Creaky voice is the quality of a voice that sounds like a door creaking on its hinges. It is normally produced in the mid to upper part of the range, and not typically at high levels of loudness. It also tends to be a low glottal airflow condition of phonation. Contrast with the related phenomenon of vocal fry.

MTD Posturing Abnormality Transiently Corrected With Creaky Voice

Visual Portfolio, Posts & Image Gallery for WordPress

Breathing position (1 of 6)

Young soprano with short phrase length, paralaryngeal discomfort, and effortfulness in singing high range—all symptoms seen with MTD. In this distant view, no abnormalities are seen during breathing.

MTD posturing (2 of 6)

Under standard light, the MTD vocal cord posturing is seen at B-flat 4 (466Hz). Note the slight lateral turning of the vocal processes (arrows) and wide dark space/ blur between the cords.

"Closed" phase (3 of 6)

G4 (392 Hz) under strobe light. Even at this middle voice pitch, closed phase is not truly closed, especially at the vocal processes.

Open phase (4 of 6)

At the same pitch, this open phase view also helps to explain breathiness and short phrase length.

Creaky voice, closed phase (5 of 6)

The patient is asked to produce the voice with creaky quality just to prove that the vocal processes are physically able to adduct. Compare this closed phase view with photo 3.

Creaky voice, open phase (6 of 6)

Open phase, still in creaky voice at G4. Compare with photo 4. Creaky voice is one temporary diagnostic antidote to MTD, not a complete “treatment.”

MTD Briefly Abolished with Creaky Voice

Visual Portfolio, Posts & Image Gallery for WordPress

Breathing position (1 of 6)

This choral teacher/ singer is troubled by breathiness and short phrase length. Here during quiet breathing, the vocal cords do not appear to be injured.

MTD posturing (2 of 6)

This photo is characteristic of her entire range: Classic MTD posturing abnormality with poor posterior closure.

Gap (3 of 6)

Strobe light, closed phase of vibration at G4 (392 Hz) shows persistent posterior commissure gap.

Open phase (4 of 6)

Open phase of vibration also at G4.

Creaky voice (5 of 6)

The patient has been requested to produce creaky voice, again at G4. In closer view of closed phase, she successfully closes the posterior commissure, though voice quality is not ideal. Compare with photo 3.

Open phase (6 of 6)

Open phase of vibration, still at G4 with creaky voice. Compare with photo 4.