Laryngeal Biomechanics in Middle Eastern Singing * Abdul-Latif Hamdan, †Abla Sibai, *Roger V. Moukarbel, and ‡Reem Deeb *†‡Beirut, Lebanon Summary: We would like to describe the muscle tension patterns observed in Middle Eastern singing and correlate these findings with demographic data. Material: A total of 42 candidates were included in this study. The med- ical charts and video records of their fiberoptic nasopharyngeal laryngoscopy were reviewed. Demographic information included age, sex, history of smok- ing, history of reflux, history of voice overuse/abuse, status in singing (pro- fessional vs. amateur), and style of singing (classical vs pop). Each frame was analyzed for each of the four muscle tension patterns (MTPs): MTP I, MTP II, MTP III, and MTP IV. Statistical method: Nonparametric Mann- Whitney U test was conducted. Results: Twenty-six subjects were profession- al singers and half sang classical singing. The mean MTP total score for all subjects was 35.58 6 21.98% (6 standard deviation). The highest muscle tension score was obtained for type III pattern followed by type II. There were no statistical differences in the mean MTP total, MTP II, and MTP III scores among the professional singers versus the amateurs. Similar results were obtained when MTP scores were compared by style of singing. Conclu- sion: The vocal technique and status of singing did not seem to affect the muscle tension score. Key Words: Biomechanics—Laryngeal—Middle Eastern—singing. INTRODUCTION With the advancement in technology and the us- age of various telescopes, assessment and diagnosis of organic and functional voice disorders became an art. Laryngeal rigid videostroboscopy permits a detailed study of the behavior of the vocal fold, whereas fiberoptic nasopharyngeal laryngoscopy allows better assessment of laryngeal biomechan- ics. Fiberoptic nasopharyngeal laryngoscopy is very well tolerated by most patients and has the ad- vantage of visualizing the whole vocal tract with minimal alteration in the normal laryngeal biome- chanics of the speaking and singing voice. The dy- namic behavior of the vocal cords in different registers and pitch ranges could also be assessed. The analysis of different movements of anatomical structures in relation to time resulted in the des- cription of various patterns. 1 Various laryngeal biomechanical alterations witnessed during the performance of a specific vocal task have been Accepted for publication July 8, 2005. From the *Department of Otolaryngology—Head & Neck Surgery, American University of Beirut Medical Center, Bei- rut, Lebanon; the †Department of Epidemiology and Popula- tion Health, Faculty of Health Sciences, American University of Beirut Medical Center, Beirut, Lebanon; and the ‡Department of Civilization Sequence, School of Arts and Sci- ences, American University of Beirut, Beirut, Lebanon. Address correspondence and reprint requests to Abdul-Latif Hamdan, Department of Otolaryngology, American University of Beirut, P.O. Box 110236, Beirut 1107 2020, Lebanon. E-mail: alhamdan@svclb.com Journal of Voice, Vol. 20, No. 4, pp. 579–584 0892-1997/$32.00 Ó 2006 The Voice Foundation doi:10.1016/j.jvoice.2005.07.003 579