title: Physiologic and Acoustic Effects of Opera Performance.
abstract: OBJECTIVE
  Opera performance is physiological and emotional, and singing performers utilize their larynges in often strenuous ways. Historically, the training of a classical voice has been considered the paragon of healthy singing. However, the natural history of a performing larynx has not been studied systematically. There is paucity of scientific studies to guide practice patterns, particularly with regard to the course and extent of post-performance physiologic and acoustic changes.
  
  
  METHODS
  A prospective case series was carried out.
  
  
  METHODS
  Principal singers in the Houston Grand Opera's 2012-2013 repertory were enlisted, for a total of seven singers. Stroboscopy was performed prior to the start of rehearsals, and at the completion of the opera's run. Data points included erythema, edema, masses or lesions, mucosal waveform, supraglottic posture; acoustic measurements were also performed.
  
  
  RESULTS
  There were statistically significant differences (P < 0.05) in the mucosal wave on pre- and postperformance stroboscopic examinations. Acoustical measures did not achieve statistical significance, but there was a trend toward increased harmonic-to-noise ratio in postperformance measures, as well as decreased frequency range and reading F0. Measures of intra- and inter-rater reliability indicated varying levels of intra-rater reliability, and generally poor inter-rater reliability.
  
  
  CONCLUSIONS
  This pilot study describes physiologic and acoustic changes that may occur over the course of a series of rehearsals and performances in the operatic larynx. In so doing, it highlights a need for larger studies with increased frequency of serial examinations to study in a systematized way what may be natural reactive changes that occur during performance.
authors.affiliation: Division of Laryngeal Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: pkwak@partners.org.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Kwak
authors.affiliation: Texas Voice Center, Houston Methodist Hospital, Houston, Texas.
authors.forename: C Richard
authors.initials: CR
authors.lastname: Stasney
authors.affiliation: Texas Voice Center, Houston Methodist Hospital, Houston, Texas.
authors.forename: Jeremy R
authors.initials: JR
authors.lastname: Hathway
authors.affiliation: Dan L. Duncan Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas.
authors.forename: Danielle
authors.initials: D
authors.lastname: Guffey
authors.affiliation: Dan L. Duncan Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas.
authors.forename: Charles G
authors.initials: CG
authors.lastname: Minard
authors.affiliation: Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Julina
authors.initials: J
authors.lastname: Ongkasuwan
mesh_terms: D000162:Acoustics; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D007830:Larynx / Q000000981:diagnostic imaging / Q000502:physiology*; D008297:Male; D010699:Phonation; D010865:Pilot Projects; D011446:Prospective Studies; D020127:Recovery of Function; D063346:Singing; D013018:Sound Spectrography; D049489:Stroboscopy; D014833:Voice Quality; D014834:Voice Training
keywords: Acoustic measures of voice; Opera; Professional voice; Stroboscopy; Vocal performance