ETS Form 1 Practice Exam 2026 – Your All-in-One Guide to Exam Success!

After medialization thyroplasty, the goal of therapy is to capitalize on the improved glottal closure by training a strong, abrupt onset of phonation. A hard glottal attack achieves this by bringing the vocal folds together quickly at the start of voice, which makes the most of the surgically enhanced closure. This leads to a crisper, more efficient voice with less air escape and better loudness and quality. A soft onset would leave the folds closing more gradually and can result in a breathier, weaker sound, which doesn’t take advantage of the surgical result. Techniques that aim to increase airflow would counteract the benefit of better closure, and neck manual manipulation isn’t a targeted strategy for optimizing phonation after this procedure.