Stereo Laryngoscopic Impact Site Prediction for Droplet-Based Stimulation of the Laryngeal Adductor Reflex
Stereo Laryngoscopic Impact Site Prediction for Droplet-Based Stimulation of the Laryngeal Adductor Reflex
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DOI：
10.1109/access.2021.3103049
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发表时间：
2021
期刊：
影响因子：
3.9
通讯作者：
J. F. Fast;Hardik R. Dava;A. Rüppel;D. Kundrat;Maurice Krauth;M. Laves;Svenja Spindeldreier;L. Kahrs;M. Ptok
中科院分区：
文献类型：
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作者：
J. F. Fast;Hardik R. Dava;A. Rüppel;D. Kundrat;Maurice Krauth;M. Laves;Svenja Spindeldreier;L. Kahrs;M. Ptok
喉内收反射（LAR）是人类喉部的重要反射。LAR故障可能导致危及生命的误吸事件。目前仍缺乏一种客观、无创、可重复的LAR评估方法。通过液滴冲击刺激喉部，称为微液滴冲击喉部测试（MIT-LAR），可以纠正这种情况。然而，液滴的不稳定性和不精确的刺激应用迄今为止阻碍了MIT-LAR获得临床意义。我们提出了一个系统，包括两个可选的定制立体喉镜，每个都提供一套独特的特性，一个液滴涂抹器模块和图像/点云处理算法，以实现基于液滴的靶向LAR刺激。通过液滴轨迹识别和空间目标重建实现液滴撞击位置预测。实验验证了重建精度和ISP精度。杆状镜和光纤喉镜的声门区域整体空间重建误差分别为（0.3±0.3）mm和（0.4±0.3）mm，整体ISP误差分别为（0.9±0.6）mm和（1.3±0.8）mm。在棒状透镜系统的情况下，96%的观察到的ISP误差值小于2毫米；在光纤组件中发现了80%的值。这一贡献代表了将可重复和客观的LAR筛查方法引入临床常规的重要一步。
The laryngeal adductor reflex (LAR) is a vital reflex of the human larynx. LAR malfunctions may cause life-threatening aspiration events. An objective, noninvasive, and reproducible method for LAR assessment is still lacking. Stimulation of the larynx by droplet impact, termed Microdroplet Impulse Testing of the LAR (MIT-LAR), may remedy this situation. However, droplet instability and imprecise stimulus application thus far prevented MIT-LAR from gaining clinical relevance. We present a system comprising two alternative, custom-built stereo laryngoscopes, each offering a distinct set of properties, a droplet applicator module, and image/point cloud processing algorithms to enable a targeted, droplet-based LAR stimulation. Droplet impact site prediction (ISP) is achieved by droplet trajectory identification and spatial target reconstruction. The reconstruction and ISP accuracies were experimentally evaluated. Global spatial reconstruction errors at the glottal area of (0.3±0.3) mm and (0.4±0.3) mm and global ISP errors of (0.9±0.6) mm and (1.3±0.8) mm were found for a rod lens-based and an alternative, fiberoptic laryngoscope, respectively. In the case of the rod lens-based system, 96% of all observed ISP error values are inferior to 2 mm; a value of 80% was found with the fiberoptic assembly. This contribution represents an important step towards introducing a reproducible and objective LAR screening method into the clinical routine.