Effect of Vocal Fry on Voice and on Velopharyngeal Sphincter

Abstract Introduction It is known that the basal sound promotes shortening and adduction of the vocal folds and leaves the mucosa looser. However there are few studies that address the supralaryngeal physiological findings obtained using the technique. Objective To check the effectiveness of using vocal fry on the voice and velopharingeal port closure of five adult subjects, whose cleft palate has been corrected with surgery. Methods Case study with five subjects who underwent otolaryngology examination by means of nasopharyngoscopy for imaging and measurement of the region of velopharyngeal port closure before and after using the vocal fry technique for three minutes. During the exam, the subjects sustained the isolated vowel /a:/ in their usual pitch and loudness. The emission of the vowel /a:/ was also used for perceptual analysis and spectrographic evaluation of their voices. Results Four subjects had an improvement in the region of velopharyngeal port closure; the results of the spectrographic evaluation were indicative of decreased hypernasality, and the results of the auditory-perceptual analysis suggested improved overall vocal quality, adequacy of loudness, decreased hypernasality, improvement of type of voice and decreased hoarseness. Conclusion This study showed a positive effect of vocal fry on voice and greater velopharyngeal port closure.

Effect of Vocal Fry on Voice and on Velopharyngeal Sphincter.

Introduction It is known that the basal sound promotes shortening and adduction of the vocal folds and leaves the mucosa looser. However there are few studies that address the supralaryngeal physiological findings obtained using the technique. Objective To check the effectiveness of using vocal fry on the voice and velopharingeal port closure of five adult subjects, whose cleft palate has been corrected with surgery. Methods Case study with five subjects who underwent otolaryngology examination by means of nasopharyngoscopy for imaging and measurement of the region of velopharyngeal port closure before and after using the vocal fry technique for three minutes. During the exam, the subjects sustained the isolated vowel /a:/ in their usual pitch and loudness. The emission of the vowel /a:/ was also used for perceptual analysis and spectrographic evaluation of their voices. Results Four subjects had an improvement in the region of velopharyngeal port closure; the results of the spectrographic evaluation were indicative of decreased hypernasality, and the results of the auditory-perceptual analysis suggested improved overall vocal quality, adequacy of loudness, decreased hypernasality, improvement of type of voice and decreased hoarseness. Conclusion This study showed a positive effect of vocal fry on voice and greater velopharyngeal port closure.

Características vocais acústicas do som basal em homens com fissura pós-forame reparada / Acoustic characteristics of vocal fry in men with repaired post-foramen cleft

TEMA: características vocais acústicas da emissão em registro basal de pacientes adultos masculinos, portadores de fissura palatina pós-forame reparada cirurgicamente. PROCEDIMENTOS: estudo de casos envolvendo quatro sujeitos do sexo masculino portadores de fissura palatina pós-forame reparada cirurgicamente. Foi realizada análise acústica da emissão sustentada da vogal [a] em registro modal e basal, através dos programas Multi Dimensional Voice Program (análise da fonte glótica) e Real-Time Spectrogram (análise espectrográfica), ambos da Kay Elemetrics Corp. RESULTADOS: por meio da análise espectrográfica do basal, observou-se: diminuição de definição, intensidade e de largura de banda de alguns formantes, diminuição da intensidade de todo o espectro, e discreta diminuição do ruído nas altas frequências; o efeito damping apresentou discreto aumento. Pela análise da fonte glótica no basal através do MDVPA, observou-se: frequência fundamental dentro da faixa do registro modal de fala e aumentada quando comparada à emissão para comparação em registro modal; grande aumento das medidas que evidenciam variação de frequência e de amplitude; maioria das medidas de jitter e de shimmer significativamente aumentadas; medidas de ruído, de quebras de voz, de segmentos não sonorizados e de tremor aumentadas; e índice de fonação suave (SPI) significativamente diminuído. CONCLUSÃO: os resultados evidenciam a alta instabilidade e ruído da emissão em registro basal, bem como sua fraca intensidade e diminuição do fluxo aéreo transglótico.

PURPOSE: to describe the vocal acoustic characteristics of emission in vocal fry of male adult patients, with surgically repaired post-foramen cleft. METHODS: study of cases involving four male subjects with surgically repaired post-foramen cleft. Acoustic analysis concerning sustained emission of vowel [a] was accomplished in modal register and vocal fry, through the programs Multi Dimensional Voice Program (glottic source analysis) and Real-Time Spectrogram (spectrographic analysis), both by Kay Elemetrics Corp. RESULTS: through the vocal fry spectrography analysis we perceived: decrease of definition, intensity and definition band spectrography in some formants, decrease of intensity as for the entire spectrum, and a slight decrease of noise in high frequencies; damping effect showed slight increase. Through the glottic source analysis in vocal fry, we perceived: fundamental frequency in the modal speech register zone and it was higher when compared to the emission for comparison in the modal register; large increase in the measures that show variation of frequency and amplitude; most of the jitter and shimmer measures were significantly increased; increased measures of noise, voice break, unvoiced segment and vocal tremor; and soft phonation index (SPI) significantly decreased. CONCLUSIONS: the findings evidence the high instability and the emission noise in fry register, as well as its weak intensity and diminished transglottic air flow.

Músculo tiroaritenoideo e som basal: uma revisão de literatura / Thyroarytenoid muscle and vocal fry: a literature review

O trabalho do fonoaudiólogo utiliza-se de exercícios vocais como o som basal (SB), que se origina da grande atividade contrátil do músculo laríngeo intrínseco tiroaritenoideo (TA). O objetivo deste estudo foi revisar a literatura relacionada ao TA e ao SB. Realizou-se levantamento bibliográfico dos últimos 20 anos sobre o assunto nas bases de dados LILACS, SciELO, PubMed, Web of Science e Google Scholar. Verificou-se que o feixe interno do TA apresenta fibras de contração lenta, isotônicas, resistentes à fadiga; o feixe externo apresenta fibras de contração rápida, fatigáveis, isométricas. O SB caracteriza-se pela percepção dos pulsos de vibração glótica durante a emissão nas frequências mais graves da tessitura vocal (crepitação em graves ou vocal fry), principalmente pela ação do TA, especialmente sua porção interna, que se encurta de forma evidente, soltando a mucosa em grande volume ao longo da borda livre, aumentando a pressão subglótica e os níveis de jitter, shimmer e ruído, e reduzindo o fluxo aéreo. Com base na literatura, a exercitação isométrica do TA externo ocorreria com o SB sustentado na frequência mais grave possível ao sujeito (contração máxima), durante seis segundos, de cinco a dez vezes diárias, compatível com o predomínio de fibras de contração rápida. Na exercitação isotônica do TA interno, utilizar-se-iam sons agudos para estirá-lo, alternando emissões em SB (contração concêntrica) e em registro modal de cabeça ou em falsete (sons hiperagudos) (contração excêntrica), com várias séries diárias de oito a 12 repetições, compatível com o predomínio de fibras de contração lenta.

The work of speech-language pathologists uses exercises such as the vocal fry (VF), which originates from the great contractile activity of the intrinsic laryngeal thyroarytenoid muscle (TA). The aim of this study was to review the literature related to TA and VF. A literature review of the last 20 years on the subject was performed in the databases LILACS, SciELO, PUBMED, Web of Science and Google Scholar. It was found that the internal beam of the TA has slow twitch fibers, isotonic, resistant to fatigue; the external beam provides fast twitch, fatigable and isometric fibers. The VF is characterized by the perception of the vibration of the glottal pulses during the emission of the lowest frequencies in the vocal range (crackling in bass or vocal fry), mainly by the action of the TA, especially its inner portion, which shows evident shortening, dropping the mucosa in great volume along the free edge, increasing subglottic pressure and jitter, shimmer and noise levels, and reducing the airflow. Based on the literature, the isometric exercise with the external TA happens with VF sustained in the lowest possible frequency to the subject (maximum contraction), for six seconds, five to ten times daily, consistent with its predominance of fast twitch fibers. In the isotonic exercise with the internal TA, high sounds must be to stretch the muscle, alternating emissions by VF (concentric contraction) and in modal register and falsetto head (high-pitched sounds) (eccentric contraction) with several daily series of eight to 12 repetitions, consistent with the predominance of slow twitch fibers.

Cleft palate repair: velopharyngeal closure before and during the basal tone.

UNLABELLED: Patients with palatine fissure have inadequate velopharyngeal closure (VPC), with consequent vocal hypernasality which can be reduced by a basal tone. AIM: To compare VPC during a basal tone with the emission of a modal recording, in patients with repaired post-foramen palatine fissure. MATERIALS AND METHODS: Case study with four adult men, all with repaired post-foramen palatine fissure. VPC images through nasal-pharyngoscopy during the emission o f the [a] vowel in a modal and basal recording. The images were studied by four ENTs. RESULTS: In three subjects there was no change in the type of VPC considering the recordings analyzed; the changes which happened to most of the subjects are associated only to the degree of movement of the structures involved, since in the basal recording the movement of the laryngeal lateral walls was kept, the movement of the posterior pharyngeal wall stabilized, the movement of the palatine veil was mildly reduced, and the Passavant fold was evident. CONCLUSIONS: The type of VPC was kept in the four subjects analyzed, when we compared the modal and basal recordings, there was a modification in the degree of movements in the structures involved, making it clear the Passavant Fold.

Fissura palatina reparada: fechamento velofaríngeo antes e durante o som basal / Cleft palate repair: velopharyngeal closure before and during the basal tone

Portadores de fissura palatina apresentam inadequado fechamento velofaríngeo (FVF), com consequente hipernasalidade vocal que pode ser diminuída com o som basal. OBJETIVO: Comparar o FVF durante a realização do som basal com a emissão em registro modal, em pacientes com fissura palatina pós-forame reparada. MATERIAIS E MÉTODOS: Estudo de Casos com quatro homens adultos, portadores de fissura palatina pós-forame reparada. Imagens do FVF por nasofaringoscopia, durante a emissão da vogal [a] em registro modal e basal. Julgamento das imagens realizado por quatro otorrinolaringologistas. RESULTADOS: Em três sujeitos, não houve mudança no tipo de FVF entre os registros analisados; as modificações que ocorreram na maioria dos sujeitos referem-se apenas ao grau de movimentação das estruturas envolvidas, pois, em registro basal, o movimento das paredes laterais da faringe se manteve, o movimento da parede posterior da faringe estabilizou, o movimento do véu palatino diminuiu discretamente, e a Prega de Passavant se evidenciou. CONCLUSÕES: O tipo de FVF se manteve em três dos quatro sujeitos analisados, quando comparado o registro modal com o basal, havendo modificações no grau da movimentação das estruturas envolvidas, evidenciando a Prega de Passavant.

Patients with palatine fissure have inadequate velopharyngeal closure (VPC), with consequent vocal hypernasality which can be reduced by a basal tone. AIM: to compare VPC during a basal tone with the emission of a modal recording, in patients with repaired post-foramen palatine fissure. MATERIALS AND METHODS: case study with four adult men, all with repaired post-foramen palatine fissure. VPC images through nasal-pharyngoscopy during the emission o f the [a] vowel in a modal and basal recording. The images were studied by four ENTs. RESULTS: in three subjects there was no change in the type of VPC considering the recordings analyzed; the changes which happened to most of the subjects are associated only to the degree of movement of the structures involved, since in the basal recording the movement of the laryngeal lateral walls was kept, the movement of the posterior pharyngeal wall stabilized, the movement of the palatine veil was mildly reduced, and the Passavant fold was evident. CONCLUSIONS: The type of VPC was kept in the four subjects analyzed, when we compared the modal and basal recordings, there was a modification in the degree of movements in the structures involved, making it clear the Passavant Fold.