Patterns of Vocal Fold Closure in Professional Singers

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Patterns of Vocal Fold Closure in Professional Singers PATTERNS OF VOCAL FOLD CLOSURE IN PROFESSIONAL SINGERS CARIE VOLKAR Master of Music in Voice Performance University of Akron May 2005 submitted in partial fulfillment of requirement for the degree MASTER OF ARTS IN SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY at the CLEVELAND STATE UNIVERSITY MAY 2017 We hereby approve this thesis for Carie Volkar Candidate for the Master of Arts in Speech Pathology and Audiology degree for the Department of Speech and Hearing and the CLEVELAND STATE UNIVERSITY’S College of Graduate Studies by Thesis Chairperson, Violet O. Cox, Ph.D., CCC-SLP _____________________________________________ Department & Date Thesis Committee Member, Myrita Wilhite, Au.D. _____________________________________________ Department & Date Thesis Committee Member, Brian Bailey, D.M.A. _____________________________________________ Department & Date Student’s Date of Defense: May 2, 2017 ACKNOWLEDGEMENTS I would like to take this opportunity to thank all those who guided me through this process. I would like to thank my family for their love and support throughout my life and education. I would also like to thank my friends for always being there for me and pushing me to take care of myself while in the program. I would like to express my most sincere gratitude to my thesis chairperson, Dr. Violet Cox for her mentorship throughout my thesis and this program. I would like to thank her for the enthusiasm and passion she shared for my research topic. I would like to thank her for training me in stroboscopy and for being the methodologist in my investigation. I thank her for her patience and motivation to finish this step towards completing my Master’s degree. I also would like to thank her for the immense knowledge I have gained from the courses she has taught throughout the program. It is because of her that I feel confident working in the medical setting of our field. Additionally, I would like to thank the Dr. Brian Bailey and Dr. Myrita Wilhite, thesis methodologists and members of my thesis committee for their insightful feedback and support of my research. I would like to express my gratitude to the participants for taking the time out of their lives to be a part of this study and the trust it takes to be examined in this manner. I would like to thank all the supervisors I have worked with for helping to shape me into the clinician I have become. Lastly, I would like to thank and congratulate my entire cohort. If it had not been for meeting these dedicated and intelligent clinicians I am not sure I would have survived this process. Thank you from the bottom of my heart. PATTERNS OF VOCAL FOLD CLOSURE IN PROFESSIONAL SINGERS CARIE VOLKAR ABSTRACT The present study aimed to investigate differences in vocal fold (VF) closure patterns in singers of varying genres with use of videostroboscopy. Three participants were selected to be in groups of different singing genres including classical, musical theatre, and pop/rock. A control group of non-singers were also included. Vocal tasks were assessed through acoustic, subjective, and stroboscopic analysis. Significant differences were observed between the classical group of singers and the pop/rock group. The VF closure patterns were relatively normal for the classical singers in comparison to the abnormal patterns in pop/rock singers. The musical theatre group had both normal and abnormal patterns. There was no significant differences between groups when analyzing the acoustic data through descriptive means. The acoustic data indicated all participants within relatively normal limits for the parameters assessed, except some inconsistencies with maximum phonation time (MPT). The subjective analysis showed differences between the classical and pop/rock groups in terms of vocal health and hygiene. The classical group showed the best vocal health and hygiene practices compared to the fair practices of the pop/rock group. The results between the classical and pop/rock group indicates that the lack of vocal training and competing with loud instrumentation in noisy environments may contribute to the recruitment of laryngeal musculature to achieve VF closure. These findings may indicate the need of vocal training and education in vocal health and hygiene for pop/rock singers. iv TABLE OF CONTENTS Page ABSTRACT…………………………………………………………………………….. iv LIST OF FIGURES…………………………………………………………………...... vii LIST OF TABLES & GRAPHS…...……………………………………...…...……..... viii NOMENCLATURE……………………………………………………..…...………..... ix CHAPTER I. INTRODUCTION…………………………………………………………………….. 1 Physiology of Voice Production……………………………………...………….. 1 Parameters of the Vocal Folds…………...…………………………...………..… 3 The Professional Voice………………………………………………………..... 10 Purpose…………………………………………………………………..……… 12 Literature review…………………………………………………………...…… 13 Hypothesis and solution………………………………………………………… 16 II. METHODS…………………………………………………………………………... 18 IRB/Consent……………………….………….………………………………… 18 Participant Selection………………....…………………………………………. 18 Objective Vocal Analysis…………………………………..……………..……. 20 Videostroboscopy…………..………………………………………..…………. 21 Subjective Vocal Analysis……………………………………………..……….. 22 III. RESULTS…………………………………………………...……………..……….. 23 Videostroboscopy…………………………………………….…………..…….. 24 Classical/Opera Singers………………………………………………… 24 Musical Theatre Singers………………………………………………... 29 Pop/Rock Singers……………………………………..……………..….. 33 Non-Singers…………………………………………………………….. 38 v Aerodynamic and Acoustic Vocal Parameters………..……….…………..…… 41 Classical/Opera Singers………………………………………………… 44 Musical Theatre Singers………………………………………………... 45 Pop/Rock Singers……………………………………………...……...… 47 Non-Singers…………………………………………………………….. 48 Perceptual Self-Assessment of Voice………………………….……………….. 49 IV. DISCUSSION………………………………………………………………….…… 53 Conclusion……………………………………………………………………… 53 Limitations and Future Research…………………………………………….…. 59 REFERENCES………………………………………………………………….……… 61 APPENDICES…………………………………………………………………..……… 65 A. Instructions to Participants…………………………………………………….. 66 B. Consent Form……………………………………………………...……...…… 68 C. Brief Screening Tool……………………………………………………...…… 70 D. Voice Evaluation Form………..…………………………………………..…... 71 E. Praat™ Acoustic Participant Data…………………………………………….. 73 vi LIST OF FIGURES Figure Page 1.1 Laryngeal anatomy………………………………………………………...…………. 2 1.2 Vocal folds set in motion by airstream……………………………………..…........... 2 1.3 Assessment of glottic closure patterns…………………………………………..…… 6 1.4 Common vocal fold closure patterns……………………………….………..…….… 6 1.5 Amplitude and phase patterns…………………………………….………………….. 8 1.6 Periodic vibrations……………………………………………….…………………... 9 3.1 Classical/opera participant male 25………………...…………….………………… 24 3.2 Classical/opera participant female 26……………………………...……………….. 26 3.3 Classical/opera participant male 28………………………………………………… 27 3.4 Musical theatre participant female 21…………..……………...…………………… 29 3.5 Musical theatre participant male 26………………………………………………… 30 3.6 Musical theatre participant female 36……………………….……………………… 31 3.7 Pop/rock participant female 21……………..………………………………….…… 33 3.8 Pop/rock participant male 29……………………………...…………………...…… 35 3.9 Pop/rock participant male 34…………………………….……………………….… 36 3.10 Non-singer participant female 23………….……….……………………………… 38 3.11 Non-singer participant male 26……………….…………………………………… 39 3.12 Non-singer participant female 34……………..…………………………………… 40 vii LIST OF TABLES & GRAPHS Table/Graphs Page 3.1 Praat vocal parameter averages……………………………………...………...……. 43 3.2 Classical/opera participant spectrographs……………...…………………………… 44 3.3 Musical theatre participant spectrographs………………….………..…………...… 45 3.4 Pop/rock participant spectrographs……………………………………….………… 47 3.5 Non-singer participant spectrographs………………………………....…….……… 48 viii NOMENCLATURE VF - vocal folds F0- fundamental frequency MPT- maximum phonation time Phonotrauma- excessive vocal abuse/misuse GERD- gastroesophageal reflux disease ix CHAPTER I INTRODUCTION Professional singers tend to be more prone to vocal injury or vocal fold (VF) pathology due to the demands of performance schedules. These demands include, but are not limited to: maximal endurance, increased stamina, wide frequency range, and projection of the voice. The aim of this study is to investigate the nature of vocal fold closure among professional singers of different genres and non-singers. Physiology of Voice production The human vocal folds are located within the larynx (Figure 1.1) which is anatomically positioned at the levels of the cervical vertebrae 3 through 6 (C3 – C6) in adults. To produce phonation, the airstream passes between the two vocal folds that have come together. These folds are set into a vibratory pattern by the passing airstream (Figure 1.2). They vibrate at a speed ranging from approximately 100 to over 1000 times per second, Hertz depending on their length and thickness. 1 (From The Professional Voice Resource Guide: vocal nodules/nodes.) Figure 1.1 Laryngeal anatomy (aerial view) (From Hirano, M. & Bless, D., (1993) Videostroboscopic examination of the larynx.) Figure 1.2 Vocal folds set in motion by air stream from the lungs in aerial/front views 2 Parameters of the vocal folds viewed with stroboscopic examination The parameters the investigator evaluated with stroboscopy were the vocal fold margins and symmetry, mucosal wave, vocal fold closure pattern, amplitude and phase, periodicity or aperiodicity of the vocal fold vibrations, and the presence or lack of supraglottic hyperfunction seen with abnormal arytenoid and ventricular fold movement. These parameters
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