Interactions of subglottal pressure and neuromuscular activation on fundamental frequency and intensity.

OBJECTIVES/HYPOTHESIS Fundamental frequency (F0) and intensity sound pressure level (SPL) of voice are controlled by intrinsic laryngeal muscle (ILM) activation and subglottal pressure (Psub). Their interactions were investigated. METHODS In an in vivo canine model, the thyroarytenoid (TA), lateral cricoarytenoid/interarytenoid (LCA/IA), and cricothyroid (CT) muscles were independently activated from threshold to maximal contraction by neuromuscular stimulation in various combinations, whereas airflow was increased to phonation onset pressure and beyond. The resultant acoustic output was analyzed for effects of Psub on vibratory stability, F0, and SPL. Muscle activation plots and vocal range profiles by individual ILM activation states were analyzed. RESULTS Cricothyroid activation increased phonation onset F0, but vibration was less stable in high CT conditions and displayed vibratory mode change. In addition, a decrease in F0 with increased Psub was observed in high CT conditions. Intensity increased with Psub in all conditions, but the slope was greater at high CT, low TA/LCA/IA activations. Lateral cricoarytenoid/interarytenoid activation improved vocal efficiency. To maintain same F0 with increasing SPL (messa di voce), TA activation was decreased and LCA/IA activation was increased. The same F0 and SPL could be achieved with a variety of ILM activation combinations. CONCLUSION Cricothyroid is primarily required for increasing F0, whereas TA can increase or decrease F0 and SPL. Lateral cricoarytenoid/interarytenoid activation likely maintains vocal fold adduction during increased Psub and improves vocal efficiency. This study also demonstrates laryngeal motor equivalence, the ability of the larynx to achieve the same target F0 and SPL with multiple combinations of ILM activation. LEVEL OF EVIDENCE N/A. Laryngoscope, 126:1123-1130, 2016.