Laughing

Ever wonder how we laugh?

https://vimeo.com/160649997
VESS of the laryngopharynx during laughter
VESS Recorded at Bastian Voice Institute
https://vimeo.com/166868972
Laughing that can be seen and heard!
In this video, Dr. Bastian looks into the esophagus via VESS.

Supraglottic phonation

Making voice by means of supraglottic vibration rather than glottic (true vocal cord) vibration. The supraglottic tissues used for vibration can vary between individuals. Vibrating tissue can be the false vocal cords (false cord phonation), aryepiglottic cords, or apical arytenoid mucosa.

Supraglottic phonation may become necessary if the vocal cords are absent or scarred to the point of being unable to vibrate. Examples might include larynx trauma, partial laryngectomy with loss of one or both vocal cords or an inability to bring them close enough together to be entrained into vibration, or progressive radiation damage (radiation fibrosis), usually many years after treatment for cancer.


Photos:



False Cord Phonation

False cord phonation is making voice by vibrating the false vocal cords. This kind of phonation is unlike normal phonation or voice-making, which uses the true vocal cords.

This produces a much deeper, rougher voice quality than normal phonation. It is purposefully used in certain kinds of vocal performance, such as Tibetan chant or heavy metal screaming. It can also occasionally serve as an alternate voice for a person whose true cords are unable to vibrate—due, for example, to their surgical removal or to scarring. It can also be produced concurrently with true cord phonation to produce a “Louis Armstrong” effect.


Photos:

Visual Portfolio, Posts & Image Gallery for WordPress
False cord phonation due to flaccid true cords (1 of 5): before false cords begin to vibrate

False cord phonation due to flaccid true cords (1 of 5): before false cords begin to vibrate

An elderly man, quiet by nature who uses the voice little, complains of weak, gravelly voice quality. This view of phonation, standard light, shows a slightly wider dark line of phonatory blurring. Also, the false vocal cords are overly approximated, but not yet participating in vibration (for that, see images 4 and 5).
False cord phonation due to flaccid true cords: before false cords begin to vibrate

False cord phonation due to flaccid true cords (2 of 5): before false cords begin to vibrate

Strobe light reveals an unusually wide amplitude of vibration, denoting flaccidity of the true vocal cords.
False cord phonation due to flaccid true cords: before false cords begin to vibrate

False cord phonation due to flaccid true cords (3 of 5): before false cords begin to vibrate

Maximum closed phase shows the telltale residual opening at the anterior commissure (from this perspective, the lowermost end of the true cords), also a potent indicator of flaccidity.
False cord phonation due to flaccid true cords: after false cords begin to vibrate

False cord phonation due to flaccid true cords (4 of 5): after false cords begin to vibrate

When asked to produce louder voice, the false cords begin to participate in vibration, and a rough, gravelly superimposed “ godfather” quality arrives. Notice that the true cords are in at least partial open phase of vibration.
False cord phonation due to flaccid true cords: after false cords begin to vibrate

False cord phonation due to flaccid true cords (4 of 5): after false cords begin to vibrate

When asked to produce louder voice, the false cords begin to participate in vibration, and a rough, gravelly superimposed “ godfather” quality arrives. Notice that the true cords are in at least partial open phase of vibration.

True and False Cord Voice

Visual Portfolio, Posts & Image Gallery for WordPress
Thin and weak voice

Thin and weak voice (1 of 4)

This man has a thin and weak voice, often with a superimposed gravelly, rough quality. In this view, false cords, marked with dotted lines, obscure the true cords and their vibration is indicated by blurred margins.
True cords during closed phase

True cords during closed phase (2 of 4)

At much closer range under strobe light, the true cords are approximated during the closed phase of vibration. The false cords should remain lateralized throughout voice production (but don’t).
Flase cords during open phase

Flase cords during open phase (3 of 4)

From same viewing position, but during open phase of vibration, showing very “wide” amplitude of vibration caused by flaccidity. The false cords are beginning to come together.
False cords during phonation

False cords during phonation (4 of 4)

Withdrawing the scope slightly, one can now see the false cords have completed their vibratory closure, explaining the superimposed rough quality. The arrow points to where true cords are, hidden in darkness below the false cords.

True and False Cord ‘Godfather’ Voice

Visual Portfolio, Posts & Image Gallery for WordPress
Bowing

Bowing (1 of 4)

The true cords are together posteriorly but with major bowing seen at the pre-phonatory instant, to explain the husky, weak quality of voice.
Closed phase

Closed phase (2 of 4)

As a result of the need to compress together the weak true cords, false cords also overcompress. This is closed phase of true cords; false cords have not yet reached midline as they are vibrating more slowly than the true cords.
False cord phonation

False cord phonation (3 of 4)

Now the false cords have come into contact but below them the true cords have begun their open phase of vibration. We hear the husky, weak true voice with the superimposed rough, gravelly false cord phonation.
True and False cords in open phase

True and False cords in open phase (4 of 4)

The true cords are at maximum open phase with enormous lateral excursions typical of flaccid cords. False cords are also at open phase, but as shown in photos 2 and 3, they are vibrating at a lower frequency and out of phase with the true cords.

True and False Cords Vibrate Mostly in Tandem (in phase)

Visual Portfolio, Posts & Image Gallery for WordPress
True cords vibrate

True cords vibrate (1 of 4)

At relatively high pitch, only the true cords vibrate. This is closed phase, under strobe light.
Open phase of vibration

Open phase of vibration (2 of 4)

Open phase, same pitch.
True and false cords, closed phase

True and false cords, closed phase (3 of 4)

At low pitch, where false cord phonation is facilitated. Both true and false cords are in closed phase of vibration (though the true cords are obscured by the false cords).
True and false cords, open phase

True and false cords, open phase (4 of 4)

Both true and false cords are simultaneously in open phase of vibration.

Another Voice Without Vocal Cords

Visual Portfolio, Posts & Image Gallery for WordPress
Hemilaryngectomy

Hemilaryngectomy (1 of 4)

After removal of the anterior larynx (hemilaryngectomy) for cancer that recurred after radiation therapy. Though not well seen here, the vocal cords are surgically absent. The black dot seen is for orientation to the next photo. A = arytenoid; E = epiglottis.
Within the larynx

Within the larynx (2 of 4)

A view within the larynx. Note again that vocal cords are surgically absent, with only the arytenoid cartilages remaining at the level of the cords. The black dot, on the left arytenoid cartilage, orients to the prior photo. The dot is on the right vocal process.
arytenoid mounds

"Wolfman Jack" voice (3 of 4)

The patient is about to produce his rough, “Wolfman Jack” voice but the arytenoid mounds have not yet started to vibrate.
Arytenoid vibration

Arytenoid vibration (4 of 4)

Aggressive voice use brings arytenoid mounds into vibration (notice blurring). With time and practice, this kind of supraglottic voice can serve moderately well, but it is always difficult to be heard in competition with background noise.

Audio:

True cord phonation

False cord phonation

True and false cord phonation

Tracheoesophageal Party Wall

The membranous shared wall between the trachea and esophagus. The tracheoesophageal party wall is also known as the membranous trachea. This membranous wall makes up one-third of the trachea’s circumference; the other two-thirds is bolstered and stiffened by cartilaginous rings. These stiff cartilaginous rings help to keep the trachea open, whereas the membranous wall has some flexibility and may momentarily bulge into and narrow the tracheal passageway, as during a cough or a Valsalva maneuver.


Photos:



Posterior Commissure

The flat, front-facing surface of the glottic aperture that lies between the vocal cord posterior ends. When the vocal cords are in abducted (breathing) position, the posterior commissure is at its widest, since the cords’ posterior ends are spread furthest apart from each other. When the vocal cords have come together into adducted (voicing) position, the posterior commissure is essentially just the point of contact between the posterior ends of the cords.

In individuals who have acid reflux or other inflammatory conditions, the mucosa at the posterior commissure may thicken (pachyderma).

See also: anterior commissure.

Pyriform sinus

Pyriform sinus refers to the pear-shaped fossa (Latin for “trench”) just lateral to the laryngeal entrance. Its medial surface is the aryepiglottic cord; laterally it is bounded by the thyroid cartilage, and posteriorly by the low posterior pharyngeal wall. The pyriform fossas and post-arytenoid area together constitute the “swallowing crescent,” which channels swallowed material just before it enters the esophagus, behind the larynx.

Vocal Process

A projection of the anterior arytenoid cartilage, to which is attached the membranous vocal cord.


Photos: