Effects on Vocal Fold Collision and Phonation Threshold Pressure of Resonance Tube Phonation With Tube End in Water

Abstract

Purpose: Resonance tube phonation in water (RTPW) or in air is a voice therapy method successfully used for treatment of several voice pathologies. Its effect on the voice has not been thoroughly studied. This investigation analyzes the effects of RTPW on collision and phonation threshold pressures (CTP and PTP), the lowest subglottal pressure needed for vocal fold collision and phonation, respectively.Method: Twelve mezzo-sopranos phonated into a glass tube, the end of which was placed under the water surface in a jar. Subglottal pressure, electroglottography and audio signals were recorded before and after exercise. Also, the perceptual effects were assessed in a listening test with an expert panel which also rated the subjects' singing experience.Results: Resonance tube phonation significantly increased CTP, and also tended to improve perceived voice quality. The latter effect was mostly greater in singers who did not practice singing daily. In addition, a more pronounced perceptual effect was found in singers rated as being less experienced.Conclusion: Resonance tube phonation significantly raised CTP and tended to improve perceptual ratings of voice quality. The effect on PTP failed to reach significance.

Evaluating the efficacy of voice therapy for functional, organic and neurological voice disorders

“…Similarly, there is recent interest in the examination of flow phonation therapy or semi‐occluded vocal tract therapy. This approach appears to be supported by a significant body of laboratory‐based evidence to claim ‘proof of concept’ . These studies provide a reasonable justification for the call for improved scientific evaluation of intervention effectiveness.…”

Do Different Semi-Occluded Voice Exercises Affect Vocal Fold Adduction Differently in Subjects Diagnosed with Hyperfunctional Dysphonia?

“…Therefore, exercises such as lip trills, tongue trills, phonation in water and blowing raspberries may be useful for patients with high muscle tension not only because the CQ is lowered (as demonstrated in earlier studies), but also because of the massage-like effect. Enflo et al [30] reported that during phonation into the resonance tube in water, variation of oral pressure modifies the transglottal pressure (which drives the vocal folds), and this, in turn, causes changes in the EGG signal amplitude. In a high-speed and electroglottographic study, a modulation effect on vocal fold vibration when producing bubbles was also observed [27].…”

Intraoral pressures produced by thirteen semi-occluded vocal tract gestures

“…In human subjects studies, SOVT exercises have been found to improve perceived voice quality (12–15) and acoustic output (11, 13), though results relating to the underlying physiology of voice production have been variable. Guzman et al also observed that SOVT exercises ‘produced a lower [vertical laryngeal position], narrower aryepiglottic opening, and a wider pharynx than resting position’ in 20 subjects with hyperfunctional dysphonia (16), while Laukkanen et al noted an increase in thyroarytenoid activity relative to cricothryroid activity during and following SOVT exercises (17).…”