Chaos in Voice, From Modeling to Measurement

Jack J. Jiang, Yu Zhang, and Clancy McGilligan

Madison, Wisconsin
Summary: Chaos has been observed in turbulence, chemical reactions, nonlin-
ear circuits, the solar system, biological populations, andseems tobe anessential
aspect of most physical systems. Chaos may also be central to the interpretation
of irregularity in voice disorders. This presentation will summarize the results
from a series of our recent studies. These studies have demonstrated the
prescence of chaos in computer models of vocal folds, experiments with
excised larynges, and human voices. Methods based on nonlinear dynamics
can be used to quantify chaos and irregularity in vocal fold vibration.
Studies have suggested that disordered voices from laryngeal pathologies such
as laryngeal paralysis, vocal polyps, and vocal nodules might exhibit chaotic
behaviors. Conventional parameters, such as jitter and shimmer, may be unreli-
able for analysis of periodic and chaotic voice signals. Nonlinear dynamic
methods, however, have differentiated between normal and pathological phon-
ations and can describe the aperiodic or chaotic voice. Chaos theory and
nonlinear dynamics can enchance our understanding and therefore our assess-
ment of pathological phonation.
Key Words: ChaosNonlinear dynamic methodsVocal fold model
Voice analysis.
INTRODUCTION
Chaos is a term that describes pseudorandom
behavior generated by a system that is both deter-
ministic and nonlinear. Although chaos was once
thought to be unique, it has now been widely ob-
served, such as in turbulence, chemical reactions,
nonlinear circuits, the solar system, and biological
Accepted for publication January 5, 2005.
From the Department of Surgery, Division of Otolaryngology
Head and Neck Surgery, University of Wisconsin Medical
School, Madison, WI 53792-7375. E-mail: jiang@surgery.wisc.
edu
Supported by the National Institute of Deafness and other
Communication Disorders under National Institutes of Health
grants 1-RO1DC006019 and 1-RO1DC05522.
Journal of Voice, Vol. 20, No. 1, pp. 217
0892-1997/$32.00
2006 The Voice Foundation
doi:10.1016/j.jvoice.2005.01.001
2
populations.
1
Recent studies in neurology and cardi-
ology suggest that chaotic activity is an important
aspect of physiologic systems.
2
An example of phys-
iologic chaos was presented in the in vitro studies of
heart cells fromembryonic chicks,
3
in which electric
shocks delivered to heart cells resulted in period-
doubling bifurcations and irregular dynamics. The
output of a chaotic system is unpredictable and
extremely sensitive to slight differences in initial
conditions. However, methods based on nonlinear
dynamics, including general dimension (Hausdorff
dimension, information dimension, correlation
dimension, etc.), entropy (Kolmogrov entropy,
second-order entropy, etc.), and Lyapunov expo-
nents, enable us to quantitatively describe chaotic
behavior.
1,4
Investigations of chaotic activities in
physiologic systems suggest that changes in
nonlinear dynamic measures may indicate states of
pathophysiological dysfunction. Poon and Merrill,
5
CHAOS IN VOICE 3
for example, found that chaotic activity decreased
in electrocardiogram (ECG) signals from patients
with congestive heart failure. Hornero et al
6
found
that the electroencephalogram (EEG) signals gener-
ated by schizophrenic patients had a signicantly
lower correlation dimension than the EEG signals
of normal subjects. These examples suggest that
chaos theory and nonlinear dynamic methods
might potentially be applied to diagnose physiologi-
cal disorders and evaluate the effects of clinical
treatments.
Over the last two decades, observations in com-
puter models of the vocal folds,
717
experiments with
excised larynges,
1820
and nonlinear dynamic analy-
sis of human voices
2129
have established the exis-
tence of chaos in human voice production. As noted
by many researchers, the nonlinearities of the voice
source mechanisms (eg, the nonlinear pressure-ow
relation in the glottis, the nonlinear stress-strain
curves of vocal fold tissues, and the nonlinearities
associated with vocal fold collision) make this devel-
opment unsurprising. Titze et al
24
originally sug-
gested how to improve our understanding of voice
disorders with nonlinear dynamic concepts and anal-
ysis methods. Since then, researchers have applied
these new tools to studying abnormal conditions
associated with laryngeal pathologies,
8,11,16,25,3034
to differentiate normal and pathologic voices and
diagnose pathologies,
3540
and to assess the effects
of clinical treatments.
41
These studies are promising,
although much development is still needed for prac-
tical methods. Some traditional voice analysis meth-
ods, such as jitter and shimmer, may be unreliable
for analyzing aperiodic voices.
30,4244
Nonlinear
dynamic methods provide information complemen-
tary and nonredundant to existing analysis meth-
ods.
25,37,40
Thus, nonlinear dynamic methods could
provide more information to clinicians.
In this article, we review our recent work on the
application of chaos theory and nonlinear dynamic
methods to the study of voices, focusing on studies
with computer vocal fold models, excised laryn-
ges, and human voices. The work of other research-
ers is also briey reviewed. The purpose of this
article is to stimulate the development of clinically
valuable analysis methods that can be applied to
quantify chaotic laryngeal activity and to assess
Journal of Voice, Vol. 20, No. 1, 2006
treatment effects of laryngeal pathologies. The em-
phasis is on applying chaos theory and nonlinear
dynamic methods to achieve this goal.
WHY NONLINEAR DYNAMIC ANALYSIS?
Titze
30
has qualitatively classied voice signals
into type 1, type 2, and type 3 signals. Type 1
signals are nearly periodic, type 2 signals contain
strong modulations or subharmonics, and type 3 sig-
nals are irregular and aperiodic. The typical wave-
forms of the three types of signals are shown in
Figure 1,
34
where the sampling rate is 25 kHz, the
fundamental frequency f
0
1/T, and A, B, and C
correspond to the waveforms of the type 1, 2, and
3 signals, respectively. Usually, the complexity of
a voice signal affects the applicability of traditional
analysis methods. It has been suggested that jitter
and shimmer, which are two acoustic perturbation
measures that have been traditionally used by re-
searchers, are appropriate only for nearly periodic
type 1 signals. Jitter is a measure of short-term
(cycle-to-cycle) variation in the fundamental fre-
quency of a voice signal, and shimmer is a measure of
short-term (cycle-to-cycle) variation in the ampli-
tude of a voice signal. Perturbation measures such
as jitter and shimmer presuppose, by denition, near
periodicity, and thus their usefulness may break
down for type 2 and type 3 signals. Studies examin-
ing the reliability and applicability of jitter and shim-
mer have found large variances and poor reliability
FIGURE 1. The typical waveforms of type 1, type 2, and type
3 voice signals.
JACK J. JIANG ET AL 4
when analyzing disordered or aperiodic voices.
30,4244
Spectrographic display and perceptual analysis have
been recommended for type 2 and type 3 signals,
respectively.
30,44
Although perceptual evaluation of
vocal function is simple, the inherent subjectivity
of perceptual judgments makes them potentially un-
reliable as well as difcult to quantify.
45,46
Factors
that contribute to the inconsistencies of perceptual
evaluation include different internal standards be-
tween the raters of a voice signal and differences in
how listeners focus their attention on the various
aspects of voice.
47
In addition, both perceptual eval-
uation and spectrographic display may fail to quanti-
tatively detect subtle changes in vocal function.
Because traditional voice analysis methods are lim-
ited, complementary objective measures that analyze
both nearly periodic and aperiodic voices are
desirable.
Nonlinear dynamic methods, including Poincare
map, fractal dimension, correlation dimension, Kol-
mogorov entropy, and Lyapunov exponents, can ana-
lyze irregular or chaotic activities.
1,4,48
We will
briey describe three such methods that have ana-
lyzed voices: the correlation dimension, the Lyapu-
nov exponents, and the Kolmogorov entropy. To
understand these analysis methods, the concept of
a phase space needs to be described. A phase space
is a space dened by multiple dynamic variables
composed of positions and velocities. The vibra-
tions of a dynamical system such as the vocal folds
can be shown as a trajectory in phase space with time
evolution. The trajectory in phase space qualitatively
shows the dynamics of a system: Periodic vibrations
produce a closed trajectory, whereas aperiodic vibra-
tions produce an irregular trajectory. When multiple
dynamic variables cannot be assessed, it is useful
to reconstruct the phase space of a voice signal by
plotting a single time series x(t
i
), t
i
t
0
it,
(i 1,2,,N), which is sampled at the time interval
, against itself at some time delay or lag.
4,49
We
can create the reconstructed phase space with the fol-
lowing m-dimensional time delay vector,
X(t){x(t),x(t),,x(t(m1))}, where mis the
embedding dimension and is the time delay. When
m 2D 1 (where D is the Hausdorff dimension),
the reconstructed phase space is topologically equiv-
alent to the original phase space. Because of the
nite length and nite precision of voice data, the
Journal of Voice, Vol. 20, No. 1, 2006
time delay is an important parameter in the recon-
struction of a phase space. If is too small, the
lagged variables are strongly correlated such that
the trajectory in the reconstructed phase space is
stretched around a diagonal line. On the other hand, if
is too large, the trajectory in the reconstructed
phase space is characterized by self-intersection.
Proper choice of the time delay yields an optimal
phase space reconstruction. The time delay can
be estimated with the mutual information method
proposed by Fraser and Swinney.
50
Mutual informa-
tion measures the general dependence of two vari-
ables. Fraser and Swinney
50
found that the rst
minimum value in the curve of mutual information
versus time delay provides an effective criterion for
choosing the proper time delay , which will ensure
that the variable and lagged variables are gener-
ally independent.
The correlation dimension D
2
, which was pro-
posed by Grassberger and Procaccia,
51
is a geometric
measure of a trajectory in phase space that describes
how strongly two points on the trajectory are corre-
lated. It has been widely used by researchers in
experiments because of its simplicity and fast
convergence in numerical calculation, as well as its
ability to describe irregular phenomena. The correla-
tion dimension quanties the complexity or irregu-
larity of a trajectory in phase space, which can be
classied as a zero-dimensional xed point (static
states), a one-dimensional limit cycle (periodic os-
cillations), a two-dimensional quasi-periodic torus
(superposition of two or more oscillations with no
rationally dependent frequencies), or a fractal-
dimensional chaotic trajectory (aperiodic oscilla-
tions). A system with a higher correlation dimension
may require more variables to describe its behavior.
With the correlation dimension, chaos can be distin-
guished from random white noise: The estimate of
D
2
of white noise does not converge with the in-
crease of the embedding dimension m, whereas the
estimate of D
2
of a chaotic system converges to a
nite value. Although Lyapunov exponents require
complex numerical algorithms, they have proven to
be one of the most effective descriptors of chaos.
Lyapunov exponents are related to the average rate
of exponential divergence or convergence of neigh-
boring orbits in phase space. Generally, a system
containing at least one positive Lyapunov exponent
CHAOS IN VOICE 5
is dened as chaotic, whereas a system with no
positive exponent is regular. Asystemwith a positive
Lyapunov exponent shows local instabilities and
extreme sensitivity to initial conditions. In other
words, any slight change in state will be exponentially
amplied, which results in a totally different output.
Kolmogorov entropy quanties the rate of loss of
information about the state of a dynamic system
as it evolves over time. For regular behaviors (static
states, periodic oscillations, and quasi-periodic os-
cillations), Kolmogorov entropy is equal to zero.
For chaotic systems with nite degrees of freedom,
Kolmogorov entropy is nite. Kolmogorov entropy
approaches innity for true randombehavior. Thus, a
nite and positive second-order entropy value (the
lower bound of Kolmogorov entropy) provides a
sufcient condition for chaos.
52
We will briey describe the procedures that calcu-
late correlation dimension, Kolmogorov entropy,
and Lyapunov exponents. Readers interested in de-
tailed descriptions of calculation procedures should
refer to the literature.
1,4,8,10,14,20,21,2441,4852
For a
time series x(t
i
), we reconstructed a m-dimensional
delay-coordinate phase space X
i
{x( t
i
),x( t
i
),,
x( t
i
(m1))} with the time delay technique, where
m was determined according to the embedding theo-
rem and the time delay was estimated with the
mutual information method proposed by Fraser and
Swinney.
50
After reconstructing the phase space of
a time series, we used the GrassbergerProcaccia
algorithm
51
with the Theiler
53
improvement to calcu-
late the correlation integral C(r), where r is the radius
around X
i
. The correlation integral C(r) measures the
number of distances between points in the recon-
structed phase space that are smaller than the radius
r. For small r, C(r) shows a power lawbehavior C(r)
r
D2
e
m K2
which reveals the geometrical scaling
property of the trajectory in phase space.
51
Based
on C(r), we estimated the correlation dimension D
2
in the scaling region of the radius r with the increase
of the embedding dimension m. The estimate of
correlation dimension can be obtained when the em-
bedding dimension m is sufciently large. Figure 2A
shows the reconstructed phase space of the type 3
signal in Figure 1, where t 1/f
s
, the sampling
rate f
s
25 kHz, and the proper time delay 11 t
was obtained with the mutual information method.
Journal of Voice, Vol. 20, No. 1, 2006
FIGURE 2. A. The reconstructed phase space of the type 3
signal, where t 1/ f
s
and f
s
25 kHz. B. The estimated
dimension versus r, in which the curves from top to bottom
correspond to m 1,2,,10, respectively.
Figure 2B shows the curves of the estimated dimen-
sion versus r. Despite the irregular shape of the
reconstructed phase space, the estimated correlation
dimension converges to 3.560.04 within the scal-
ing region 13.6 r 14, when m increases from
1 to 10 (see Figure 2B). Similar to the correlation
dimension D
2
, second-order entropy K
2
was esti-
mated in the scaling region of the radius r with the
increase of the embedding dimension m.
52
We used
the method of Holzfuss and Lauterborn
54
to calculate
the Lyapunov exponents of a time series.
To investigate the variability of jitter, shimmer,
and correlation dimension analysis over time, we
used a running window to analyze 11 consecutive
JACK J. JIANG ET AL 6
400-ms voice segments selected from a nearly peri-
odic signal and 11 consecutive 400-ms voice seg-
ments selected from an aperiodic signal. The nearly
periodic signal was producedbyanormal subject, and
the aperiodic signal was produced by a patient with
a vocal polyp. The time shift between two consecu-
tive segments was 20 ms. Jitter and shimmer were
estimated with the Multi-Dimensional Voice Pro-
gram (MDVP; Kay Elemetrics Corporation, Lincoln
Park, NJ). Figure 3 shows the variability of jitter,
shimmer, and correlation dimension over time for
the nearly periodic and aperiodic signal, where
curves I, II, III, IV, V, and VI correspond to D
2
of
the periodic voice, D
2
of the aperiodic voice, jitter
of the periodic voice, jitter of the aperiodic voice,
shimmer of the periodic voice, and shimmer of
the aperiodic voice, respectively. Jitter, shimmer,
and correlation dimension provide stable analyses
for the nearly periodic type 1 signal. However, for
the aperiodic type 3 signal, jitter and shimmer show
large variances and thus poor reliability, whereas
the correlation dimension has a comparatively small
variance, which demonstrates its reliability for
analysis of disordered or aperiodic voices.
55
This
example suggests that nonlinear dynamic analysis
methods represent more useful descriptors of irregu-
lar and aperiodic voices.
Methodological issues regarding jitter and shimmer
have received considerable attention. Jitter and shim-
mer have been found to be sensitive to variations
in microphone type and placement,
56
recorder and
tape types,
57,58
sampling size or signal length,
59
noise,
60
extraction algorithm,
61
and analysis
systems.
62,63
Figure 4A and Bdemonstrates that cor-
relation dimension is more robust to the effects of
shorter signal lengths and lower sampling rates than
jitter and shimmer calculated with MDVP.
55
Figure
4A shows the effect of signal length on the mean
values of jitter, shimmer, and correlation dimension
analysis of 14 nearly periodic voices. With MDVP,
shimmer gives stable results when signal lengths
are higher than 200 ms (48.6 cycles), which is the
minimum signal length required for MDVP analysis,
and jitter gives stable results when signal lengths are
higher than 500 ms (about 122 cycles). In compari-
son, correlation dimension analysis is stable when
signal lengths are higher than 20 ms (about 4.8
cycles). Figure 4B illustrates the effect of sampling
Journal of Voice, Vol. 20, No. 1, 2006
FIGURE 3. The time variances of jitter, shimmer, and correla-
tion dimension for 11 voice segments selected from the type 3
voice in Figure 1 using a running window with length 400 ms,
where curves I, II, III, IV, V, and VI correspond to D
2
of the
periodic voice, D
2
of the aperiodic voice, jitter of the periodic
voice, jitter of the aperiodic voice, shimmer of the periodic voice,
and shimmer of the aperiodic voice, respectively.
rate on the mean values of jitter, shimmer, and corre-
lation dimension analysis. Jitter and shimmer both
give stable results when the sampling rate is above
25 kHz, which is the minimum sampling rate
required for MDVP analysis. Correlation dimension
yields stable estimates even when the sampling rate
is decreased to 2 kHz. Sampling noise resulting from
low sampling rates may disrupt pitch tracking and
estimation of jitter and shimmer. Correlation dimen-
sion does not require measurement of cycle period
and so does not share this limitation of jitter and
shimmer. Correlation dimension avoids some
methodological issues associated with perturbation
methods. Additionally, applying the correlation di-
mension might reduce experimental costs because
lower quality recording equipment could be used
by researchers. Nonlinear dynamic analysis may be
valuable for describing irregular laryngeal activities,
exploring new methods for diagnosing laryngeal pa-
thologies, and assessing the effects of treatment of
laryngeal pathologies. More support for these claims
will be furnished in the following sections on vocal
fold models, excised larynx experiments, and human
voices analysis.
VOCAL FOLD MODELS
Motivations for designing computer models of
the vocal folds have ranged fromspeech synthesis to
CHAOS IN VOICE 7
FIGURE 4. The effects of signal length and sampling rate on
estimation of jitter, shimmer, and correlation dimension. A.
Signal length. B. Sampling rate.
medical applications. Because vocal fold models
give researchers complete control over phonation
parameters, which allows simulation of a wide range
of phonation conditions, they have been important to
the study of irregularities associated with laryngeal
pathologies such as vocal fold paralysis
12,17,64,65
and
vocal nodules and polyps.
16,66,67
Many simplied
versions of the IshizakaFlanagan
68
vocal fold
model have been proposed for study, in which sev-
eral mass, damping, and stiffness parameters are
applied to model vocal fold vibrations. However,
the exact relationship of the mass and stiffness of
these lump parameter models with the biomechani-
cal properties of vocal fold tissue is unclear. Finite
element models, on the other hand, allow us to con-
sider the biomechanical properties of vocal fold
Journal of Voice, Vol. 20, No. 1, 2006
tissue, but they lead to large numerical calculations
that complicate analysis.
67,69
Models can simulate irregular vocal fold vibra-
tions. Chaotic vibrations may occur when aero-
dynamic and biomechanical parameters, such as
subglottal pressure, stiffness, mass, and tension, are
out of the range that produces regular vibrations.
11,14
Figure 5A shows the effect of subglottal pressure
on vocal fold vibrations in a symmetric two-mass
model, where the maximal amplitude of the right
lower mass x
1
was obtained with a Poincare map
at a zero velocity plane
1
0. In a Poincare
map, dynamical systems are illustrated as follows:
A simple periodic orbit appears as a single point, a
periodic orbit with nite commensurable frequency
components gives rise to several discrete points,
andchaoticbehavior is shownas scatteredpoints with
a fractal structure. We use the default values of mass,
stiff, and damping, and we provide all parameters in
units of centimeters, grams, and milliseconds and
their corresponding combinations.
14
Signicantly,
small subglottal pressures fail to drive vocal fold
vibrations. If subglottal pressure exceeds the phona-
tion threshold pressure, periodic vocal fold vi-
brations result. However, if subglottal pressure is
excessively increased, nonlinear effects in the vocal
fold system become important and vibrations are
irregular and chaotic. Turbulent noise and random
parameter perturbations, which might result from
neurological and biomechanical effects, may
broaden the range of parameter values that produce
aperiodic vibrations.
15
Asymmetry between the vocal folds may also
induce chaos. In an asymmetric model, one vocal
fold has normal values for biomechanical parameters
such as mass, stiffness, and tension, whereas the
other side has abnormal values. The early study
by Isshiki et al
64
showed that tension imbalances
between the vocal folds produced subharmonics.
With a simplied version of the IshizakaFlanagan
model,
68
Steinecke and Herzel
12
found that when
tension parameter Q deviates from 1, chaotic vibra-
tions might occur that are relevant to disordered
voices from patients with superior and recurrent
nerve paralysis. Asymmetric stiffness and mass also
may induce subharmonics and chaotic vibrations.
Figure 5B shows the dependence of the maximal
amplitude of the right lower vocal mass x
1r
12
on
JACK J. JIANG ET AL 8
FIGURE 5. A. Effect of subglottal pressure on vocal fold
vibrations in a symmetric two mass model, where the maximal
amplitude of the right lower vocal mass x
1
was obtained using a
Poincare map at
1
0. B. The dependence of the maximal
amplitude of the right lower vocal mass x
1r
on the uniform
asymmetric stiffness parameter K
un
.
the uniform asymmetric stiffness parameter K
un
,
where the subglottal pressure is 0.012-cm H
2
O.
K
un
1 corresponds to symmetric stiffness, and
K
un
1 corresponds to asymmetric stiffness. When
the difference between the stiffness of the vocal folds
is signicantly large, subharmonics result. Asym-
metric vocal fold stiffness is found in patients with
vocal fold scar and Parkinsons disease. Subhar-
monic patterns also have been found in multiple
mass models with uniform and local asymmetries
in vocal fold mass and stiffness.
65
Signicant changes in the mechanical structure
of the vocal folds, such as through the introduction of
mass lesions, like vocal polyps, nodules, cysts, or
the Reinke edema, may cause the vocal folds to
Journal of Voice, Vol. 20, No. 1, 2006
vibrate chaotically during phonation. The vocal fold
model with a unilateral vocal polyp developed by
Zhang and Jiang
16
shows that vocal polyps interfere
with glottal closure and cause nonzero direct current
(DC) ow (Figure 6A). Increasing vocal polyp size
increases vocal-fold asymmetry and strengthens
the nonlinear interactions of the vocal polyp and the
vocal folds, which produces a greater perturbation
of vocal fold vibrations. Figure 6B shows the effects
of polyp size S
0
on the maximal amplitude of the
left lower vocal mass x
1l
in the vocal fold model,
where S
0
is a dimensionless parameter of polyp
size,
16
and polyp length, depth, and height are uni-
formly changed. When the polyp size S
0
/1, which
corresponds to a very small polyp, the periodic state
of the vocal fold vibrations does not qualitatively
change. However, when S
0
is sufciently increased,
chaotic vibrations appear. This result suggests that
an increase in polyp size would produce a decline
in voice quality. Conversely, a signicant reduction
in polyp size, such as would result from surgical
excision, might reproduce periodic vibrations. Sur-
gical removal of mass lesions has been clinically
shown to lead to voice improvements,
7072
such as
reduction of DC leakage and perceptual rough-
ness. The model with a vocal polyp may provide a
theoretical approach to study the effects of clinical
treatment of laryngeal mass lesions.
Unlike lump parameter models, which treat the
vocal fold as a system of masses and springs,
nite element models take into consideration the
biomechanical properties of vocal fold tissue. Find-
ings from studies conducted with both types of
models indicate that regular and irregular vocal fold
dynamics are governed by nite degrees of freedom,
which implies that low-order models are appropriate
for studying irregular and regular vocal fold dynam-
ics. In the elastic continuum model of Berry et al,
9
which possesses hundreds of degrees of freedom,
two or three empirical eigenfunctions capture the
main vibratory patterns of the vocal folds. These
ndings are consistent with those of Neubauer
et al,
73
who decomposed glottal contour patterns
obtained from high-speed image sequences into
vibratory modes. Neubauer et al
73
found that
two eigenfunctions captured approximately 98% of
the glottal dynamics for normal phonations and that
a minimum of three eigenfunctions were needed to
CHAOS IN VOICE 9
FIGURE 6. A. Glottal volume velocity ow U for the normal
vocal folds and vocal folds with a polyp. B. Effect of vocal polyp
size S
0
on the maximal amplitude of the left lower vocal mass
x
1l
in the vocal fold model.
capture the vibration patterns associated with bi-
phonation (the existence of independent vibratory
frequencies).
Nonlinearity is a fundamental aspect of the laryn-
geal system. If the laryngeal systems were linear,
chaotic vibrations would not result when biome-
chanical parameters like tension and subglottal pres-
sure exceed the range of normal values, nor would
they occur when parametric asymmetries exist be-
tween the vocal folds, or when vocal fold morphol-
ogy is altered by the presence of a vocal mass.
Bifurcation and chaos are frequently observed in
voices from patients with laryngeal pathologies.
Nonlinear vocal fold models can test the application
of nonlinear dynamic methods to study irregular
vocal fold activities as well as to simulate pathologi-
cal conditions and the effects of clinical treatment.
Journal of Voice, Vol. 20, No. 1, 2006
Disordered voices from patients with laryngeal pa-
thologies may have a nite yet higher dimension than
voices from normal subjects, which indicates more
complex dynamics, and successful clinical treatment
of disordered voices may result in a lowered dimen-
sion. This result has recently been examined through
nonlinear dynamic analyses of excised larynx
phonations and human voices.
EXCISED LARYNX EXPERIMENTS
Excised larynx experiments offer two main advan-
tages over model studies: (1) an excised larynx more
closely resembles the morphology of the in vivo
larynx than a computer model, and (2) excised larynx
experiments permit direct observation of vocal fold
vibrations. Otherwise, excised larynx experiments
offer many of the same advantages that models offer
over human voice analysis: The phonation parame-
ters in excised laryngeal experiments can be system-
atically monitored and independently controlled to
meet specic requirements, which include extremes
that are difcult to obtain in humans; conditions may
either be kept constant or changed gradually to
study bifurcations from one vibratory regime to an-
other; stationarity and signal length are easy to
control because the parameters controlling phon-
ations, eg, subglottal pressure, can be sustained for
long periods of time; and nally, direct measurement
of important data is easy and there is no need to
bother with human subjects. As a result of these
advantages, excised larynx experiments have been
applied from a very early date to understand phona-
tion and have recently studied irregular laryngeal
behavior.
74
Van den Berg and Tan
75
reported that at high
subglottal pressures, the glottis acquired an irregular
curve and noise dominated the voice signal. Isshiki
et al
64
studied asymmetrical tension in excised laryn-
ges and a computer model, and they found that
tension imbalances induced complicated and irregu-
lar vibrations. With bifurcation analysis, Berry
et al
18
observed that voice instabilities resulted from
changes in subglottal pressure and vocal fold
asymmetries. Svec et al
19
studied chest-falsetto reg-
ister jumps in human subjects and excised human
larynges. They found that a small change in vocal-
fold tension might cause an abrupt change in register
JACK J. JIANG ET AL 10
and pitch. Jiang and Titze
76
dened and measured
the phonation instability pressure (PIP) to determine
the irregular phonation (IP) range. Vocal fold vibra-
tions became irregular and phonation perceptually
rough when subglottal pressure exceeded the PIP.
Our recent study suggests that these irregular
vibrations may be chaotic.
20
We used an excised larynx setup to study excised
larynx phonations while varying subglottal pressure
and to compare nonlinear dynamic analysis with
perturbation analysis. The larynges were mounted
on an apparatus described in detail by Jiang et al
20
The acoustic signal picked up by the microphone
was audio-to-digital converted at the sampling
frequency 20 kHz and processed on a computer. We
selected the middle segments of phonation samples
with a length of 2 s for analysis. Traditional voice
analysis methods, including voice spectrograms,
jitter, and shimmer, were calculated. The software
Cspeech 4.0 (Kay Elemetrics Corporation) extracted
the measures of percent jitter and percent shimmer.
Excised larynx phonations were studied while in-
creasing subglottal pressure. The subglottal pressure
P
s
8-cm H
2
O drove normal and periodic vocal
fold vibrations. A range of subglottal pressures ex-
isted in which vibrations sustained a nearly regular
and periodic pattern. However, when P
s
exceeded
this range, irregular vibrations were produced and
sound became rough. The minimum value of P
s
needed to produce voice instabilities has been de-
ned as the PIP.
76
When subglottal pressure was
increased above the PIP, irregular vibrations resulted
andwererecordedforanalysis. WhenP
s
increasedfrom
8-cm H
2
O to 12-cm H
2
O and from 8-cm H
2
O to 16-
cm H
2
O, the vibratory patterns of the excised larynx
showed a period-doubling bifurcation and a quick
transition from periodic motion to chaos, respectively,
as shown in Figure 7A and B, respectively.
20
The
phenomena of the period-doubling bifurcation and
the quick transition from periodic motion to chaos
can also be observed in a hemi-larynx, as illustrated
in Figure 7C, and D, respectively. Chaotic vibrations
may occur in excised larynx experiments when sub-
glottal pressure exceeds the normal phonation range.
A similar phenomenon, called above range phona-
tion, was found in a symmetric computer model.
14
Quick transitions from periodic motion to chaos
as well as from period-doubling bifurcation to
Journal of Voice, Vol. 20, No. 1, 2006
chaos are found both in excised larynx experiments
and in theoretical models,
11,14,18,20
which demon-
strate that experimental observations in excised la-
rynges have qualitative similarities with computer
simulations of vocal fold vibrations.
Figure 8A and B show the time series and fre-
quency spectrum of a normal excised larynx phona-
tion, respectively, and Figure 9Aand Bshowthe time
series and frequency spectrumof an irregular excised
larynx phonation, respectively.
20
The normal phona-
tion (NP) has a periodic time series and discrete
frequency peaks. In contrast, the IP has an aperiodic
time series and a noise-like broadband frequency
spectrum. Correlation dimension D
2
and maximal
Lyapunov exponent
1
of the NP were estimated as
D
2
1.05 0.02 and
1
0 bits/T
s
. D
2
and
1
of
the IP were estimated as D
2
2.68 0.03 and
1
0.039 bits/T
s
. The periodic time series, discrete
frequency peaks, correlation dimension D
2
1.05,
and maximal Lyapunov exponent
1
0 show that
the NP has regular characteristics. On the other
hand, the aperiodic waveform, broadband frequency
spectrum, correlation dimension D
2
2.68, and posi-
tive maximal Lyapunov exponent
1
0.039 indicate
that the IP has chaotic dynamics.
Figure 10 shows the distributions of two nonlinear
dynamic measures (correlation dimension D
2
and
maximal Lyapunov exponent
1
) and two perturba-
tion measures (jitter and shimmer) calculated for
20 irregular excised larynx phonations (IP) and 20
normal excised larynx phonations (NP), which corre-
spond fromleft to right to jitter, shimmer, correlation
dimension D
2
, and maximal Lyapunov exponent
1
,
respectively.
20
t tests were performed on these four
measures. The differences between the IPs and NPs
for jitter (t 2.35, P 0.01) andshimmer (t 1.58,
P 0.1) are not signicant at the .01 level. In con-
trast, D
2
s(t 5.48, P 0.0001) and
1
s(t 8.67,
P 0.0001) of the IPs and NPs are signicantly dif-
ferent at the 0.01 level. These results suggest that
jitter and shimmer should be applied with caution,
particularly when aperiodic or chaotic voice signals
are being analyzed; however, nonlinear dynamic
methods may provide valuable analysis tools.
NONLINEAR TIME SERIES ANALYSIS
OF DISORDERED VOICES
Clinical observations demonstrate that most la-
ryngeal diseases cause changes in voice quality,
CHAOS IN VOICE 11
FIGURE 7. A. Period-doubling bifurcation exhibited by the excised larynx. B. Quick transition from periodic motion to chaos
exhibited by the excised larynx. C. Period-doubling bifurcation exhibited by the hemilarynx. D. Quick transition from periodic
motion to chaos exhibited by the hemilarynx.
which results in voice irregularities and voice insta-
bilities. Laryngeal stroboscopy and high-speed pho-
tography have revealed that pathologies can lead
to irregular vibratory patterns of the vocal folds.
13,73
Nonlinear dynamic methods are capable of analyz-
ing irregular behaviors and might be valuable in
several areas of voice study, including evaluation of
clinical treatments, classication of voices according
to the taxonomy of disorder proposed by Titze,
30
differentiation of normal and pathologic voices, and
possibly diagnosis of laryngeal pathologies. Prelimi-
nary studies have shown promise in these areas.
Nonlinear dynamic methods have been applied to
differentiate normal and pathological voices from
patients with vocal polyps.
39
This study included
voice samples from 68 patients with vocal polyps
and 79 normal subjects. Subjects were asked to
sustain the vowel /a/ at a comfortable pitch and
intensity, as steadily and as long as possible. Figure 11
Journal of Voice, Vol. 20, No. 1, 2006
illustrates the correlation dimension D
2
distribution
of all subjects.
39
Unlike random noise, the estimated
D
2
of the samples from both the pathologic and the
normal subjects are nite. The mean and standard
deviation (mean 1.38, SD 0.24) of the D
2
of
normal subjects voice samples are signicantly
lower (t tests show P 0.001) than those of patho-
logic subjects (mean 1.59, SD 0.34). This
result suggested that the correlation dimensions of
normal voices might be signicantly different from
the correlation dimensions of voices from patients
with vocal polyps. Titze et al
24
found that the corre-
lation dimension of a dysphonic subject with polypo-
sis was higher than that of a healthy subject. With
the time series of fundamental frequency and ampli-
tude peaks derived from microphone signals, Kakita
and Okamoto
35
found that the median correlation
dimension value of 17 dysphonic subjects was higher
than that of 8 healthy subjects, which indicates that
JACK J. JIANG ET AL 12
FIGURE 8. Normal excised larynx phonation. A. The time
series. B. The frequency spectrum.
perceptually rough voices have more complex dy-
namics than normal voices. Hertrich et al
36
found
that the electroglottographic signals of patients with
Parkinsons disease and cerebellar diseases had
signicantly higher fractal dimensions than the
electroglottographic signals of normal subjects.
Giovanni et al
37
used the maximal Lyapunov expo-
nent to successfully differentiate between normal
subjects and patients with unilateral laryngeal pa-
ralysis. These studies show that both normal and
pathologic voices may be low dimensional, and that
nonlinear dynamic methods may describe the
inuence of laryngeal pathologies on voice quality
by differentiating pathological voices from normal
voices.
Nonlinear dynamic analysis is useful for classify-
ing voice signals and represents a new approach
Journal of Voice, Vol. 20, No. 1, 2006
FIGURE 9. Irregular excised larynx phonation. A. The time
series. B. The frequency spectrum.
that can supplement traditional analysis methods.
Recently, nonlinear dynamic methods have been ap-
plied to quantitatively study signal typing.
34
A total
of 122 pathological sustained vowels from patients
with Parkinsons disease, vocal nodules and polyps,
laryngeal paralysis, and laryngeal carcinoma were
evaluated. Figure 12A illustrates the estimated D
2
of
the typical three types of signals in Figure 1,
34
where the curves I, II, III, and IVcorrespond to white
noise, type 3, type 2, and type 1 signals, respectively.
In contrast with the innite dimension of white noise,
the estimated D
2
s of the type 1, 2, and 3 signals
converge to 1.48 0.02, 2.16 0.04, and 3.56
0.04, respectively, with the increase of m. Cor-
relation dimension tends to increase from type 1 to
type 2 signals, and then again from type 2 to type
CHAOS IN VOICE 13
FIGURE 10. Comparison of the distributions of jitter, shimmer, correlation dimension, and the maximal Lyapunov exponent for
normal and irregular excised larynx phonations, where NP and IP correspond to normal and irregular phonations, respectively. The
line inside the box marks the median, whiskers mark the 10th and 90th percentiles, and the dots mark the outlying points.
3 signals. For all 122 voice samples, the D
2
distribu-
tions of the three types of signals are shown in
Figure 12B.
34
We used a KruskaiWallis one-way
analysis of variance (ANOVA) on ranks on the D
2
values. Post hoc pair comparison tests with the
StudentNewmanKeuls method revealed a statisti-
cally signicant difference between any two types
of signals (P 0.001). D
2
s of the nearly periodic
type 1 signals are statistically lowest. D
2
s of the
type 2 signals, which contain periodic modulations
and bifurcations, are statistically higher. D
2
s of
the aperiodic type 3 signals are statistically highest.
Thus, correlation dimension analysis effectively
classies the three types of signals.
Perturbation analysis has been applied to objec-
tively evaluate the effects of surgical treatment of
laryngeal pathologies.
43,70,72
However, as discussed
here, perturbation analysis is only reliable for nearly
periodic voice signals under limited conditions.
Nonlinear dynamic methods can complement pertur-
bation analysis methods because they can effectively
analyze aperiodic voices, and they may be useful
for assessingtheeffects of laryngeal surgeryandother
Journal of Voice, Vol. 20, No. 1, 2006
voice treatments. This hypothesis is supported by
our study of voices before and after surgical excision
of vocal polyps, in which we used two nonlinear
dynamic measures (correlation dimension D
2
and
second-order entropy K
2
) and two perturbation
measures (jitter and shimmer) to assess the effects
of surgical excision of polyps.
41
Jitter and shimmer
were estimated with MDVP. Nineteen patients with
vocal polyps (13 women and 6 men) were included.
The average age of the patients was 41.6 years
old (standard deviation 7.4). Patients received
evaluation before and after surgical excision of
polyps. For all nearly periodic voice samples re-
corded before and after surgery, Figure 13 shows
the distributions of jitter, shimmer, D
2
, and K
2
for the
presurgery and postsurgery groups, respectively.
41
The results of a MannWhitney rank sum test
showed that although jitter decreased signicantly
after surgery (P 0.001), shimmer was not signi-
cantly different for the presurgery and postsurgery
groups at the .05 signicant condence level. On
the other hand, for both nearly periodic and aperiodic
voices, the correlation dimension and second-order
JACK J. JIANG ET AL 14
FIGURE 11. Correlation dimension distributions for the
normal and vocal polyp groups.
entropy showed a statistically signicant decrease
(P 0.001) after vocal polyp excision. Correlation
dimension and second-order entropy analysis dem-
onstrated that both presurgical and postsurgical
voices were low dimensional and that postsurgical
voices had decreased dynamical complexity and in-
creased dynamical predictability. These ndings are
in agreement with the ndings of the study of a
vocal fold model with a unilateral vocal polyp,
16
which is discussed in the section on vocal fold models.
Although nonlinear dynamic analysis methods are
potentially valuable tools for studying voice, practi-
cal issues exist in the application of these analysis
methods, particularly issues resulting from the ef-
fects of noise and the complexity of numerical algo-
rithms. Development of simple and robust methods
for analyzing chaotic activities in voice is important
for routine clinical applications. More studies are
needed to resolve these issues and improve the appli-
cability of nonlinear dynamic analysis methods to
voice study.
CONCLUSIONS
In this article, we reviewed some recent work
in the application of chaos theory and nonlinear
dynamic analysis methods to the study of com-
puter models of the vocal folds, excised larynx
experiments, and human voices. The combined
application of computer model studies, excised
Journal of Voice, Vol. 20, No. 1, 2006
FIGURE 12. A. Estimated correlation dimensions of the typi-
cal three types of signals in Figure1, as well as white noise, where
the curves I, II, III, and IV correspond to white noise, type
3, type 2, and type 1 signals, respectively. B. The distributions
of correlation dimensions for the three types of voice signals.
larynx experiments, and analyses of human voice
data can greatly enhance our understanding of chaos
in voice production and its relationship to voice
instabilities and disorders. Preliminary applications
of chaos theory and nonlinear dynamic methods to
the study of voice hold great promise. More studies
are needed to examine the clinical relevance of these
newconceptual and analytic tools. Practical analysis
methods need to be developed and tested, and more
extensive evaluations, larger numbers of subjects,
and more types of laryngeal pathologies are needed
to examine the applicability of nonlinear dynamic
analysis.
Perturbation analysis of voices became popular
in the last decades although the limitations of such
methods have been widely accepted. Nonlinear dy-
namic methods complement traditional analysis
CHAOS IN VOICE 15
FIGURE 13. The distributions of jitter, shimmer, correlation dimension, and second-order entropy before and after surgery, where
A and B correspond to after and before surgery, respectively. The line inside the box marks the median, whiskers mark the 10th
and 90th percentiles, and the dots mark the outlying points.
methods. Nonlinear dynamic analysis methods need
not replace existing methods, but they could improve
the array of voice analysis tools available to the clini-
cian. The combination of traditional and nonlinear
dynamic analyses could potentially improve our
ability to analyze pathologic voices from patients
with laryngeal pathologies. More research is needed
to study voice from the viewpoint of chaos and de-
velop procedures combining traditional and nonlin-
ear dynamic analysis that can objectively describe
voice disorders, diagnose laryngeal pathologies, and
evaluate the effects of treatment of laryngeal
pathologies.
REFERENCES
1. Moon FC. Chaotic and Fractal Dynamics: An Introduction
for Applied Scientists and Engineer. New York: Wiley;
1992.
Journal of Voice, Vol. 20, No. 1, 2006
2. Sataloff RT, Hawkshaw M. Chaos in Medicine: Source
Readings. San Diego, CA: Singular Publishing Group;
2001.
3. Guevara MR, Glass L, Shrier A. Phase locking, period-
doubling bifurcations, and irregular dynamics in periodi-
cally stimulated cardiac cells. Science. 1981;214:1350
1353.
4. Ott E, Sauer T, Yorke JA, eds. Coping with Chaos. New
York: Wiley; 1994.
5. Poon CS, Merrill CK. Decrease of cardiac chaos in conges-
tive heart failure. Nature. 1997;389:492495.
6. Hornero R, Alonso A, Jimeno N, Jimeno A, Lopez M. Non-
linear analysis of time series generated by schizophrenic
patients. IEEE Eng Med Biol Mag. 1999;3:8490.
7. Awrejcewicz J. Bifurcation portrait of the human vocal cord
oscillation. J Sound Vibrations. 1990;136:151156.
8. Herzel H. Bifurcations andchaos invoicesignals. Appl Mech
Rev. 1993;46:399413.
9. Berry DA, Herzel H, Titze IR, Krischer K. Interpretation
of biomechanical simulations of normal and chaotic vocal
fold oscillations with empirical eigenfunctions. J Acoust
Soc Am. 1994;95:35953604.
JACK J. JIANG ET AL 16
10. Herzel H, Berry D, Titze I, Steinecke I. Nonlinear dynamics
of the voice: signal analysis and biomechanical modeling.
Chaos. 1995;5:3034.
11. Herzel H, Knudsen C. Bifurcations in a vocal fold
model. Nonlinear Dynamics. 1995;7:5364.
12. Steinecke I, Herzel H. Bifurcations in an asymmetric vocal-
fold model. J Acoust Soc Am. 1995;97:18741884.
13. Mergell P, Herzel H, Titze IR. Irregular vocal-fold vibra-
tionhigh-speed observation and modeling. J Acoust Soc
Am. 2000;108:29963002.
14. Jiang JJ, Zhang Y, Stern J. Modeling of chaotic vibrations
in symmetric vocal folds. J Acoust Soc Am. 2001;110:
21202128.
15. Jiang JJ, Zhang Y. Chaotic vibration induced by turbulent
noise in a two-mass model of vocal folds. J Acoust Soc
Am. 2002;112:21272133.
16. Zhang Y, Jiang JJ. Chaotic vibrations of a vocal-fold model
with a unilateral polyp. J Acoust Soc Am. 2004;115:
12661269.
17. Tao C, Zhang Y, Du GH, Jiang JJ. Estimating model param-
eters using chaos synchronization. Phys Rev E. 2004;69:
0326204.
18. Berry DA, Herzel H, Titze IR, Story BH. Bifurcations in
excised larynx experiments. J Voice. 1996;10:129138.
19. Svec JG, Harm KS, Miller DG. On pitch jumps between
chest and falsetto registers in voice: data from living and
excised human larynges. J Acoust Soc Am. 1999;106:
15231530.
20. Jiang JJ, Zhang Y, Ford CN. Nonlinear dynamics of phon-
ations in excised larynx experiments. J Acoust Soc Am.
2003;114:18.
21. Mende W, Herzel H, Wemke K. Bifurcations and chaos in
newborn infant cries. Phys Lett A. 1990;145:418424.
22. Baken RJ. Irregularity of vocal period and amplitude: a
rst approach to the fractal analysis of voice. J Voice.
1990;4:185197.
23. Herzel H, Steinecke I, Mende W, Wermke K. Chaos and
bifurcations during voiced speech. In: Mosekilde E, ed.
Complexity, Chaos and Biological Evolution. New York:
Plenum Press; 1991:4147.
24. Titze IR, Baken R, Herzel H. Evidence of chaos in vocal
fold vibration. In: Titze IR, ed. Vocal Fold Physiology:
New Frontiers in Basic Science. San Diego, CA: Singular
Publishing Group; 1993:143188.
25. Herzel H, Berry D, Titze IR, Saleh M. Analysis of vocal
disorders with methods from nonlinear dynamics. J Speech
Hear Res. 1994;37:10081019.
26. Narayanan SS, Alwen AA. A nonlinear dynamical systems
analysis of fricative consonants. J Acoust Soc Am. 1995;
97:25112524.
27. Kumar A, Mullick SK. Nonlinear dynamical analysis of
speech. J Acoust Soc Am. 1996;100:615629.
28. Lee MH, Lee JN, Soh KS. Chaos in segments from Korean
traditional singing and western singing. J Acoust Soc Am.
1998;103:11751182.
29. Robb MP. Bifurcations and chaos in the cries of full-term
and preterm infants. Folia Phoniatr Logoped. 2003;55:
233240.
Journal of Voice, Vol. 20, No. 1, 2006
30. Titze IR. Workshop on Acoustic Voice Analysis: Summary
Statement. Denver, CO: National Center for Voice and
Speech; 1995:136.
31. Behrman A, Baken RJ. Correlation dimension of electrog-
lottographic data from healthy and pathologic subjects.
J Acoust Soc Am. 1997;102:23712379.
32. Behrman A. Global and local dimensions of vocal dynam-
ics. J Acoust Soc Am. 1999;105:432443.
33. Boek W, Wieneke GH, Dejonckere PH. Clinical relevance
of the fractal dimension of Fo perturbations computed by
the box-counting method. J Voice. 1997;11:437442.
34. Zhang Y, Jiang JJ. Nonlinear dynamic analysis in signal
typing of pathological human voices. Electron Lett. 2003;
39:10211023.
35. Kakita Y, Okamoto H. Visualizing the characteristics of
vocal uctuation from the viewpoint of chaos: an attempt
toward qualitative quantication. In: Fujimura O, Okamoto
H, eds. Vocal Fold PhysiologyVoice Quality Control.
San Diego, CA: Singular Publishing Group; 1995:235248.
36. Hertrich I, Lutzenberger W, Spieker S, Ackermann H.
Fractal dimension of sustained vowel productions in
neurological dysphonias: an acoustic and electroglotto-
graphic analysis. J Acoust Soc Am. 1997;102:652654.
37. Giovanni A, Ouaknine M, Triglia J-M. Determination of
largest Lyapunov exponents of vocal signal: application to
unilateral laryngeal paralysis. J Voice. 1998;13:341354.
38. Matassini L, Hegger R, Kantz H, Manfredi C. Analysis of
vocal disorders in a feature space. Med Eng Phys. 2000;
22:413418.
39. Jiang JJ, Zhang Y. Nonlinear dynamic analysis of speech
from pathologic subjects. Electron Lett. 2002;38:294295.
40. Zhang Y, Jiang JJ, Biazzo L, Jorgensen M, Berman M.
Perturbation and nonlinear dynamic analyses of voices from
patients with unilateral laryngeal paralysis. J Voice. In press.
41. Zhang Y, McGilligan C, Zhou L, Vig M, Jiang J. Nonlinear
dynamic analysis of voices before and after surgical exci-
sion of vocal polyps. J Acoust Soc Am. 2004;115:2270
2277.
42. Karnell MP, Chang A, Smith A, Hoffman H. Impact of
signal type on validity of voice perturbation measures.
NCVS Stat Progr Report. 1997;11:9194.
43. Dejonckere PH, Bradley P, Clemente P, Cornut G, Crevier-
Buchman L, Friedrich G, et al. A basic protocol for
functional assessment of voice pathology, especially for in-
vestigating the efcacy of (phonosurgical) treatments and
evaluating new assessment techniques. Guideline elabo-
rated by the Committee on Phoniatrics of the European
Laryngological Society (ELS). Eur Arch Otorhinolaryngol.
2001;258:7782.
44. Kay Elemetrics Corporation. Multi-Dimensional Voice
Program: Software Instruction Manual. Pine Brook, NJ:
Kay Elemetrics Corporation; 1993.
45. Kreiman J, Gerratt BR. Validity of rating scale measures
of voice quality. J Acoust Soc Am. 1998;104:15981608.
46. Gerratt BR, Kreiman J. Measuring vocal quality with
speech synthesis. J Acoust Soc Am. 2001;110:25602566.
CHAOS IN VOICE 17
47. Millet B, Dejonckere PH. What determines the differences
in perceptual rating of dysphonia between experienced
rater? Folia Phoniatr Logopaed. 1998;256:312315.
48. Kantz H, Schreiber T. Nonlinear Time Series Analysis.
Cambridge, UK: Cambridge University Press; 1997.
49. Packard NH, Crutcheld JP, Farmer JD, Shaw RS. Geome-
try from a time series. Phys Rev Lett. 1980;45:712.
50. Fraser AM, Swinney HL. Independent coordinates for
strange attractors from mutual information. Phys Rev Lett.
1986;33:11341140.
51. Grassberger P, Procaccia I. Measuring the strangeness of
strange attractors. Physica D. 1983;9:189208.
52. Grassberger P, Procaccia I. Estimation of the Kolmogorov
entropy from a chaotic signal. Phys Rev A. 1983;45:
25912593.
53. Theiler J. Spurious dimension from correlation algorithms
applied to limited time series data. Phys Rev A. 1986;34:
24272432.
54. Holzfuss J, Lauterborn W. Lyapunov exponents from a time
series of acoustic chaos. Phys Rev A. 1989;39:21462152.
55. Zhang Y, Wallace SM, Jiang JJ. Comparison of nonlinear
dynamic methods and perturbation methods for voice
analysis. J Acoust Soc Am. 2005. In press.
56. Titze IR, Winholtz WS. Effect of microphone type and
placement on voice perturbation measurements. J Speech
Hear Res. 1993;36:11771190.
57. Titze IR, Horii Y, Scherer RC. Some technical considera-
tions in voice perturbation measurements. J Speech Hear
Res. 1987;30:252260.
58. Jiang JJ, Lin E, Hanson DG. Effect of tape recording on
perturbation measures. J Speech Hear Res. 1998;41:
10311041.
59. Karnell MP. Laryngeal perturbation analysis: minimum
length of analysis window. J Speech Hear Res. 1991;34:
544548.
60. Carson CP, Ingrisano DRS, Eggleston KD. The effect of
noise on computer-aided measures of voice: a comparison
of Cspeech and the Multi-Dimensional Voice Program
software using the CSL 4300B module and multi-speech
for Windows. J Voice. 2003;17:1220.
61. Titze IR, Liang H. Comparison of F0 extraction method for
high-precision voice perturbation measurements. J Speech
Hear Res. 1993;36:11201133.
62. Bielamowicz S, Kreiman J, Gerratt BR, Dauer MS,
Berke GS. Comparision of voice analysis systems for per-
turbation measurement. J Speech Hear Res. 1996;39:
126134.
Journal of Voice, Vol. 20, No. 1, 2006
63. Karnell MP, Scherer RS, Fischer LB. Comparison of funda-
mental frequency and perturbation measurements among
three analysis systems. J Voice. 1995;9:383393.
64. Isshiki N, Tanabe M, Ishizaka K, Broad D. Clinical signi-
cance of asymmetrical vocal cord tension. Ann Otol.
1977;86:5866.
65. Wong D, Ito MR, Cox NB, Titze IR. Observation of pertur-
bations in a lumped-element model of the vocal folds with
application to some pathological cases. J Acoust Soc Am.
1991;89:383394.
66. Koizumi T, Taniguchi S, Itakura F. An analysis-by-synthesis
approach to the estimation of vocal cord polyp features.
Laryngoscope. 1993;103:10351042.
67. Jiang JJ, Diaz CE, Hanson DG. Finite element modeling
of vocal fold vibration in normal phonation and hyperfunc-
tional dysphonia: implication for the pathogenesis of vocal
nodules. Ann Otol Rhinol Laryngol. 1998;107:603609.
68. Ishizaka K, Flanagan JL. Synthesis of voiced sounds from
a two-mass model of the vocal cords. Bell Sys Tech J.
1972;51:12331268.
69. Alipour F, Berry D, Titze I. A nite-element model of vocal
fold vibration. J Acoust Soc Am. 2000;108:30033012.
70. Woo P, Casper J, Colton R, Brewer D. Aerodynamic and
stroboscopic ndings before and after microlaryngeal
phonosurgery. J Voice. 1994;8:186194.
71. Bastian RW. Vocal fold microsurgery in singers. J Voice.
1996;10:389404.
72. Zeitels SM, Hillman RE, Desloge R, Mauri M, Doyle
PB. Phonomicrosurgery in singers and performing artists:
treatment outcomes, management theories, and future direc-
tions. Ann Otol Rhinol Laryngol. 2002;111:2140.
73. Neubauer J, Mergell P, Eysholdt U, Herzel H. Spatio-
temporal analysis of irregular vocal fold oscillations:
biphonation due to desynchronization of spatial modes.
J Acoust Soc Am. 2001;110:31793192.
74. Cooper DS. Research in laryngeal physiology with excised
larynges. In: Cummings CW, editor. Otolaryngolgy
Head and Neck Surgery. Vol. 3. St. Louis, MO: Mosby;
1986:17661776.
75. Van Den Berg J, Tan TS. Results of experiments with human
larynges. Practa Ota-Rhino-Laryngol. 1959;21:425450.
76. Jiang JJ, Titze IR. Amethodological study of hemilaryngeal
phonation. Laryngoscope. 1993;103:872882.