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Avian vocalizations are produced by precisely coordinated motion of the respiratory, syringeal and upper vocal tract systems. Syringeal muscles are controlled with unprecedented resolution, down to independent control of individual muscle fibres. However, we currently lack an anatomical description of syrinx muscles at single fibre resolution. Here, we combined a micron-resolution synchrotron X-ray CT scan of the zebra finch syrinx with micro-dissections of independent specimens to resolve syrinx muscle morphology at individual muscle fibre level. We define two new, previously unknown muscles and update the fibre trajectories and attachment sites of three previously described muscles. Our new insights into the fine anatomy of syrinx muscles show that not one, but both avian vocal folds can be directly controlled by contracting syrinx muscles. Thus, our data reveal novel anatomical complexity with consequences for the biomechanics and motor control of sound production.This article is part of the theme issue 'The biology of the avian respiratory system'.

Although laryngeal high-speed videoendoscopy (HSV) is crucial for studying vocal fold vibrations, its translation to clinical practice has been hindered by the large volume of data it produces and the difficulty in interpreting current analysis methods. Although image processing techniques have been developed to map spatial-temporal data into two-dimensional representations, they alter the geometrical construction of the glottis and do not provide standard quantitative features, thus challenging clinical interpretation. In response, we propose a new visualization and analysis framework for assessing the dynamics of vocal folds based on the empirical distribution of the glottal edge using HSV. This procedure analyzes vocal fold oscillations by preserving the shape of the glottis and quantifying the asymmetry between right and left vocal fold displacements along the anterior-posterior axis. This method was evaluated on four groups of participants: ten with normal voices, ten with vocal fold nodules, ten with muscle tension dysphonia, and two with unilateral vocal fold paralysis. The proposed method produces distinct representations for normal and pathological vocal fold vibratory behaviors and derived features based on amplitude and phase asymmetry metrics that show statistically significant differences between normal and pathological groups. Comparative analysis with state-of-the-art techniques indicates that our proposed method can complement the assessment of vocal fold vibration and enhance the clinical translation of HSV.

Strength of vocal fold adduction has been hypothesized to be a critical factor influencing vocal acoustics but has been difficult to measure directly during phonation. Recent work has suggested that upper esophageal sphincter (UES) pressure, which can be easily assessed, increases with stronger vocal fold adduction, raising the possibility that UES pressure might indirectly reflect vocal fold adduction strength. However, concurrent UES pressure and vocal acoustics have not previously been examined across different vocal tasks. Doing so may offer insights into the potential use of UES pressure for relative quantification of the strength of vocal fold adduction and how this might contribute to vocal acoustics across different vocal tasks. We assessed UES pressure relative to vocal acoustics in 32 vocally healthy adults during sustained vowels, whispered sentences, and spoken sentences. Smoothed cepstral peak prominence (CPPs) and low-to-high spectral energy ratio (LHR) were derived from the acoustic signal. After controlling for resting UES pressure, age, and sex, we observed significant negative correlations between UES pressure and CPPs and a significant positive correlation between UES pressure and LHR. UES pressures were significantly higher during spoken sentences than whispered sentences and sustained vowels. Measuring UES pressure relative to vocal acoustics is a novel methodology for studying upper aerodigestive tract physiology during phonation and has the potential to enhance understanding of voice disruption in clinical populations. Clinical implications and considerations for implementation are discussed. NEW & NOTEWORTHY We identified relationships between upper esophageal sphincter (UES) pressures and vocal acoustics during phonation in vocally healthy individuals, potentially reflecting the influence of strength of vocal fold adduction and other phonatory factors on vocal acoustics. This methodology could lead to the development of a clinical and research tool that could provide insight into the strength of vocal fold adduction, a critical factor influencing voice quality that has historically been difficult to assess.

Objective: This study investigates relationships between the oscillation behavior of the medial and superior vocal fold (VF) surfaces during sustained phonation in a human cadaver hemilarynx., Methods: An experimental test stand synchronously captured the medial and superior VF surfaces of a human ex vivo hemilarynx during sustained phonation using two high-speed camera setups in 24 experimental settings. The 3D coordinates of the medial VF surface were reconstructed by triangulation of sewn-in marker points, while laser-based reconstruction was used for the superior VF surface. Correlation analysis and linear regression were used to quantify the connections of the mean and maximal vertical and lateral VF displacements and the VF velocities. Additionally, stepwise linear regression was used to analyze the impact of the measurement variables mean flow rate, adduction and elongation., Results: Strong linear relationships between all of the tested corresponding parameter pairs of the superior and medial VF surfaces were found (p<.001). Mean and maximum vertical displacements of the medial surface were both approximately 50% of the superior surface. The mean lateral displacements for the medial surface were 12% below the superior surface but 12% higher for the maximum values. The mean and maximum VF velocities were 32% and 36% lower for the medial surface., Conclusion: The suggested multi-modal test stand allows efficient, comprehensive analysis of human hemilarynges and provides promising information about the interaction of the different VF areas and opens up the systematic analysis of multiple hemilarynges., Significance: In future, our results could integrate into ENT diagnostics using 3D laryngoscopy where the hidden medial VF surface dynamics may be predicted from the observable superior surface.

Objective: This study investigated the immediate effects and their persistence (at 15 minutes) of various durations of semi-occluded vocal tract exercise (SOVTE) (standard tube into water and modified mask+tube into water exercises) as measured by electroglottographic (EGG) and nasometric parameters., Methods: The study included 30 women aged 19 through 28 years with healthy voices, and it comprised five randomly implemented procedures (Ps): P1-tube phonation into water for 5 minutes; P2-tube phonation into water for 10 minutes; P3-tube+ventilation mask phonation into water for 5 minutes; P4-tube+ventilation mask phonation into water for 10 minutes; P5-phonation with ventilation mask for 5 minutes. Fifteen-minute voice rest breaks were provided between each procedure. Nasometric and electroglottographic measurements were taken before, during, immediately after and at 5, 10, and 15 minutes after the exercises, and the recorded measurements were analyzed., Results: The immediate effects of P3 and P4 on voice quality showed better performance than the other procedures. Among all the procedures, P1 had the smallest effect on voice quality in terms of nasometric and EGG parameters and the least degree of effect permanence. In all the fluctuating SOVTE procedures except P1, the nasalance scores decreased (P1, P2, P3, and P4: fluctuating SOVTE; P5: steady SOVTE)., Conclusion: The tube phonation exercises modified by the addition of a ventilation mask were highly advantageous in terms of EGG parameters. In addition to this, regardless of the mode of application of the retention time, it was observed that the positive effect (ie, lower vertical laryngeal position) of the exercises applied for 10 minutes was higher than the exercises applied for 5 minutes., (Copyright © 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Objectives: The Vocal Tract Organ has had a number of iterations resulting from advances in available technology as well as requirements of perceptual experiments and performance paradigms. The objective of this paper is to relate the development history of the Vocal Tract Organ from the original vision to what it is today as a modern version of the Vox Humana pipe organ stop for application in voice production and perception research., Study Design: Descriptive METHODS/DESIGN: The latest Vocal Tract Organ is a polyphonic eight-channel eight-stop one manual Vocal Tract Organ that enables tab stop selected three-D printed vocal tracts to be used to create sound. This version includes eight stops (four for female vowel oral tracts and four for male vowel oral tracts). The stops are implemented using conventionally engraved pipe organ stop tabs labeled "Vox Humana Female" or "Vox Humana Male" followed by the three-D printed vowel: "EE", "AH", "ER" or "UU." This is described alongside the development stages from which it emerged and covers all previous versions of the Vocal Tract Organ. At the heart of the latest instrument is a Bela BeagleBone Black with a Bela cape audio expander board which incorporates eight 16-bit audio outputs at 44.1 kHz sampling rate (earlier versions based on the Arduino Mega board were limited to 8-bit audio at an audio sampling rate of 16.384 kHz which limited the overall output spectrum). The latest Vocal Tract Organ is programmed using the audio graphical programming language Pure Data which is directly compatible with the Bela system. The Pure Data patch creates eight larynx outputs at the pitches set by the keys depressed on the keyboard and these are routed to Vocal Tract Organ loudspeakers with three-D printed vocal tracts attached., Results: The Bela system has enabled real-time synthesis of eight-note polyphonic sounds to eight separate three-D printed vocal tracts, each being selectable via an organ tab stop switch. The instrument has been cased in a purpose-designed and built prototype laser-cut enclosure that incorporates the eight tab stops, a MIDI keyboard input, a pipe organ style swell (volume) pedal connection, four stereo (eight channels) audio amplifiers and terminal connections for the eight loudspeakers., Conclusions: The Vocal Tract Organ functions as a musical instrument for performance and as an instrument for vowel and pitch perception research. Implementing it with the Bela family of processors allows for low audio latency of 1 ms and rapid prototyping due to being able to program directly with the high-level graphical audio programming language, Pure data (Pd)., (Crown Copyright © 2022. Published by Elsevier Inc. All rights reserved.)

Objectives and Background: To investigate whether voice focus adjustments can alter the audio-vocal feedback and consequently modulate speech/voice motor control. Speaking with a forward-focused voice was expected to enhance audio-vocal feedback and thus decrease the variability of vocal fundamental frequency (F0)., Materials and Method: Twenty-two healthy, untrained adults (10 males and 12 females) were requested to sustain vowel /a/ with their natural focus and a forward focus and to naturally read the nasal, oral, and mixed oral-nasal sentences in normal noise-masked auditory conditions. Meanwhile, a miniature accelerometer was externally attached on the noise to detect the nasal vibrations during vocalization. Audio recordings were made and analyzed using the long-term average spectrum (LTAS) and power spectral analysis of F0., Results: Compared with naturally-focused vowel production and oral sentences, forward-focused vowel productions and nasal sentences both showed significant increases in nasal accelerometric amplitude and the spectral power within the range of 200∼300 Hz, and significantly decreased the F0 variability below 3 Hz, which has been reported to be associated with enhanced auditory feedback in our previous research. The auditory masking not only significantly increased the low-frequency F0 variability, but also significantly decreased the ratio of the spectral power within 200∼300 Hz to the power within 300∼1000 Hz for the vowel and sentence productions. Gender differences were found in the correlations between the degree of nasal coupling and F0 stability as well as in the LTAS characteristics in response to noise., Conclusions: Variations in nasal-oral acoustic coupling not only change the formant features of speech signals, but involuntarily influence the auditory feedback control of vocal fold vibrations. Speakers tend to show improved F0 stability in response to a forward-focused voice adjustment., (Copyright © 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Previous studies of laryngeal and respiratory control of the voice source often focus on main effects of individual control parameters but not their interactions. The goal of this study is to systematically identify important interaction effects in laryngeal and respiratory control of the voice source and vocal fold contact pressure in a three-dimensional voice production model. Computational simulations were performed with parametric variations in vocal fold geometry, stiffness, prephonatory glottal gap, and subglottal pressure. The results showed that, while the glottal closure pattern and source spectral shape were dominantly controlled by vocal fold vertical thickness, the prephonatory glottal gap had important effects in thick vocal folds or near phonation onset. Coordinated adjustments in both the prephonatory glottal gap and thickness were required to produce a long duration of the closed phase and strong high-frequency harmonic production. Interaction between subglottal pressure and transverse stiffness was observed in the control of the peak vocal fold contact pressure. The contact pressure was highest in vocal folds with low transverse stiffness when exposed to high subglottal pressure, indicating the importance of maintaining a balance between subglottal pressure and transverse stiffness to minimizing vocal fold injury., (© 2024 Acoustical Society of America.)

This study focuses on the development of a wearable real-time Humming Detector Device (HDD) aimed at enhancing the control of assistive devices through humming. As the need for portable user-friendly tools in assistive technology grows, the HDD offers a non-invasive solution to detect vocal cord vibrations. Vibrations, detected thanks to an accelerometer worn on the neck, are processed in real time using a Fast Fourier Transform (FFT) to identify specific humming frequencies, which are then translated into commands for controlling assistive devices via Bluetooth Low Energy (BLE) transmission. The device was tested with 13 healthy subjects to validate its potential and determine the optimal number of distinct commands that users can achieve. The HDD's portability and precision make it a promising alternative to traditional voice recognition systems, particularly for individuals with speech impairments.

Although [h] is described as a glottal fricative, it has never been demonstrated whether [h] has its source exclusively at the glottis. In this study, sound source locations and their influence on sound amplitudes were investigated by conducting mechanical experiments and airflow simulations. Vocal tract data of [h] were obtained in three phonemic contexts from two native Japanese subjects using three-dimensional static magnetic resonance imaging (MRI). Acrylic vocal tract replicas were constructed, and the sound was reproduced by supplying airflow to the vocal tracts with adducted or abducted vocal folds. The sound source locations were estimated by solving the Navier-Stokes equations. The results showed that the amplitudes of sounds produced by the vocal tracts with an open glottis were in a similar range (±3 dB) to those with a glottal gap of 3 mm in some contexts. The sound sources in these cases were observed in the pharyngeal cavity or near the soft palate. Similar degrees of oral constrictions were observed in the real-time MRI, indicating that the sound traditionally described as [h] is produced, at least in some contexts, with sound sources of turbulent flow generated by a supralaryngeal constriction of the following vowel., (© 2024 Author(s). All article content, except where otherwise noted, is licensed under a Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).)

Objective: Within the scope of semi-occluded vocal tract exercises (SOVTEs), we aimed to examine the effects of four exercise combinations, which involved various fluid densities and tube submersion depths, on acoustic and electroglottographic (EGG) parameters., Methods: Four procedures (P) were applied consecutively to 30 female participants with normal voices using different tube submersion depths and fluid densities, including P1 (2 cm, water), P2 (2 cm, nectar), P3 (10 cm, water), and P4 (10 cm, nectar). Nasometric (Nasometer II model 6450) and EGG (Electroglottograph model 6103) measurements were taken before the procedures were initiated (pre-test) and at the end of each procedure. In addition, EGG measurements were taken for each procedure during the application., Results: For all three velar positions (oral passage, oro-nasal passage, nasal passage), the only procedure that caused a significant change compared to the pre-test stage in regard to nasalance score was P2 (2 cm nectar) in common. All other procedures except P1 (2 cm water) significantly increased velar closure compared to pre-test levels. However, when the differences between the exercises were examined, the least velar closure, compared to the other procedures, was obtained after P4 (10 cm nectar). While there was no significant difference between the procedures in the EGG measurements during the exercise, a significantly higher tendency to contact was observed after the procedures with a denser consistency, and an increase in the fundamental frequency (f o ) values occurred in the pairwise comparisons of the procedures in the measurements after the exercises., Conclusion: In SOVTEs in which water phonation is performed with a tube, the use of a fluid with a consistency denser than water can be considered a particularly promising approach. In addition, exercises performed with increasing consistencies in 2 cm depth can provide more vocal cord and velopharyngeal port closure by increasing EGG-CQ and nasalance score values. However, more care should be taken while increasing the consistency at a submersion depth of 10 cm., (Copyright © 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

During use of a laryngeal mask airway, resistance of the device and larynx contribute to the upper airway resistance. Detailed understanding of this combined resistance is crucial to support spontaneously breathing patients appropriately or to take the right measures during respiratory problems. However, their resistive behavior and which of these components determine the upper airway resistance predominantly, has not been characterized systematically. Pressure-flow-relationships of different sizes of a laryngeal mask airway, of a laryngeal model with vocal cord angles between 10° and 60° and of the combination of a laryngeal mask airway size 4 and the laryngeal model were measured. Results were fitted to the expanded Rohrer's equation and resistances were calculated. The laryngeal mask airway and the laryngeal model showed a nonlinear flow-dependent resistive behavior. Decreasing size of the laryngeal mask airway, decreasing vocal cord angles, and increasing flow rates resulted in increased resistances (all p < 0.001). Resistance of the laryngeal mask and the laryngeal model added up to the combined resistance in a summative way, where the vocal cord angle determines 59-98% of the combined resistance in adults. The upper airway resistance during the use of a laryngeal mask airway is a summative resistance with a flow-dependent, nonlinear behavior. Upper airway resistance in adults is primarily determined by the vocal cord angle during use of a laryngeal mask., (© 2024. The Author(s).)

A human laryngeal model, incorporating all the cartilages and the intrinsic muscles, was reconstructed based on MRI data. The vocal fold was represented as a multilayer structure with detailed inner components. The activation levels of the thyroarytenoid (TA) and cricothyroid (CT) muscles were systematically varied from zero to full activation allowing for the analysis of their interaction and influence on vocal fold dynamics and glottal flow. The finite element method was employed to calculate the vocal fold dynamics, while the one-dimensional Bernoulli equation was utilized to calculate the glottal flow. The analysis was focused on the muscle influence on the fundamental frequency (f o ). We found that while CT and TA  activation increased the f o in most of the conditions, TA activation resulted in a frequency drop when it was moderately activated. We show that this frequency drop was associated with the sudden increase of the vertical motion when the vibration transited from involving the whole tissue to mainly in the cover layer. The transition of the vibration pattern was caused by the increased body-cover stiffness ratio that resulted from TA activation., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives/hypothesis: The respiratory process is important in vocal training and in professional singing, the airflow is highly important. It is hypothesized that subglottal resonances are important to the singing voice in high performance singing., Study Design: Single subject, prospective., Method: A professional soprano singer shaped her vocal tract to form the vowels [a], [e], [i], [o], and [u] at the pitch d4. We measured phonated vowels and the vocal tract impedance spectra with a deterministic noise supplied by an iPhone buzzer in the range of 200 to 4,000 Hz at closed glottis, during exhalation and during inhalation while maintaining the shape of the vocal tract., Results: Measurements of the phonated vowels before and after the different glottal adjustments were highly reproducible. Vocal tract resonances and the ones resulting during respiration are reported. The impedance spectra show vowel dependent resonances with closed and open glottis. The formants of the vocal spectra are explained by including both, the vocal tract, and the subglottal resonances., Conclusion: The findings indicate that subglottal resonances influence the first formant as well as the singers's formant cluster in high-performance singing. The instrumental setup used for the impedance measurement allows a simple and lightweight procedure for a measurement of vocal tract and subglottal resonances., (Copyright © 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Voice registers are assumed to be related to different laryngeal adjustments, but objective evidence has been insufficient. While chest register is usually associated with the lower pitch range, and head register with the higher pitch range, here we investigated a professional singer who claimed an ability to produce both these registers at every pitch, throughout her entire singing range. The singer performed separated phonations alternating between the two registers (further called chest-like and head-like) at all pitches from C3 (131 Hz) to C6 (1047 Hz). We monitored the vocal fold vibrations using high-speed video endoscopy and electroglottography. The microphone sound was recorded and used for blind listening tests performed by the three authors (insiders) and by six "naive" participants (outsiders). The outsiders correctly identified the registers in 64% of the cases, and the insiders in 89% of the cases. Objective analysis revealed larger closed quotient and vertical phase differences for the chest-like register within the lower range below G4 (<392 Hz), and also a larger closed quotient at the membranous glottis within the higher range above Bb4 (>466 Hz), but not between Ab4-A4 (415-440 Hz). The normalized amplitude quotient was consistently lower in the chest-like register throughout the entire range. The results indicate that that the singer employed subtle laryngeal control mechanisms for the chest-like and head-like phonations on top of the traditionally recognized low-pitched chest and high-pitched head register phenomena. Across all pitches, the chest-like register was produced with more rapid glottal closure that was usually, but not necessarily, accompanied also by stronger adduction of membranous glottis. These register changes were not always easily perceivable by listeners, however., (Copyright © 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Objectives: An improved data-driven glottal flow model for fluid-structure interaction (FSI) simulation of the vocal fold vibration is proposed in this paper. This model aims to improve the prediction performance of the previously developed deep neural network (DNN) based empirical flow model (EFM) 1 on accuracy and efficiency., Methods: A Seq2Seq long short-term memory (LSTM) network is employed in the present model to infer the flow rate and pressure distribution from the subglottal pressure and cross-section area distribution of the glottis. The training data is collected from the generalized glottal shape library generated in Zhang et al. 1 RESULTS AND CONCLUSIONS: Compared to the EFM, the present model not only discards the time-consuming optimization process, but also drastically reduces the errors, therefore the prediction performance can be greatly improved. The present model is evaluated by coupling with a solid dynamics solver for FSI simulation, and the results demonstrate a great improvement on accuracy and efficiency., (Copyright © 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Formants (vocal tract resonances) are increasingly analyzed not only by phoneticians in speech but also by behavioral scientists studying diverse phenomena such as acoustic size exaggeration and articulatory abilities of non-human animals. This often involves estimating vocal tract length acoustically and producing scale-invariant representations of formant patterns. We present a theoretical framework and practical tools for carrying out this work, including open-source software solutions included in R packages soundgen and phonTools. Automatic formant measurement with linear predictive coding is error-prone, but formant&#95;app provides an integrated environment for formant annotation and correction with visual and auditory feedback. Once measured, formants can be normalized using a single recording (intrinsic methods) or multiple recordings from the same individual (extrinsic methods). Intrinsic speaker normalization can be as simple as taking formant ratios and calculating the geometric mean as a measure of overall scale. The regression method implemented in the function estimateVTL calculates the apparent vocal tract length assuming a single-tube model, while its residuals provide a scale-invariant vowel space based on how far each formant deviates from equal spacing (the schwa function). Extrinsic speaker normalization provides more accurate estimates of speaker- and vowel-specific scale factors by pooling information across recordings with simple averaging or mixed models, which we illustrate with example datasets and R code. The take-home messages are to record several calls or vowels per individual, measure at least three or four formants, check formant measurements manually, treat uncertain values as missing, and use the statistical tools best suited to each modeling context., (© 2023. The Author(s).)

Introduction: Vibratory positive expiratory pressure (PEP) devices are now commonly used as a resource for voice therapy. PEP devices promote improved vocal economy with the added benefit of producing a massage effect in the vocal tract. Although the benefits of PEP devices for voice have already been demonstrated, their impact on the vocal source is still not very clear. This study assesses the impact of phonation into the Acapella Choice (a type of PEP device) on the voice., Methods: Three normophonic subjects underwent high-speed videoendoscopy assessment while pressure, flow and electroglottographic data was collected., Results: Phonation into the Acapella device produces large changes in the pressure and flow profiles consequently affecting the voice source. In specific, when intraoral pressure increases as a consequence of the downward movement of the rocker arm in the Acapella device (reduction of the airflow outlet), phonation is hindered, demonstrated by the lower amplitude of vibration of the vocal folds and weaker modulation of the pressure and flow values by the glottal cycle. When the rocker arm in the Acapella device opens (increasing the airflow outlet), the opposite trend is observed where vocal fold vibration is aided and the modulation of pressure and flow by the vocal cycle increases. Based on the pressure and flow signals, we can assume that the impedance of the vocal tract alternates between two dominant regimes: increased inertive reactance (aided vibration) and increased resistance (hindered vibration)., Conclusions: PEP devices, such as the Acapella device, are efficient in modulating the pressure and flow profiles in the vocal tract leading to the alternation of glottal vibration from aided to hindered. These changes in the glottal vibration can be considered an additional consequence of the massage effect caused by the Acapella device., (Copyright © 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Voice production has been an area of interest in science since ancient times, and although advancing research has improved our understanding of the anatomy and function of the larynx, there is still little general consensus on these two topics. This review aims to outline the main developments in this field and highlight the areas where further research is needed. The most important hypotheses are presented and discussed highlighting the four main lines of research in the anatomy of the human larynx and their most important findings: (1) the arrangement of the muscle fibers of the thyroarytenoid muscle is not parallel to the vocal folds in the internal part (vocalis muscle), leading to altered properties during contraction; (2) the histological structure of the human vocal cords differs from other striated muscles; (3) there is a specialized type of heavy myosin chains in the larynx; and (4) the neuromuscular system of the larynx has specific structures that form the basis of an intrinsic laryngeal nervous system. These approaches are discussed in the context of current physiological models of vocal fold vibration, and new avenues of investigation are proposed., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier GmbH.. All rights reserved.)

Sound for the human voice is produced by vocal fold flow-induced vibration and involves a complex coupling between flow dynamics, tissue motion, and acoustics. Over the past three decades, synthetic, self-oscillating vocal fold models have played an increasingly important role in the study of these complex physical interactions. In particular, two types of models have been established: "membranous" vocal fold models, such as a water-filled latex tube, and "elastic solid" models, such as ultrasoft silicone formed into a vocal fold-like shape and in some cases with multiple layers of differing stiffness to mimic the human vocal fold tissue structure. In this review, the designs, capabilities, and limitations of these two types of models are presented. Considerations unique to the implementation of elastic solid models, including fabrication processes and materials, are discussed. Applications in which these models have been used to study the underlying mechanical principles that govern phonation are surveyed, and experimental techniques and configurations are reviewed. Finally, recommendations for continued development of these models for even more lifelike response and clinical relevance are summarized., (© 2024 Acoustical Society of America.)

Many voice disorders are linked to imbalanced muscle activity and known to exhibit asymmetric vocal fold vibration. However, the relation between imbalanced muscle activation and asymmetric vocal fold vibration is not well understood. This study introduces an asymmetric triangular body-cover model of the vocal folds, controlled by the activation of bilateral intrinsic laryngeal muscles, to investigate the effects of muscle imbalance on vocal fold oscillation. Various scenarios were considered, encompassing imbalance in individual muscles and muscle pairs, as well as accounting for asymmetry in lumped element parameters. Measurements of amplitude and phase asymmetries were employed to match the oscillatory behavior of two pathological cases: unilateral paralysis and muscle tension dysphonia. The resulting simulations exhibit muscle imbalance consistent with expectations in the composition of these voice disorders, yielding asymmetries exceeding 30% for paralysis and below 5% for dysphonia. This underscores the relevance of muscle imbalance in representing phonatory scenarios and its potential for characterizing asymmetry in vocal fold vibration., (© 2024 Acoustical Society of America.)

Purpose: The vocal fold tissues undergo nearly continuous and repeated cycles of injury and repair throughout the course of an individual's lifetime. It is well established that certain individuals are at greater risk of lesion development based on personality and behavioral classification. However, these characteristics alone do not wholly predict or explain lesion development or severity. In this review, we discuss current knowledge of mechanotransduction proteins and their potential relevance to tissue homeostasis in the vocal folds., Method: A review of literature surrounding mechanotransduction and tissue homeostasis as it relates to the vocal folds was conducted. Review of the literature included searches of PubMed, Google Scholar, and other various online peer-reviewed sources. Search terms pertained to mechanosensation, mechanotransduction, mechanically activated channels, mechanical cellular regulation, and other associated concepts and terms. Additional literature was identified through the reference lists of identified papers. Findings of this literature review were then applied to known physiology and pathophysiology of the vocal folds in order to speculate on the contribution of mechanically mediated mechanisms within the vocal fold., Discussion and Conclusion: Because the vocal folds are such mechanically active structures, withstanding nearly constant external forces, there is strong support for the idea that mechanically sensitive molecular pathways within the vocal fold tissue play a major role in tissue homeostasis in the presence of these considerable forces. As such, mechanotransduction within the vocal fold should be considered and targeted in future biological studies of vocal fold physiology.

In inspiratory phonation, the air is inhaled from the mouth. The inhaled air passes through the glottis towards the lungs, thereby inducing the vocal fold vibrations. Such phonation takes place in various situations such as sighs, laughter, and crying. To characterize the inspiratory phonation, an experimental study was carried out using a physical model of the vocal folds. By reversing the direction of the airflow that passed through the vocal fold model, the inspiratory phonation was experimentally realized and compared with the normal expiratory phonation. Our experiments revealed that the phonation threshold pressures as well as the volume flow rates decreased under the inspiratory condition. Accordingly, the vocal efficiency was increased. The fundamental frequency was also increased under the inspiratory condition. The kymograms showed that phase of the upper edge of the vocal fold advanced that of the lower edge under the inspiratory phonation. A mathematical model of the vocal folds was further constructed to elucidate these experiments. Except for few aspects, our experimental findings are in good agreement with the preceding studies on inspiratory phonation (e.g., reversed propagation of the mucosal waves observed in a singer, increased pitches in human subjects, and use of inspiratory phonation in speech therapy)., (Copyright © 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

How we produce and perceive voice is constrained by laryngeal physiology and biomechanics. Such constraints may present themselves as principal dimensions in the voice outcome space that are shared among speakers. This study attempts to identify such principal dimensions in the voice outcome space and the underlying laryngeal control mechanisms in a three-dimensional computational model of voice production. A large-scale voice simulation was performed with parametric variations in vocal fold geometry and stiffness, glottal gap, vocal tract shape, and subglottal pressure. Principal component analysis was applied to data combining both the physiological control parameters and voice outcome measures. The results showed three dominant dimensions accounting for at least 50% of the total variance. The first two dimensions describe respiratory-laryngeal coordination in controlling the energy balance between low- and high-frequency harmonics in the produced voice, and the third dimension describes control of the fundamental frequency. The dominance of these three dimensions suggests that voice changes along these principal dimensions are likely to be more consistently produced and perceived by most speakers than other voice changes, and thus are more likely to have emerged during evolution and be used to convey important personal information, such as emotion and larynx size., (© 2024 Acoustical Society of America.)

Introduction: Superficial laryngeal hydration, obtained through nebulization, is related to the moisture level on the epithelial surfaces of the vocal folds, modifying their biomechanical and aerodynamic properties. Through high-speed videolaryngoscopy it is possible to obtain objective data for laryngeal analysis after nebulization and a better understanding of this phenomenon OBJECTIVE: To verify the effects of nebulization with saline solution on laryngeal parameters of digital videokymography obtained by high-speed videolaryngoscopy examination in women and men with and without laryngeal alterations METHOD: This is a clinical, comparative intra-subject study. Fifty-nine adults were selected, with and without laryngeal alterations, 30 females and 29 males. Digital videokymographs in the anterior, middle and posterior thirds of the vocal folds of the participants were analyzed before and after nebulization with 0.9% saline solution., Results: Women without laryngeal alterations showed more parameters changes after nebulization, in which there was a decrease in maximum and medium opening, amplitude of opening of the left and right vocal fold in the anterior glottal third, and an increase of the percentage of closure of the vocal folds. These results indicate a minor extent of lateral excursion of the vocal folds during phonation. In women with laryngeal alterations, the parameters that changed after nebulization were the increased frequency of opening of the left and right vocal folds in the topography of the posterior third. In men, nebulization did not change the variables studied, except for the amplitude of the right vocal fold in men with laryngeal alterations, in the analysis of the posterior glottic third., Conclusion: The results suggest that surface hydration modifies laryngeal dynamics differently between genders. After nebulization with saline solution, women without laryngeal alterations showed a decrease in the lateralization of the vocal folds during phonation, suggesting a better phonatory efficiency., (Copyright © 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Objective: To examine changes in lateral and vertical vibratory motion along the anterior, middle, and posterior sections of the vocal folds, as a function of vocal frequency variations., Methods: Absolute measurements of vocal fold surface dynamics from high-speed videoendoscopy with custom laser endoscope were made on 23 vocally healthy adults during sustained /i:/ production at 10%, 20%, and 80% of pitch range. The 3D parameters of amplitude (mm), maximum velocity opening/closing (mm/s), and mean velocity opening/closing (mm/s) were computed for the lateral and vertical vibratory motion along the anterior, middle, and posterior sections of the vocal folds. Linear mixed model analysis was conducted to evaluate the differences in (a) vocal frequency levels (high vs. normal vs. low pitch), (b) axis level (vertical vs. lateral), (c) position level (anterior vs. middle vs. posterior), and (d) gender differences (male vs. female)., Results: Overall, the superior surface vertical motion of the vocal fold is greater compared with the lateral motion, especially in males. Along the superior surface, the mean and maximum closing velocities are greater posteriorly for low pitch. The location (anterior, middle, and posterior) along the superior surface is relevant only for vocal fold closing rather than opening, as the dynamics are different along the various locations., Conclusions: The study highlights the significance of assessing the vertical motion of the superior surface of the vocal fold to understand the complex dynamics of voice production., Level of Evidence: NA Laryngoscope, 134:3267-3276, 2024., (© 2024 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)

Voice production of humans and most mammals is governed by the MyoElastic-AeroDynamic (MEAD) principle, where an air stream is modulated by self-sustained vocal fold oscillation to generate audible air pressure fluctuations. An alternative mechanism is found in ultrasonic vocalizations of rodents, which are established by an aeroacoustic (AA) phenomenon without vibration of laryngeal tissue. Previously, some authors argued that high-pitched human vocalization is also produced by the AA principle. Here, we investigate the so-called "whistle register" voice production in nine professional female operatic sopranos singing a scale from C6 (≈ 1047 Hz) to G6 (≈ 1568 Hz). Super-high-speed videolaryngoscopy revealed vocal fold collision in all participants, with closed quotients from 30 to 73%. Computational modeling showed that the biomechanical requirements to produce such high-pitched voice would be an increased contraction of the cricothyroid muscle, vocal fold strain of about 50%, and high subglottal pressure. Our data suggest that high-pitched operatic soprano singing uses the MEAD mechanism. Consequently, the commonly used term "whistle register" does not reflect the physical principle of a whistle with regard to voice generation in high pitched classical singing., (© 2024. The Author(s).)

Purpose: Surface electromyography (sEMG) has been used to evaluate extrinsic laryngeal muscle activity during swallowing and phonation. In the current study, sEMG amplitudes were measured from the infrahyoid and suprahyoid muscles during phonation through a tube submerged in water., Method: The sEMG amplitude values measured from the extrinsic laryngeal muscles and the electroglottographic contact quotient (CQ) were obtained simultaneously from 62 healthy participants (31 men, 31 women) during phonation through a tube at six different depths (2, 4, 7, 10, 15, and 20 cm) while using two tubes with different diameters (1 and 0.5 cm)., Results: With increasing depth, the sEMG amplitude for the suprahyoid muscles increased in men and women. However, sEMG amplitudes for the infrahyoid muscles increased significantly only in men. Tube diameter had a significant effect on the suprahyoid sEMG amplitudes only for men, with higher sEMG amplitudes when phonating with a 1.0-cm tube. CQ values increased with submerged depth for both men and women. Tube diameter affected results such than CQ values were higher for men when using the wider tube and for women with the narrower tube., Conclusions: Vocal fold vibratory patterns changed with the depth of tube submersion in water for both men and women, but the patterns of muscle activation differed between the sexes. This suggests that men and women use different strategies when confronted with increased intraoral pressure during semi-occluded vocal tract exercises. In this study, sEMG provided insight into the mechanism for differences between vocally normal individuals and could help detect compensatory muscle activation during tube phonation in water for people with voice disorders.

The ventricular folds, located superiorly to the vocal folds, do not usually vibrate during normal phonations. It has been shown, however, that they do vibrate together with the vocal folds under special circumstances such as voice pathology and singing voice. Towards understanding the effect of the ventricular fold oscillations on the vocal fold oscillations, the present study developed a synthetic model that takes into account anatomical features of the human ventricular folds. The synthetic model is made of flexible silicone compounds with material properties comparable to those of human ventricular fold tissues. In our experiment, an air-flow was injected into the vocal and ventricular fold models. As the distance between the left and right ventricular folds was reduced, the ventricular folds started to co-vibrate with the vocal folds. Depending upon the distance, various oscillation patterns of the vocal-ventricular folds were observed, e.g., synchronized dynamics with 1:1 or 1:2 frequency ratio and desynchronized chaotic dynamics. The observed chaotic dynamics might be related to voice pathology induced by the ventricular phonation. A computational model was further presented to elucidate the experimental findings., (Copyright © 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Objective: To analyze the effects of androgen therapy on the thyroarytenoid (TA) muscle, expression of androgen receptors (ARs) and hyaluronic acid (HA) concentration in the vocal folds (VFs) of adult female rats., Methods: Twenty-one adult female Wistar rats were divided into experimental and control groups. The experimental group received weekly intramuscular injections of nandrolone decanoate for 9 weeks. Following euthanasia and dissection of the VFs, histomorphometric analysis of the TA muscle, immunohistochemical evaluation of ARs, and measurement of HA concentration using the ELISA-like fluorimetric method were performed., Results: The experimental group exhibited a significantly larger mean fiber cross-sectional area in the TA muscle compared to the control group (434.3 ± 68.6 μm 2 versus 305.7 ± 110.1 μm 2 ; p = 0.029), indicating muscle hypertrophy. There was no significant difference in the number of muscle fibers. The experimental group showed higher expression of ARs in the lamina propria (62.0% ± 30.3% versus 22.0% ± 22.8%; p = 0.046) and in the TA muscle (45.0% ± 22.6% versus 18.3% ± 9.8%; p = 0.024). There was no significant difference in the concentration of HA., Conclusion: Exposure of adult female rats to androgen therapy resulted in hypertrophy of the TA muscle and increased expression of ARs in the VFs. The TA muscle seems to be the primary target of testosterone action in the VF, and the up-regulation of ARs might contribute to the persistent deepening of the voice., Level of Evidence: NA Laryngoscope, 134:2316-2321, 2024., (© 2023 The American Laryngological, Rhinological and Otological Society, Inc.)

Voice disorders resulting from various pathological vocal fold conditions or postoperative recovery of laryngeal cancer surgeries, are common causes of dysphonia. Here, we present a self-powered wearable sensing-actuation system based on soft magnetoelasticity that enables assisted speaking without relying on the vocal folds. It holds a lightweighted mass of approximately 7.2 g, skin-alike modulus of 7.83 × 10 5  Pa, stability against skin perspiration, and a maximum stretchability of 164%. The wearable sensing component can effectively capture extrinsic laryngeal muscle movement and convert them into high-fidelity and analyzable electrical signals, which can be translated into speech signals with the assistance of machine learning algorithms with an accuracy of 94.68%. Then, with the wearable actuation component, the speech could be expressed as voice signals while circumventing vocal fold vibration. We expect this approach could facilitate the restoration of normal voice function and significantly enhance the quality of life for patients with dysfunctional vocal folds., (© 2024. The Author(s).)

Phonation critically depends on precise controls of laryngeal muscles in coordination with ongoing respiration. However, the neural mechanisms governing these processes remain unclear. We identified excitatory vocalization-specific laryngeal premotor neurons located in the retroambiguus nucleus (RAm VOC ) in adult mice as being both necessary and sufficient for driving vocal cord closure and eliciting mouse ultrasonic vocalizations (USVs). The duration of RAm VOC activation can determine the lengths of both USV syllables and concurrent expiration periods, with the impact of RAm VOC activation depending on respiration phases. RAm VOC neurons receive inhibition from the preBötzinger complex, and inspiration needs override RAm VOC -mediated vocal cord closure. Ablating inhibitory synapses in RAm VOC neurons compromised this inspiration gating of laryngeal adduction, resulting in discoordination of vocalization with respiration. Our study reveals the circuits for vocal production and vocal-respiratory coordination.

Previous experimental studies suggested that restraining the vocal fold vertical motion may reduce the coupling strength between the voice source and vocal tract. In this study, the effects of vocal fold vertical motion on source-filter interaction were systematically examined in a two-dimensional two-mass model coupled to a compressible flow simulation. The results showed that when allowed to move vertically, the vocal folds exhibited subharmonic vibration due to entrainment to the first vocal tract acoustic resonance. Restraining the vertical motion suppressed this entrainment. This indicates that the vertical mobility of the vocal folds may play a role in regulating source-filter interaction., (© 2024 Author(s). All article content, except where otherwise noted, is licensed under a Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).)

Introduction: Analysis of medial surface dynamics of the vocal folds (VF) is critical to understanding voice production and treatment of voice disorders. We analyzed VF medial surface vibratory dynamics, evaluating the effects of airflow and nerve stimulation using 3D reconstruction and empirical eigenfunctions (EEF)., Study Design: In vivo canine hemilarynx phonation., Methods: An in vivo canine hemilarynx was phonated while graded stimulation of the recurrent and superior laryngeal nerves (RLN and SLN) was performed. For each phonatory condition, vibratory cycles were 3D reconstructed from tattooed landmarks on the VF medial surface at low, medium, and high airflows. Parameters describing medial surface trajectory shape were calculated, and underlying patterns were emphasized using EEFs. Fundamental frequency and smoothed cepstral peak prominence (CPPS) were calculated from acoustic data., Results: Convex-hull area of landmark trajectories increased with increasing flow and decreasing nerve activation level. Trajectory shapes observed included circular, ellipsoid, bent, and figure-eight. They were more circular on the superior and anterior VF, and more elliptical and line-like on the inferior and posterior VF. The EEFs capturing synchronal opening and closing (EEF1) and alternating convergent/divergent (EEF2) glottis shapes were mostly unaffected by flow and nerve stimulation levels. CPPS increased with higher airflow except for low RLN activation and very dominant SLN stimulation., Conclusion: We analyzed VF vibration as a function of neuromuscular stimulation and airflow levels. Oscillation patterns such as figure-eight and bent trajectories were linked to high nerve activation and flow. Further studies investigating longer sections of 3D reconstructed oscillations are needed., Level of Evidence: N/A, Basic Science Laryngoscope, 134:1249-1257, 2024., (© 2023 The American Laryngological, Rhinological and Otological Society, Inc.)

Primates have varied vocal repertoires to communicate with conspecifics and sometimes other species. The larynx has a central role in vocal source generation, where a pair of vocal folds vibrates to modify the air flow. Here, we show that Madagascan lemurs have a unique additional pair of folds in the vestibular region, parallel to the vocal folds. The additional fold has a rigid body of a vocal muscle branch and it is covered by a stratified squamous epithelium, equal to those of the vocal fold. Such anatomical features support the hypothesis that it also vibrates in a manner like the vibrations that occur in the vocal folds. To examine the acoustic function of the two pairs of folds, we made a silicone compound model to demonstrate that they can simultaneously vibrate to lower the fundamental frequency and increase vocal efficiency. Similar acoustic effects are achieved using different features of the larynx for the other primates, e.g., by vibrating multiple sets of ventricular folds in several species and further by an evolutionary modification of enlarged larynx in howler monkeys. Our multidisciplinary approaches found that these functions were acquired through a unique evolutionary adaptation of the twin vocal folds in Madagascan lemurs., (© 2024. The Author(s).)

Studies have shown that certain vocal fold pathologies are more common in one sex than the other. This is often explained by differences in the composition of the lamina propria and anatomical differences between female and male vocal folds, resulting in e.g. different fundamental frequencies. Here, we investigated a potential sex-specific voice frequency effect in an in vitro setting using vocal fold fibroblasts from one male and one female donor with and without cigarette smoke extract (CSE) addition. After exposure to either male or female vibration frequency with or without CSE, cells and supernatants were harvested. Gene and protein analysis were performed by means of qPCR, western blot, ELISA and Luminex. We found that exposure of cells to both male and female vibration pattern did not elicit significant changes in the expression of extracellular matrix-, inflammation-, and fibrosis-related genes, compared to control cells. The addition of CSE to vibration downregulated the gene expression of COL1A1 in cells exposed to the female vibration pattern, as well as induced MMP1 and PTGS2 in cells exposed to both female and male vibration pattern. The protein expression of MMP1 and COX2 was found to be significantly upregulated only in cells exposed to CSE and female vibration pattern. To conclude, different vibration patterns alone did not cause different responses of the cells. However, the female vibration pattern in combination with CSE had a tendency to elicit/maintain more pro-inflammatory responses in cells than the male vibration pattern., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Kirsch et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: Mesna triggers chemical dissection in tissues by breaking down disulfide bonds and is used during surgical dissections in several areas. In this study, we aimed to investigate the effect of submucosal mesna infiltration on microflap elevation and the histopathological findings of its effects on the vocal fold lamina propria in a rabbit model., Methods: Eight adult male New Zealand white rabbits were used in the study. Each vocal fold was randomized, and 0.1 mL of mesna was injected into one-fold and 0.1 mL of saline to the contralateral fold. An incision was made on the epithelium and elevation was performed. The animals were sacrificed after two weeks, and the vocal folds were excised. Inflammatory response, fibrosis, and epithelial thickness were evaluated with hematoxylin eosin and Masson's Trichrome staining. Elevation time and histopathological features were compared between the two groups., Results: The elevation time (20.9 ± 1.6 second) in the saline group was significantly higher (P < 0.05) than in the mesna group (15.0 ± 3.4 second). The inflammation (1.3 ± 0.5 vs. 1.1 ± 1.0, respectively) and fibrosis scores (1.0 ± 0.8 vs. 0.8 ± 0.7, respectively) did not differ significantly (P > 0.05 in both). Epithelial thickness (12.5 ± 4.7 vs. 10.3 ± 5.3, respectively) did not differ significantly (P ˃ 0.05) in the mesna and saline groups either., Conclusion: We determined that mesna facilitates the microflap elevation of the vocal folds in rabbits and does not damage the histological structure of vocal folds. This study encourages future studies to evaluate the use of mesna, now actively used across disciplines, in phonosurgery as well., (Copyright © 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Introduction: This study examined the immediate acoustic, auditory-perceptual, and self-perceptual effects of two semi-occluded vocal tract exercises (SOVTs): straw phonation and straw phonation into a cup of water, delivered in a remote setting., Method: Thirty-six participants (19 females and 17 males) completed a baseline battery of acoustic recordings, followed by one of two SOVTs, and an identical post-task battery. The procedure repeated itself to include the other SOVT. Participants were also asked to rate their self-perceived vocal effort and quality following each condition. Recordings were presented to three expert listeners for completion of auditory-perceptual analysis., Results: Acoustically, a significant decrease in shimmer was noted following straw phonation. Auditory-perceptual analysis revealed a significant increase in the perception of strain following straw phonation into a cup of water. While no significant differences were found between SOVT tasks in self-perception of vocal effort, a significant increase in self-perception of vocal loudness was reported following straw phonation into a cup of water., Conclusion: SOVTs have a varied, yet significant short-term impact across acoustic, auditory-perceptual, and self-perceptual measures of voice production. Straw phonation provided consistently significant acoustic results, with nearly every variable improving to some degree. Results also support the notion that shimmer is an acoustic measure that is particularly susceptible to change following modest manipulation. These results, in addition to the auditory-perceptual and self-perceptual findings, have a direct impact on how SOVTs are being used clinically and may generalize to inform the way voice metrics are collected and analyzed., (© 2023 S. Karger AG, Basel.)

Objectives: Despite gross anatomic and histologic differences between human and canine vocal folds, similar wave patterns have been described yet not fully characterized. We reconstructed vocal fold (VF) vibration in a canine hemilarynx and performed histologic examination of the same vocal fold. We demonstrate comparable wave patterns while exploring the importance of certain anatomic architectures., Methods: An in vivo canine hemilarynx was phonated against a glass prism at low and high muscle activation conditions. Vibration was captured using high-speed video, and trajectories of VF medial surface tattooed landmarks were 3D-reconstructed. The method of empirical eigenfunctions was used to capture the essential dynamics of vibratory movement. Histologic examination of the hemilarynx was performed., Results: Oscillation patterns were highly similar between the in vivo canine and previous reports of ex vivo human models. The two most dominant eigenfunctions comprised over 90% of total variance of movement, representing opening/closing and convergent/divergent movement patterns, respectively. We demonstrate a vertical phase difference during the glottal cycle. The time delay between the inferior and superior VF was greater during opening than closing for both activation conditions. Histological examination of canine VF showed not only a thicker lamina propria layer superiorly but also a distinct pattern of thyroarytenoid muscle fibers and fascicles as described in human studies., Conclusions: Histologic and vibratory examination of the canine vocal fold demonstrated human vocal fold vibratory patterns despite certain microstructural differences. This study suggests that the multilayered lamina propria may not be fundamental to vibratory patterns necessary for human-like voice production., Level of Evidence: NA (Basic science study) Laryngoscope, 134:264-271, 2024., (© 2023 The American Laryngological, Rhinological and Otological Society, Inc.)

Human vocal folds are highly deformable non-linear oscillators. During phonation, they stretch up to 50% under the complex action of laryngeal muscles. Exploring the fluid/structure/acoustic interactions on a human-scale replica to study the role of the laryngeal muscles remains a challenge. For that purpose, we designed a novel in vitro testbed to control vocal-folds pre-phonatory deformation. The testbed was used to study the vibration and the sound production of vocal-fold replicas made of (i) silicone elastomers commonly used in voice research and (ii) a gelatin-based hydrogel we recently optimized to approximate the mechanics of vocal folds during finite strains under tension, compression and shear loadings. The geometrical and mechanical parameters measured during the experiments emphasized the effect of the vocal-fold material and pre-stretch on the vibration patterns and sounds. In particular, increasing the material stiffness increases glottal flow resistance, subglottal pressure required to sustain oscillations and vibratory fundamental frequency. In addition, although the hydrogel vocal folds only oscillate at low frequencies (close to 60 Hz), the subglottal pressure they require for that purpose is realistic (within the range 0.5-2 kPa), as well as their glottal opening and contact during a vibration cycle. The results also evidence the effect of adhesion forces on vibration and sound production., (© 2023. The Author(s).)

Cat purring, the unusual, pulsed vibration that epitomizes comfort, enjoys a special status in the world of vocal communication research. Indeed, it has long been flagged as a rare exception to the dominant theory of voice production in mammals. A new study presents histological and biomechanical evidence that purring can occur passively, without needing muscle vibration in the larynx controlled by an independent neural oscillator., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Most mammals produce vocal sounds according to the myoelastic-aerodynamic (MEAD) principle, through self-sustaining oscillation of laryngeal tissues. 1 , 2 In contrast, cats have long been believed to produce their low-frequency purr vocalizations through a radically different mechanism involving active muscle contractions (AMC), where neurally driven electromyographic burst patterns (typically at 20-30 Hz) cause the intrinsic laryngeal muscles to actively modulate the respiratory airflow. Direct empirical evidence for this AMC mechanism is sparse. 3 Here, the fundamental frequency (f o ) ranges of eight domestic cats (Felis silvestris catus) were investigated in an excised larynx setup, to test the prediction of the AMC hypothesis that vibration should be impossible without neuromuscular activity, and thus unattainable in excised larynx setups, which are based on MEAD principles. Surprisingly, all eight excised larynges produced self-sustained oscillations at typical cat purring rates. Histological analysis of cat larynges revealed the presence of connective tissue masses, up to 4 mm in diameter, embedded in the vocal fold. 4 This vocal fold specialization appears to allow the unusually low f o values observed in purring. While our data do not fully reject the AMC hypothesis for purring, they show that cat larynges can easily produce sounds in the purr regime with fundamental frequencies of 25 to 30 Hz without neural input or muscular contraction. This strongly suggests that the physical and physiological basis of cat purring involves the same MEAD-based mechanisms as other cat vocalizations (e.g., meows) and most other vertebrate vocalizations but is potentially augmented by AMC., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Textbooks and atlases of human macroscopic and microscopic anatomy of the larynx generally provide, if at all, only sparse information on the laryngeal Musculus ventricularis. However, several studies indicate that this muscle takes over the function of vestibular (ventricular) fold phonation after denervation of the Musculus vocalis. In the present study, 29 laryngeal specimens were coronally dissected at different levels, i.e. the anterior (L1), middle (L2), and posterior third of the vestibular fold (L3), and they underwent histological analysis. In all specimens the vestibular folds of both hemi-larynxes contained striated muscle bundles in variable amounts, representing a ventricularis muscle. These muscle bundles obviously originated from the lateral (external) and thyroepiglottic part of the thyroarytenoid muscle and the aryepiglottic part of the oblique arytenoid muscle, as has been described by other authors. The areas of vestibular folds and their amounts of ventricularis muscle bundles were measured using image analysis software (imageJ) by manual tracing. The mean area of the vestibular folds of both hemi-larynxes was 27.9 mm 2 (SD [standard deviation] ± 9.17), and the area occupied by fibers of the ventricularis muscle was 1.5 mm 2 (SD ± 1.78). Statistical analysis comparing the areas of both hemi-larynxes and levels resulted in no significant differences, except for the levels 2 and 3. In level 2, significantly more muscle fibers (2.0 mm 2 ; SD ± 2.21) were detectable within the vestibular fold than in level 3 (0.9 mm 2 ; SD ± 1.43). Level 1 also contained more muscle fibers (1.1 mm 2 ; SD ± 1.06) than level 3, however, without significance. In conclusion, the laryngeal ventricularis muscle is present in the majority of reported cases. Since the muscle is of clinical relevance, it should be included in anatomical textbooks by default., (© 2023 The Authors. Clinical Anatomy published by Wiley Periodicals LLC on behalf of American Association of Clinical Anatomists and British Association of Clinical Anatomists.)

Background: The efficacy of inhalation therapy depends on the drug deposition in the human respiratory tract. This study investigates the effects of vocal fold adduction on the particle deposition in the glottis., Methods: A realistic mouth-throat (MT) geometry was built based on CT images of a healthy adult (MT-A). Mild (MT-B) and great (MT-C) vocal fold (VF) adduction were incorporated in the original model. Monodisperse particles range in size from 3 to 12 μm were simulated at inspiration flow rates of 15, 30 and 45 L per minute (LPM). The regional deposition of drug aerosols was performed in 3D-printed models and quantified using high-performance liquid chromatography., Results: Both the numerical analysis and in vitro experiments show that most particles are deposited in the mouth, pharynx and supraglottis, while few are deposited in the glottis and subglottis. For most cases in MT-A, the particle quantity in glottis is lower than 0.02 N/mm 2 at 15 and 30 LPM while they increase dramatically at 45 LPM. It peaked at 0.347 N/mm 2 for 5-μm particles at 45 LPM in MT-B and 2.324 N/mm 2 for 6-μm particles at 30 LPM in MT-C. The lowest drug mass faction in the glottis in vitro were found at 15 LPM for MT-A and MT-C, and at 30 LPM for MT-B, whereas it peaked at 45 LPM for all MT models, 0.71% in MT-A, 1.16% in MT-B, and 2.53% in MT-C, respectively., Conclusion: Based on the results of this study, larger particles are more likely to be deposited in the oral cavity, oropharynx, and supraglottis than in the glottis. However, particle deposition in the glottis generally increases with VF adduction and greater inspiratory flow rates., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Incomplete glottal closure is a laryngeal configuration wherein the glottis is not fully obstructed prior to phonation. It has been linked to inefficient voice production and voice disorders. Various incomplete glottal closure patterns can arise and the mechanisms driving them are not well understood. In this work, we introduce an Euler-Bernoulli composite beam vocal fold (VF) model that produces qualitatively similar incomplete glottal closure patterns as those observed in experimental and high-fidelity numerical studies, thus offering insights into the potential underlying physical mechanisms. Refined physiological insights are pursued by incorporating the beam model into a VF posturing model that embeds the five intrinsic laryngeal muscles. Analysis of the combined model shows that co-activating the lateral cricoarytenoid (LCA) and interarytenoid (IA) muscles without activating the thyroarytenoid (TA) muscle results in a bowed (convex) VF geometry with closure at the posterior margin only; this is primarily attributed to the reactive moments at the anterior VF margin. This bowed pattern can also arise during VF compression (due to extrinsic laryngeal muscle activation for example), wherein the internal moment induced passively by the TA muscle tissue is the predominant mechanism. On the other hand, activating the TA muscle without incorporating other adductory muscles results in anterior and mid-membranous glottal closure, a concave VF geometry, and a posterior glottal opening driven by internal moments induced by TA muscle activation. In the case of initial full glottal closure, the posterior cricoarytenoid (PCA) muscle activation cancels the adductory effects of the LCA and IA muscles, resulting in a concave VF geometry and posterior glottal opening. Furthermore, certain maneuvers involving co-activation of all adductory muscles result in an hourglass glottal shape due to a reactive moment at the anterior VF margin and moderate internal moment induced by TA muscle activation. These findings have implications regarding potential laryngeal maneuvers in patients with voice disorders involving imbalances or excessive tension in the laryngeal muscles such as muscle tension dysphonia., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Sean Peterson reports financial support was provided by National Institute on Deafness and Other Communication Disorders. Matías Zañartu reports financial support was provided by National Institute on Deafness and Other Communication Disorders. Matas Zanartu reports financial support was provided by National Agency for Research and Development. Matías Zañartu reports a relationship with Lanek SPA that includes: equity or stocks., (Copyright © 2023. Published by Elsevier Ltd.)

Objectives: Local injection of glucocorticoids (GCs) into the vocal folds has been used for treating the vocal fold lesions. While the positive effects on vocal fold nodules, polyps, or scarring have been clinically reported, some concern remains around the potential adverse effects such as vocal fold atrophy, and the mechanisms remain unclear. The present study examined the histology and gene expression of locally injected GC into the vocal folds in rats., Methods: Thirteen-week-old male Sprague-Dawley rats were used in the experiments. Triamcinolone acetonide (TAA) or saline were administered repeatedly to the right vocal folds at a weekly interval, and rats were euthanized one week after the last administration for histological examination. Genetic examination was assessed hyaluronic acid (HA) metabolism at 1 or 3 days after a single TAA injection by quantitative real-time polymerase chain reaction (qRT-PCR)., Results: The group which underwent four TAA injections showed a significant decrease in HA in the lamina propria (LP), thickness of the LP and total cell numbers of the LP compared with the saline group. In contrast, there was no significant difference in the area of collagen accumulation and the thyroarytenoid muscle, although there was a tendency of atrophy of the muscle. After single injection of TAA, qRT-PCR showed a significant decrease in the expression of HA synthases, Has2 and Has3., Conclusions: The current animal study first demonstrates that repeated intracordal injection of GCs may lead to atrophy of vocal folds caused by decrease of deposition of HA in the LP and decrease of gene expression of Has., (Copyright © 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

The goal of this computational study is to quantify global effects of vocal tract constriction at various locations (false vocal folds, aryepiglottic folds, pharynx, oral cavity, and lips) on the voice source across a large range of vocal fold conditions. The results showed that while inclusion of a uniform vocal tract had notable effects on the voice source, further constricting the vocal tract only had small effects except for conditions of extreme constriction, at which constrictions at any location along the vocal tract decreased the mean and peak-to-peak amplitude of the glottal flow waveform. Although narrowing in the epilarynx increased the normalized maximum flow declination rate, vocal tract constriction in general slightly reduced the source strength and high-frequency harmonic production at the glottis, except for a limited set of vocal fold conditions (e.g., soft, long vocal folds subject to relatively high pressure). This suggests that simultaneous laryngeal and vocal tract adjustments are required to maximize source-filter interaction. While vocal tract adjustments are often assumed to improve voice production, our results indicate that such improvements are mainly due to changes in vocal tract acoustic response rather than improved voice production at the glottis., (© 2023 Acoustical Society of America.)

Neck muscles play important roles in various physiological tasks, including swallowing, head stabilization, and phonation. The mechanisms by which neck muscles influence phonation are not well understood, with conflicting reports on the change in fundamental frequency for ostensibly the same neck muscle activation scenarios. In this work, we introduce a reduced-order muscle-controlled vocal fold model, comprising both intrinsic muscle control and extrinsic muscle effects. The model predicts that when the neck muscles pull the thyroid cartilage in the superior-anterior direction (with a sufficiently large anterior component), inferior direction, or inferior-anterior direction, tension in the vocal folds increases, leading to fundamental frequency rise during sustained phonation. On the other hand, pulling in the superior direction, superior-posterior direction, or inferior-posterior direction (with a sufficiently large posterior component) tends to decrease vocal fold tension and phonation fundamental frequency. Varying the pulling force location alters the posture and phonation biomechanics, depending on the force direction. These findings suggest potential roles of particular neck muscles in modulating phonation fundamental frequency, with implications for vocal hyperfunction., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: Estimation of physiological control parameters of the vocal system from the produced voice outcome has important applications in clinical management of voice disorders . Previously we developed a simulation-based neural network for estimation of vocal fold geometry, mechanical properties, and subglottal pressure from voice outcome features that characterize the acoustics of the produced voice. The goals of this study are to (1) explore the possibility of improving the estimation accuracy of physiological control parameters by including voice outcome features characterizing vocal fold vibration; and (2) identify voice feature sets that optimize both estimation accuracy and robustness to measurement noise., Methods: Feedforward neural networks are trained to solve the inversion problem of estimating the physiological control parameters of a three-dimensional body-cover vocal fold model from different sets of voice outcome features that characterize the simulated voice acoustics, glottal flow, and vocal fold vibration. A sensitivity analysis is then performed to evaluate the contribution of individual voice features to the overall performance of the neural networks in estimating the physiologic control parameters., Results and Conclusions: While including voice outcome features characterizing vocal fold vibration increases estimation accuracy, it also reduces the network's robustness to measurement noise, due to high sensitivity of network performance to voice outcome features measuring the absolute amplitudes of the glottal flow and area waveforms, which are also difficult to measure accurately in practical applications. By excluding such glottal flow-based features and replacing glottal area-based features by their normalized counterparts, we are able to significantly improve both estimation accuracy and robustness to noise. We further show that similar estimation accuracy and robustness can be achieved with an even smaller set of voice outcome features by excluding features of small sensitivity., (Copyright © 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)