Pressure, Flow, and Glottal Area Waveform Profile Changes During Phonation Using the Acapella Choice Device.

Area of Science:

• Laryngology and Voice Science
• Speech-Language Pathology
• Biomedical Engineering

Background:

• Vibratory positive expiratory pressure (PEP) devices are widely used in voice therapy to improve vocal economy and provide a massage effect.
• While PEP devices' benefits for voice are known, their precise impact on the vocal source remains unclear.
• This study investigates the effects of phonation through the Acapella Choice PEP device on voice production.

Purpose of the Study:

• To assess the impact of phonation into the Acapella Choice device on the voice source.
• To elucidate the relationship between PEP device mechanics and vocal fold vibration characteristics.

Main Methods:

• Three participants with normal phonation underwent high-speed videoendoscopy.
• Simultaneous collection of intraoral pressure, airflow, and electroglottographic data during phonation.
• Analysis of vocal fold vibration patterns in response to PEP device use.

Main Results:

• Phonation via the Acapella device significantly alters pressure and flow profiles, affecting the voice source.
• Reduced airflow outlet (increased intraoral pressure) hinders vocal fold vibration (lower amplitude, weaker modulation).
• Increased airflow outlet aids vocal fold vibration and enhances pressure/flow modulation by the glottal cycle, suggesting alternating vocal tract impedance.

Conclusions:

• Acapella PEP devices effectively modulate vocal tract pressure and flow, causing alternating glottal vibration between aided and hindered states.
• These modulations in glottal vibration are a direct consequence of the PEP device's mechanical action.
• The observed changes in vocal fold vibration may contribute to the therapeutic massage effect of PEP devices.