1. The Low Mandible Maneuver and Its Resonential Implications for Elite Singers 
Angelika Nair, Garyth Nair, Gernot Reishofer 
Journal of Voice 
Volume 30, Issue 1, Pages 128.e e32 (January 2016)
DOI: /j.jvoice
Copyright © 2016 The Voice Foundation Terms and Conditions

2. Figure 1
MRI images from phase I of our LMM study which illustrate the Low Mandible Maneuver—left image, speaking /i/ and the right image, singing /i/ with full classical resonance.
MRI courtesy of the Medical University of Graz, Austria.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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3. Figure 2
Phase I imagery from Graz—overlay of an ultrasound image (light gray) tongue shape (/i/) and an MRI done in the prone position to account for the potential gravitational artifacts in the MRI imagery.
Image from our collaboration with the Medical University of Graz, Austria.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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4. Figure 3
The spectrum of Western singing styles with those closest to the norms of speech on the left and the non–speech-like resonance norms on the right. Also, to avoid a possible confusion of terms, please note the difference between rehabilitated versus rehabituated.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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5. Figure 4
The resonance spaces in the supraglottal vocal instrument. (Note that the velopharyngeal port is shown closed because most phonemes require the nasal space to be removed from the resonance system.)
Illustration by Garyth Nair.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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6. Figure 5
An MRI overlay of the TMJ of the singer at rest (red) and performing the LMM (green). The LMM condyle position of a sung [ɑ] is indicated by the arrow. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
Image from our collaboration with the Medical University of Graz, Austria.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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7. Figure 6 Diagram showing the anatomic components of the TMJ.
Illustration by Angelika Nair.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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8. Figure 7
Two jaw-opening paradigms. The two skulls at the top show the mandible at rest in its normal configuration (l) and the mouth opened (r). The bottom skulls show the LMM in operation with the condyle dropped (l) and the resulting increase in mouth opening and oral resonance that results from the maneuver.
Illustration by Garyth Nair.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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9. Figure 8
Close up of the downward and forward drift of the condyle to the bottom of the articular eminence.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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10. Figure 9 Head and neck muscles anatomy. Illustration by Angelika Nair.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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11. Figure 10 Sagittal view of a US image. Illustration by Angelika Nair.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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12. Figure 11
EdgeTrak software capturing the edge of the sagittal tongue profile (red line) as well as the hard palate (yellow line). (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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13. Figure 12
US image showing the water bolus starting from the alveolar ridge to obtain a stable position of the hard palate.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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14. Figure 13
The HATS rig built out of a professional microphone boom stand (vertical) and two Manfrotto universal photo arms.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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15. Figure 14
Detail of the HATS in action showing the transducer and the intercessory fluid reservoir that permits mandible movement during image acquisition. Also, note the reference points at the forehead and under the nose that stabilizes the skull.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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16. Figure 15
US image embedded in a sagittal profile. The posterior tongue appears on the left. Note the angular shadow on the right side of the image. This is an acoustic shadow cast by the front of the mandible that unfortunately prevents us from seeing the extreme anterior tip of the tongue.
Illustration by Garyth Nair.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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17. Figure 16
Oral cavity producing a spoken /ɑ/ and /i/ vowel (left) and performing an LMM /ɑ/ and /i/ vowel (right). Notice the size and shape of the fluid reservoir at the bottom of the wedge. It indicates that the mandible has dropped approximately 1 cm. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
Illustration by Angelika Nair.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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18. Figure 17
Three MRI images showing the LMM at rest (left), back vowel (middle), and front consonant (right). The different lines showing the SAR (turquoise), the positions of the mandible (green), and the larynx (blue) and their elevations (M, L). (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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19. Figure 18
Increase in vocal resonance during LMM. The dark herring-boned area denotes the resonance space available during a non-LMM /i/ vowel. The white areas are the spaces that are added during LMM.
Image from our collaboration with the Medical University of Graz, Austria.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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20. Figure 19
Spoken and sung LMM comparison of the vowels [ɑ] and [i] from the US procedure (top). LMM comparison of the vowels [ɑ] and [i] spoken (spk) and sung (sng) of each subject from the MRI procedure (middle). Comparison of the laryngeal elevation on the spoken (spk) and sung (sng) vowels [ɑ] and [i] from the MRI procedure (bottom; light gray and white columns alternating between subjects).
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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21. Figure 20
Graphics from the US procedure of the mean amplitude (dB) of the fundamental frequency (F0), the harmonics in the range of the first formant (F1) for [ɑ] and [i], as well as in the range of 2.0–3.5 kHz. Various pitches and multiples of the fundamental frequency (nF0) are indicated in the horizontal axis of each graph. Note, because of illness, subject 5 could not participate in this imaging procedure and is not included in this illustration.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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22. Figure 21
Graphics from the MRI procedure of the mean amplitude (dB) of the fundamental frequency (F0), the harmonics in the range of the first formant (F1) for [ɑ] and [i], as well as in the range of 2.0–3.5 kHz. Various pitches and multiples of the fundamental frequency (nF0) are indicated in the horizontal axis of each graph. Note, the audio of subject 1 was not usable and could not be included in this illustration.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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23. Figure 22
Overall efficiency of LMM from US (top), MRI (middle), and the laryngeal elevation (bottom) on an Italian sung phrase. Note, because of illness, subject 5 is missing in the US.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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24. Figure 23
Oral cavity producing a spoken /ɑ/ and /i/ vowel (left) and performing an LMM /ɑ/ and /i/ vowel (right). Notice the size and shape of the fluid reservoir at the bottom of the wedge (green) as well as the advanced tongue root on the sung /i/ (circled and indicated by an arrow). The latter indicating an increase in pharyngeal volume. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
Illustration by Angelika Nair.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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25. Figure 24
Top right image, spoken /i/ and the left image, sung /i/ with full classical resonance. Note the drop of the mandible and the larynx. Note that, in the top right-hand static image, the singer's velopharyngeal port was not closed—in a moving MRI, the port would have been closed and would appear identical to the corollary region in the top left side image. Bottom images showing spoken /ɑ/ (right) and sung /ɑ/ (left) with full classical resonance. Also note the different angles following the LMM (yellow line). (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
Images from our collaboration with the Medical University of Graz, Austria.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
Copyright © 2016 The Voice Foundation Terms and Conditions

26. Figure 25
Comparison of spoken (left) and sung (right) consonants. Note again the size and shape of the fluid reservoir on the bottom wedge. EdgeTrak software capturing the edge of the sagittal tongue profile (red line) as well as the hard palate (yellow line). (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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27. Figure 26
Different mandible strategies found in all five subjects. (A) mandible at rest. (B) Anterior drop of the mandible (speech template). (C) Complete LMM, entire jaw platform is down. (D) Posterior drop of the mandible.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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28. Figure 27
The internationally ranked singer, Thomas Hampson, in two frames from a video of him singing the word “la” from Rossini's Largo al factotum. The two images are just 1/30000 of a second apart in time. On the left, one sees the /l/, and on the right, the open /ɑ/. The two guidelines indicate the elevation of the posterior and anterior mandible.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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29. Figure 28
Authors vision of US through a USB transducer, incorporated in VoceVista and run on a tablet.
Illustration by Angelika Nair.
Journal of Voice  , 128.e e32DOI: ( /j.jvoice )
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