Evaluation of the Laryngeal Adductor Reflex with a Mechatronic Micro-droplet Laryngoscope

用机电微滴喉镜评估喉内收肌反射

• 批准号: 314572885
• 负责人: Dr.-Ing. Lüder Alexander Kahrs
• 金额: --
• 依托单位: University of Toronto Mississauga
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2016
• 资助国家: 德国
• 起止时间: 2015-12-31 至 2022-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/314572885?language=en
• 关键词: Evaluation; Laryngeal; Adductor; Reflex; Mechatronic

The proposed research deals with endoscopic, mechatronic microdroplet dispension for (1) controlled triggering of the laryngeal adductor reflex (LAR, a reflexive glottic closure mechanism ) and (2) image-based qualitative and quantitative measurement of the laryngeal adductor reflex (LAR). Even though LAR plays an imminent role in protecting the lower airways, little is known regarding its basic principles. A reason for this might be, that up to date no practical and safe device exists for the controlled reflex triggering. The Department of Phoniatrics and Pediatric Audiology, Hannover Medical School has recently developed a first prototype that demonstrates benefits of fluid-based reflex stimulation. Disadvantages of the actual prototype have been related to non-reliable reflex stimulation within the subject group (less than 50%) due to multifactorial reasons. This project aims to show that optimized methods for microdroplet dispension will enable valid and reliable reflex characterization and mapping. Based on these methods our hypothesis is that fundamental new research in laryngology and neurolaryngology can be conducted (e.g. reflex fatigue or spatial reflex maps). Technical development is necessary to overcome current limitations and will result in an endoscopic, mechatronic microdroplet dispenser for image-based measurement of LAR that allows precise targeting of the droplets on the endolaryngeal structures. The work program includes: 1) Design with regard to anatomical constraints. Based on clinical data, dimensions and contours of components entering the patients oral cavity and pharynx will be optimized. 2) Investigation on fluid transport and dispension. 3) Reproducible experimental setup and methods as well as characterization of usable parameters. 4) Computer-aided stimulation of LAR by image processing (e.g. triangulation) and target visualization (augmented reality). 5) Finally, new methods and a new prototype will be evaluated in parts and holistic in a neurolaryngological context (informed consent subject trials). The expected outcome of this project is groundbreaking research and knowledge generation in the field of the laryngeal adductor reflex. Additionally, we expect a new method that is feasible for a reliable clinical diagnosis of dysphagia. This also provides the basis for further exploitation in the field of phoniatrics as well as the care of impaired patients, i.e. after stroke.

该研究涉及内窥镜下的机电微滴滴滴(1)控制喉内收肌反射（LAR，一种反射性声门关闭机制）和(2)基于图像的喉内收肌反射（LAR）的定性和定量测量。尽管LAR在保护下气道方面起着迫在眉睫的作用，但人们对其基本原理知之甚少。其中一个原因可能是，到目前为止，还没有实用和安全的装置来控制反射触发。汉诺威医学院声学和儿童听力学系最近开发了第一个原型，证明了基于液体的反射刺激的好处。实际原型的缺点是由于多因素的原因，在被试组内不可靠的反射刺激（少于50%）。该项目旨在表明微滴分布的优化方法将实现有效和可靠的反射表征和映射。基于这些方法，我们的假设是喉病学和神经喉病学的基础新研究可以进行（例如反射疲劳或空间反射图）。为了克服目前的限制，技术发展是必要的，并将导致内窥镜、机电微液滴分配器，用于基于图像的LAR测量，使液滴精确定位在咽内结构上。工作方案包括：1)解剖约束设计。根据临床数据，优化进入患者口腔和咽部的部件的尺寸和轮廓。2)流体输送与分布研究。3)可重复的实验设置和方法，以及可用参数的表征。4)通过图像处理（如三角测量）和目标可视化（增强现实）对LAR进行计算机辅助刺激。5)最后，新方法和新原型将在神经喉病学背景下进行部分和整体评估（知情同意受试者试验）。该项目的预期结果是喉内收肌反射领域的突破性研究和知识生成。此外，我们期待一种新的方法，是可行的，可靠的临床诊断吞咽困难。这也为语音病学领域的进一步开发以及受损患者（即中风后）的护理提供了基础。

项目成果

Towards Fully Automated Determination of Laryngeal Adductor Reflex Latencies through High-Speed Laryngoscopy Image Processing

通过高速喉镜图像处理全自动测定喉内收肌反射潜伏期

• DOI: 10.1007/978-3-662-56537-7_41
• 发表时间: 2018
• 作者: Fast JF;Ptok M;Jungheim M;Szymanski R;Ortmaier T;Kahrs LA
• 通讯作者: Kahrs LA

Euclidean distances of laryngopharyngeal structures obtained from CT data for preclinical development of laryngoscopic devices

从 CT 数据获得的喉咽结构的欧几里德距离，用于喉镜装置的临床前开发

• DOI: 10.1007/s00276-019-02397-3
• 发表时间: 2020
• 期刊: Surgical and Radiologic Anatomy
• 影响因子: 1.4
• 作者: Diers D;Fast JF;Götz F;Kahrs LA;Miller S;Jungheim M;Ptok M
• 通讯作者: Ptok M

Stereo Laryngoscopic Impact Site Prediction for Droplet-Based Stimulation of the Laryngeal Adductor Reflex

• DOI: 10.1109/access.2021.3103049
• 发表时间: 2021
• 期刊: IEEE Access
• 影响因子: 3.9
• 作者: J. F. Fast;Hardik R. Dava;A. Rüppel;D. Kundrat;Maurice Krauth;M. Laves;Svenja Spindeldreier;L. Kahrs;M. Ptok

An actuated larynx phantom for pre-clinical evaluation of droplet-based reflex-stimulating laryngoscopes

用于基于液滴的反射刺激喉镜的临床前评估的驱动喉体模型

• DOI: 10.1515/cdbme-2019-0035
• 发表时间: 2019
• 期刊: Current Directions in Biomedical Engineering
• 作者: Fast JF;Jungheim M;Ortmaier T;Ptok M;Kahrs LA
• 通讯作者: Kahrs LA

Towards microprocessor-based control of droplet parameters for endoscopic laryngeal adductor reflex triggering

基于微处理器的内窥镜喉内收肌反射触发液滴参数控制

• DOI: 10.1515/cdbme-2017-0050
• 发表时间: 2017
• 期刊: Current Directions in Biomedical Engineering
• 作者: Fast JF;Muley A;Kühn D;Meisoll F;Ortmaier T;Jungheim M;Ptok M;Kahrs LA
• 通讯作者: Kahrs LA