The diaphragm was cranially displaced in supine position for both singing and breathing and its motion range increased. These results facilitate a more realistic extrapolation of research data obtained in a supine position.

This study compares the use of electroglottograms (EGGs) and glottal area waveforms (GAWs) to study phonation in different vibratory states as produced by professionally trained singers. Six western classical tenors were asked to phonate pitch glides from modal to falsetto phonation, or from modal to their stage voice above the passaggio (SVaP). For each pitch glide the sample entropy (SampEn) of the EGG signal was calculated to detect the occurrence of phonatory instabilities and establish a "ground truth" for the performed phonation type. The cycles before the maximum SampEn were labeled as modal, and the cycles after the peak were labeled as either falsetto, or SVaP. Three automatic categorizations of vibratory state were performed using clustering: one based only on the EGG, one based on the GAW, and one based on their combination. The error rate (clustering vs ground truth) was, on average, lower than 10% for all of the three settings, revealing no special advantage of the GAW over EGG, and vice versa. Modal voice cycles exhibited a larger contact quotient, larger normalized derivative peak ratio, and lower rise time, compared to SVaP and falsetto. The GAW-based normalized maximum area declination rate was larger in SVaP compared to modal voice.

PURPOSE To enable three-dimensional (3D) vocal tract imaging of dynamic singing or speech tasks at voxel sizes of 1.6 × 1.6 × 1.3 mm3 at 1.3 s per image. MATERIALS AND METHODS A Stack-of-Stars method was implemented and enhanced to allow for fast and efficient k-space sampling of the box-shaped vocal tract using a 3 Tesla MRI system. Images were reconstructed using an off-line image reconstruction using compressed sensing theory, leading to the abovementioned spatial and temporal resolutions. To validate spatial resolution, a phantom with holes of defined sizes was measured. The applicability of the imaging method was validated in an eight-subject study of amateur singers that were required to sustain phonation at a constant pitch, past their comfortable expiratory level. A segmentation of the vocal tract over all phonation time steps was done for one subject. Anatomical distances (larynx position and pharynx width) were calculated and compared for all subjects. RESULTS Analysis of the phantom study revealed that the imaging method could provide at least 1.6 mm isotropic resolution. Visual inspection of the segmented vocal tract during phonation showed modifications of the lips, tongue, and larynx position in all three dimensions. The mean larynx position per subject amounted to 52-85 mm, deviating up to 5% over phonation time. Parameter pharynx width was 32-181 mm2 on average per subject, deviating up to 16% over phonation time. Visual inspection of the parameter course revealed no common compensation strategy for long sustained phonation. CONCLUSION The results of both phantom and in vivo measurements show the applicability of the fast 3D imaging method for voice research and indicate that modifications in all three dimensions can be observed and quantified. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2017;46:94-101.

Objectives/Hypothesis In professional classical singing, an even voice quality throughout the entire singing voice range is essential. Transitions between vocal registers (passaggio) are the technically most challenging aspects in classical singing. It is hypothesized that they are most affected by vocal fold mass lesions (VFML). Study Design Cohort study. Methods In this study, the effect of VFML on vocal fold vibration in the passaggio regions was analyzed in four female and three male singers suffering from organic dysphonia. The singers were asked to sing an ascending glissando through the passaggio regions, before and after treatment. The vocal fold vibration was documented with transnasal endoscopic high-speed imaging recordings at 20,000 frames per second, supplemented by synchronized acoustic and electroglottographic recordings. Results Major irregularities were found in the passaggio region of four singers before treatment, whereas the respective phonations below the passaggio were almost regular. In two female singers only the upper, but not the lower passaggio was affected. In all four of these participants, the passaggio region was more regular after treatment. In the remaining three participants, the VFML showed no effect on the passaggio region. However, the singers' ability to reach higher pitches was impaired, but was resolved after treatment. Conclusions The data in this case study strongly suggest that the passaggio region could be affected by VFML, even if phonation outside the passaggio regions is unimpaired. When planning surgical procedures for professional singers, clinical examination protocols should therefore include phonatory tests across the passaggio regions. Level of Evidence 4 Laryngoscope, 127:1392–1401, 2017

Der Einfluss funktioneller Phonationsverdickungen auf das Schwingungsverhalten der Stimmlippen bei stimmlich herausfordernden Aufgaben ist noch nicht im Detail verstanden. In dieser Studie wurden Glissandi von 220 bis 440 Hz und von 440 bis 880 Hz auf dem Vokal [a:] bei je 4 professionellen Sangerinnen zum einen ohne organischen Befund und ohne Dysphonie (Gruppe A), zum anderen mit funktionellen Phonationsverdickungen (Gruppe B) und zum Dritten mit organischer Dysphonie (Gruppe C) mittels Hochgeschwindigkeitsendoskopie („high speed digital imaging“, HSDI, 20.000 Bilder/s), akustischen und elektroglottographischen (EGG-)Signalen untersucht. Anhand der EGG-Stichprobenentropie („sample entropy“) wurden Zeitfenster zur Analyse von Registerubergangsphanomen gebildet. Ferner wurden alle Stimmsignale („glottal area waveform“, GAW; akustisches und EGG-Signal) einer perzeptiven Bewertung hinsichtlich der Wahrnehmbarkeit von Registrierungsvorgangen unterzogen. Die absolute „sample entropy“ zeigte Maxima in Grundfrequenzbereichen, in denen typischerweise Registerubergange zu finden sind. Gruppe B unterschied sich weder im Rating noch in den Werten der „sample entropy“ deutlich von Gruppe A. Die absoluten Werte der „sample entropy“ lagen fur die Gruppe C nur fur das untere Glissando oberhalb der beiden anderen Gruppen. Die groseren Irregularitaten der Stimmlippenschwingungen waren in dieser Gruppe jedoch im oberen Glissando zu beobachten. Funktionelle Phonationsverdickungen wirken sich nicht negativ in Hinblick auf die Biomechanik in stimmtechnisch herausfordernden Bereichen wie Registerubergangen aus. Die Verwendung der „sample entropy“ als Kriterium zur Detektion von Registerubergangen ist vielversprechend, bedarf jedoch weiterer Validierung.

Summary Introduction The influence of vowels on the frequency region where registration events in male voices usually occur (passaggio) has not yet been clarified. Particularly, for tenors who frequently have to sing across the passaggio, it might be assumed that the vowel quality has an influence on the stability of phonation. Methods In this investigation, six professionally trained Western classical tenors performed a glide from A3 (220 Hz) to A4 (440 Hz) and were recorded using high-speed videoendoscopy at 20,000 fps via transnasal flexible endoscopy. The participants produced transitions (1) from modal register to falsetto and (2) from modal register to stage voice above the passaggio on the vowels [aː], [iː], and [uː]. Simultaneously, acoustic and electroglottographic (EGG) signals were recorded. The glottal area waveform (GAW) open quotient (OQ), the EGG OQ, and the sample entropy derived from the EGG were calculated and phonovibrograms were established. Results In comparison to [iː] and [uː], vowel [aː] showed lower values regarding the sample entropy and greater periodicity in the phonovibrograms during the passaggio. For [iː] and [uː], the falsetto showed greater GAW OQ than the stage voice above the passaggio but no great difference for vowel [aː]. There was a good agreement between GAW OQ and EGG OQ for GAW OQ values below .65. However, for values greater than .65, the EGG OQ showed greater disagreement. Conclusions The data support the hypothesis that the vowel condition influences the phonatory stability concerning the passaggio, suggesting that vowel [aː] is associated with greater phonation stability.

The respiratory system is a central part of voice production, but for phonation neither the underlying functional relations between diaphragm (DPH) and rib cage (RC), nor differences to normal breathing are yet understood. This study aims to compare respiratory dynamics in phonation and breathing via dynamic MRI of the lung. Images of the breathing apparatus of 6 professional singers were captured in a 1.5T MRI system in supine position during vital capacity breathing and maximal long sustained phonation at 3 different pitches and loudness conditions. In a dynamic series of cross-sectional images of the lung, distances between characteristic anatomical landmarks were measured. During exhalation in normal breathing the diaphragm and rib cage moved synchronously to reduce lung volume, but during phonation different functional units could be identified, which support phonation by facilitating the control of subglottic pressure.

To enable three-dimensional (3D) vocal tract imaging of dynamic singing or speech tasks at voxel sizes of 1.6 × 1.6 × 1.3 mmA Stack-of-Stars method was implemented and enhanced to allow for fast and efficient k-space sampling of the box-shaped vocal tract using a 3 Tesla MRI system. Images were reconstructed using an off-line image reconstruction using compressed sensing theory, leading to the abovementioned spatial and temporal resolutions. To validate spatial resolution, a phantom with holes of defined sizes was measured. The applicability of the imaging method was validated in an eight-subject study of amateur singers that were required to sustain phonation at a constant pitch, past their comfortable expiratory level. A segmentation of the vocal tract over all phonation time steps was done for one subject. Anatomical distances (larynx position and pharynx width) were calculated and compared for all subjects.Analysis of the phantom study revealed that the imaging method could provide at least 1.6 mm isotropic resolution. Visual inspection of the segmented vocal tract during phonation showed modifications of the lips, tongue, and larynx position in all three dimensions. The mean larynx position per subject amounted to 52-85 mm, deviating up to 5% over phonation time. Parameter pharynx width was 32-181 mmThe results of both phantom and in vivo measurements show the applicability of the fast 3D imaging method for voice research and indicate that modifications in all three dimensions can be observed and quantified.2 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2017;46:94-101.

In professional classical singing, an even voice quality throughout the entire singing voice range is essential. Transitions between vocal registers (passaggio) are the technically most challenging aspects in classical singing. It is hypothesized that they are most affected by vocal fold mass lesions (VFML).Cohort study.In this study, the effect of VFML on vocal fold vibration in the passaggio regions was analyzed in four female and three male singers suffering from organic dysphonia. The singers were asked to sing an ascending glissando through the passaggio regions, before and after treatment. The vocal fold vibration was documented with transnasal endoscopic high-speed imaging recordings at 20,000 frames per second, supplemented by synchronized acoustic and electroglottographic recordings.Major irregularities were found in the passaggio region of four singers before treatment, whereas the respective phonations below the passaggio were almost regular. In two female singers only the upper, but not the lower passaggio was affected. In all four of these participants, the passaggio region was more regular after treatment. In the remaining three participants, the VFML showed no effect on the passaggio region. However, the singers' ability to reach higher pitches was impaired, but was resolved after treatment.The data in this case study strongly suggest that the passaggio region could be affected by VFML, even if phonation outside the passaggio regions is unimpaired. When planning surgical procedures for professional singers, clinical examination protocols should therefore include phonatory tests across the passaggio regions.4 Laryngoscope, 127:1392-1401, 2017.

Summary Introduction Recent research has revealed that classically trained tenors tend to constrict epilaryngeal structures when singing in and above the passaggio (ie, the frequency region where register events typically occur). These constrictions complicate visibility of vocal fold oscillatory patterns with transoral rigid high-speed video endoscopy, thus limiting the current understanding of laryngeal dynamics in the passaggio region of tenors. Materials and Methods This investigation analyzed seven professionally trained western classical tenors using high-speed digital imaging (HSDI) at 20,000 frames per second via transnasal flexible endoscopy. The participants produced transitions (a) from modal to falsetto register and (b) from modal to stage voice above the passaggio (SVaP) during ascending pitch glides from A3 (220 Hz) to A4 (440 Hz) on vowel /i/. HSDI data were complemented by simultaneous acoustic and electroglottographic recordings. Results For many subjects both transition types were associated with constrictions of the epilaryngeal structures during the pitch glide. These constrictions appeared to be more distinct for the SVaP than for falsetto. No major irregularities of vocal fold oscillations in the sense of fundamental frequency jumps were observed for either transition type. However, during the transitions, the open quotient derived from the glottal area waveform (OQ GAW ) increased; in falsetto, the OQ GAW was greater and the electroglottographic cepstral peak prominence was lower than in SVaP. Conclusions Epilaryngeal constrictions should be considered typical for tenors singing at high fundamental frequencies. Vocal fold oscillatory patterns are changing not only for the register shift from modal to falsetto but also for the transition from modal to SVaP, indicating a need for laryngeal adjustments during these transitions.

The role of the vocal tract for phonation at very high soprano fundamental frequencies (F0s) is not yet understood in detail. In this investigation, two experiments were carried out with a single professional high soprano subject. First, using two dimensional (2D) dynamic real-time magnetic resonance imaging (MRI) (24 fps) midsagittal and coronal vocal tract shapes were analyzed while the subject sang a scale from Bb5 (932 Hz) to G6 (1568 Hz). In a second experiment, volumetric vocal tract MRI data were recorded from sustained phonations (13 s) for the pitches C6 (1047 Hz) and G6 (1568 Hz). Formant frequencies were measured in physical models created by 3D printing, and calculated from area functions obtained from the 3D vocal tract shapes. The data showed that there were only minor modifications of the vocal tract shape. These changes involved a decrease of the piriform sinus as well as small changes of tongue position. Formant frequencies did not exhibit major differences between C6 and G6 for F1 and F3, respectively. Only F2 was slightly raised for G6. For G6, however, F2 is not excited by any voice source partial. Therefore, this investigation was not able to confirm that the analyzed professional soprano subject adjusted formants to voice source partials for the analyzed F0s.

Introduction Dynamic MRI analysis of phonation has gathered interest in voice and speech physiology. However, there are limited data addressing the extent to which articulation is dependent on loudness. Material and Methods 12 professional singer subjects of different voice classifications were analysed concerning the vocal tract profiles recorded with dynamic real-time MRI with 25fps in different pitch and loudness conditions. The subjects were asked to sing ascending scales on the vowel /a/ in three loudness conditions (comfortable = mf, very soft = pp, very loud = ff, respectively). Furthermore, fundamental frequency and sound pressure level were analysed from the simultaneously recorded optical audio signal after noise cancellation. Results The data show articulatory differences with respect to changes of both pitch and loudness. Here, lip opening and pharynx width were increased. While the vertical larynx position was rising with pitch it was lower for greater loudness. Especially, the lip opening and pharynx width were more strongly correlated with the sound pressure level than with pitch. Conclusion For the vowel /a/ loudness has an effect on articulation during singing which should be considered when articulatory vocal tract data are interpreted.