This study highlights the potential of active shape modeling to advance understanding of factors underlying morphologic and pitch-related functional variations affecting vocal structures and the airway in health and disease.

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Kinesthesis, the sense of muscular effort that accompanies bodily movement, is known to be important in musical performance. Less well understood is the role of the kinesthetic sense in musical listening. Recent observations that listening to music is associated with fast, subtle, pitch-related patterns of kinesthetic sensations that involve the ears, eustachian tubes, nasopharynx, vocal tract, and even muscles of facial expression challenges traditional accounts of auditory processing divorced from peripheral vocal input and suggests, instead, the hypothesis that auditory and vocal processing mechanisms rely on shared peripheral substrates in addition to shared central (brain-based) substrates. Furthermore, the presence of kinesthetic sensations that arise in response to novelty, following voluntary switches of attention and even in anticipation of familiar sounds suggests that the kinesthetic sense plays an important part in the listening process. Here, the significance of kinesthetic sensations associated with listening behavior is discussed within the context of recent MRI investigations (where pitch-related changes associated with vocal production are investigated under conditions that reduce articulatory and postural input to a minimum) together with evidence from a diverse range of historical and contemporary sources. Overall, evidence from a wide range of disciplines supports the hypothesis that auditory-vocal processing relies on shared peripheral substrates in addition to shared central substrates and suggests a framework within which kinesthetic vocal sensations may be further investigated. Wide-ranging implications arising from improved awareness of the part played by the kinesthetic sense in musical listening are discussed.