Assessing and Quantifying Air Added to the Voice by Means of Laryngostroboscopic Imaging, EGG, and Acoustics in Vocally Trained Subjects.

Objective: To assess and quantify singers' strategies for adding air to phonation to sound "breathy" in a healthy manner STUDY DESIGN: Case-control study with 20 professional singers.

Methods: Twenty singers were recorded performing sustained vowels in the Complete Vocal Technique Neutral vocal mode with and without audible air added to the voice by means of laryngostroboscopic imaging using a videonasoendoscopic camera system, electroglottography, long-term average spectrum, as well as acoustic signals and audio perception. Singers completed Voice Handicap Index and Reflux Symptom Index questionnaires prior to examination.

Results: Air added to the voice resulted in an expected glottal gap along the length of the vocal folds, with little to no further difference in the supraglottic area, as compared with the Neutral phonation. Air added resulted in lowered Qx, mean Sound Pressure Level, and Cepstral Peak Prominence, but higher Harmonics-to-Noise Ratio, Jitter, and Shimmer, with decreased energy at the fundamental frequency. Adding audible air to the phonation did not exhibit similar effects on acoustics for males and females. Also, for females, H1-H2 difference decreased with air added, while it increased for males.

Conclusion: Singers produce an audible airy phonation similar yet significantly different to the breathy phonation reported for both healthy and pathological speakers.