On the relation between subglottal pressure and vocal intensity in singing voice disorders

This study, conducted on singers consulting at a phoniatric outpatient clinic, aims to investigate whether the relationship between subglottal pressure and vocal intensity varies depending on the type of vocal pathology.

A retrospective study was conducted using the medical files, acoustic, and aerodynamic assessments of 134 singing patients at a University Hospital in France. The assessments included measurements of vocal intensity and estimated subglottal pressure during singing at different pitches and loudness.

A significant difference was observed in the relationship between intensity and estimated subglottal pressure between singers with organic voice disorders, functional voice disorders and without voice disorder. Vocal efficiency was reduced in singers with organic laryngeal lesions: for the same estimated subglottal pressure, they produced lower intensities regardless of the pitches sung. Using an ascending hierarchical clustering, we identified two groups of pathologies. The first group included Reinke's edema, laryngocele, and polyps. Consistent with existing data, we found that these singer patients produced sounds of lower intensity at higher subglottal pressure values compared to singers without a disorder. The second group included singers with nodules, their relationship between intensity and estimated subglottal pressure tended to differ from that of singers without a disorder.

Our exploratory study on singer patients demonstrates that laryngeal pathologies influence the relationship between estimated subglottal pressure and vocal intensity. These preliminary findings confirm the value of estimated subglottal pressure during singing voice assessment. Future research should focus on larger groups of singer patients with more homogeneous laryngeal lesions.