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Updated: Feb 4, 2026

Construction and Characterization of a Novel Vocal Fold Bioreactor
Published on: August 1, 2014
Changes in Vocal Fold Morphology During Singing Over Two Octaves
F Unteregger1, P Wagner1, F Honegger1
1Department of Otorhinolaryngology, Head and Neck Surgery, Division of Phoniatrics, University Hospital Basel, Basel, Switzerland.
Objective:
Vocal folds are widely assumed to only elongate to raise vocal pitch. However, the mechanisms seem to be more complex and involve both elongation and tensioning of the vocal folds in series. The aim of the present study was to show that changes in vocal fold morphology depend on vocal fold elongation and tensioning during singing.
Study Design:
This was a prospective study.
Methods:
Forty-nine professional female singers (25 sopranos, 24 altos) were recruited and three-dimensional laryngeal images analyzed in a coronal view derived from high-resolution computed tomography scans obtained at the mean speaking fundamental frequency (ƒ0) and one (2ƒ0) and two octaves (4ƒ0) above ƒ0.
Results:
The vocal fold angle, defined by a tangent above and below the vocal folds, was 58° at ƒ0, 47° at 2ƒ0, and 59° at 4ƒ0.
Conclusion:
The decreased caudomedial angle of the vocal fold from ƒ0 to 2ƒ0 (change in muscle belly from ";fat" to "thin") and increased angle from 2ƒ0 to 4ƒ0 (from "thin" to "fat") strongly supports the hypothesis that the vocal folds elongate and then tension when singing from ƒ0 to 4ƒ0. This is the first study to show this relationship in vivo.
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