The messa di voce (MdV), which consists of a continuous crescendo and subsequent decrescendo on one pitch is one of the more difficult exercises of the technical repertoire of Western classical singing. With rising lung pressure, regulatory adjustments both on the level of the glottis and the vocal tract are required to keep the pitch stable. The dynamic changes of vocal tract dimensions with the bidirectional variation of sound pressure level (SPL) during MdV were analyzed by two-dimensional real-time magnetic resonance imaging (25 frames/s) and synchronous audio recordings in 12 professional singer subjects. Close associations in the respective articulatory kinetics were found between SPL and lip opening, jaw opening, pharynx width, uvula elevation, and vertical larynx position. However, changes in vocal tract dimensions during plateaus of SPL suggest that perceived loudness could have been varied beyond the dimension of SPL. Further multimodal investigation, including the analysis of sound spectra, is needed for a better understanding of the role of vocal tract resonances in the control of vocal loudness in human phonation.

Within the realm of voice classification, singers could be sub-categorized by the weight of their repertoire, the so-called “singer's Fach.” However, the opposite pole terms “lyric” and “dramatic” singing are not yet well defined by their acoustic and articulatory characteristics. Nine professional singers of different singers' Fach were asked to sing a diatonic scale on the vowel /a/, first in what the singers considered as lyric and second in what they considered as dramatic. Image recording was performed using real time magnetic resonance imaging (MRI) with 25 frames/s, and the audio signal was recorded via an optical microphone system. Analysis was performed with regard to sound pressure level (SPL), vibrato amplitude, and frequency and resonance frequencies as well as articulatory settings of the vocal tract. The analysis revealed three primary differences between dramatic and lyric singing: Dramatic singing was associated with greater SPL and greater vibrato amplitude and frequency as well as lower resonance frequencies. The higher SPL is an indication of voice source changes, and the lower resonance frequencies are probably caused by the lower larynx position. However, all these strategies showed a considerable individual variability. The singers' Fach might contribute to perceptual differences even for the same singer with regard to the respective repertoire.

Respiratory kinematics are important for the regulation of voice production. Dynamic MRI is an excellent tool to study respiratory motion providing high-resolution cross-sectional images. Unfortunately, in clinical MRI systems images can only be acquired in a horizontal subject position, which does not take into account gravitational effects on the respiratory apparatus. To study the effect of body posture on respiratory kinematics during phonation, 8 singers were examined both in an open-configuration MRI with a rotatable gantry and a conventional horizontal MRI system. During dynamic MRI the subjects sang sustained tones at different pitches in both supine and upright body positions. Sagittal images of the respiratory system were obtained at 1–3 images per second, from which 6 anatomically defined distances were extracted to characterize its movements in the anterior, medium and posterior section of the diaphragm as well as the rip cage (diameter at the height of the 3rd and 5th rip) and the anterior–posterior position of the diaphragm cupola. Regardless of body position, singers maintained their general principles of respiratory kinematics with combined diaphragm and thorax muscle activation for breath support. This was achieved by expanding their chest an additional 20% during inspiration when singing in the supine position but not for sole breathing. The diaphragm was cranially displaced in supine position for both singing and breathing and its motion range increased. These results facilitate a more realistic extrapolation of research data obtained in a supine position.

Objectives: To achieve glottal gap closure in unilateral vocal fold paralysis (UVFP) through complementary ansa cervicalis nerve muscle pedicle laryngeal reinnervation (ANMP‐LR).Introduction: ANMP‐LR is easy to learn and does not require recurrent laryngeal nerve (RLN) transection.Materials and Methods: Twelve patients with unilateral vocal fold paralysis (UVFP) were included, who received ANMP‐LR and could be followed up for at least 6–24 months. At baseline, after 3–6 (T1), 12 (T2) and 24 months (T3), Voice Handicap Index (VHI), perceived roughness (R) and breathiness (B), sound pressure level (SPLmax), maximum phonation time (MPT), Dysphonia Severity Index (DSI) and glottal gap (GG) were recorded.Results: R and B were significantly reduced at T1, MPT and SPLmax increased significantly up to T1 (MPT to 15.8 s; SPLmax to 91.5 dB). Similarly, VHI dropped significantly and the residual glottal gap (GG) was significantly reduced between T0 and T1. All outcomes remained stable until T3. There was a non‐significant tendency to further improvement until T3 in SPLmax and GG.Discussion: The T1–T3 outcomes of the complementary ANMP‐LR are comparable with the standard LR and also with thyroplasty. As with all LR techniques, younger patients and those with shorter paralysis benefit more. Patients with evidence of unfavorable laryngeal synkinesis are more likely to benefit from a standard LR with RLN transection.Conclusions: Younger patients with insufficient synkinetic reinnervation and persisting or progressive glottis closure insufficiency in UVFP benefit from early reinnervation. When the easy‐to‐learn ANMP technique is used, any partial rehabilitation that has already been achieved or any remaining chance of spontaneous reinnervation via the RLN is not compromised.Level of Evidence: 3

In voice production, interactions occur between the oscillating vocal folds, the respiratory system, and the vocal tract. However, it is not yet sufficiently understood how the respiratory system could affect the vocal tract configuration. It is hypothesized that a reduction in tracheal pull, caused by decreasing lung volume, along with shifts in dominant exhalation forces (from inspiratory to expiratory muscles), leads to a larynx elevation with shortening of the vocal tract tube, and consecutively, articulatory adjustments to preserve consistent sound quality. Seventeen professional operatic singers performed a maximum phonation time task on comfortable pitch while being recorded with dynamic 2D-magnetic resonance imaging (MRI) (25 fps, pixel resolution of 1.6 x 1.6 mm²) including simultaneous audio recording. From the MRI footage, articulatory movements were calculated for vertical larynx position, pharynx width at the narrowest point, lip opening, jaw opening, and jaw protrusion. Spectral data were extracted from the audio signals after noise reduction. The larynx moved in cranial direction in 5 of 9 female and 3 of 8 male participants during the phonatory exhalation. Such movement was directly counteracted by other articulators in four cases. In 12 of the subjects, articulatory and/or spectral events in the form of adaptions or twitches occurred around and after 50% of the phonation time. Most subjects exhibited changes in articulator positioning as well as adjustments to the subsequently sustained fundamental frequency during the first and last 10% of the sustained phonation. The articulatory movements during the task were non-systematic. Sudden events/adaptations in the second half of the phonatory exhalation could potentially mark a passage of the REL. The cranial movement of the larynx could be attributed to the decreasing tracheal pull; however, this was not evident in all subjects, suggesting a high degree of individuality in the regulation of respiratory movement in relation to vertical larynx position. Overall, the data indicate that it is important to consider continuous and sudden articulatory movements during sustained measurements.