Design, construction, and evaluation of implants for vocal fold alteration and re

描述（由申请人提供）：拟议研究的主要目标是应用机械工程的设计、动态测试和材料测试方法，以更好地了解现有和新的声带植入物和假体对声带内侧化、部分或全部固有层重建对天然喉组织的机械特性和动态响应以及最终对声音质量的影响。据推测，所提出的方法的系统应用最终将有助于创建具有代表天然组织的坚固耐用的机械行为的植入物和假体。在使用声带植入物和假体对涉及固有层的声带病变进行手术修复方面已经做了很多工作，例如疤痕、声带沟和萎缩，这仍然是喉科和语音外科领域的临床问题。使用的生物材料包括特定类型的脂肪、胶原蛋白、透明质酸、筋膜和各种合成材料，例如硅胶、Gore-Tex 或羟基磷灰石。以前的工作是在没有详细了解所用合成或生物材料的机械性能和响应的情况下完成的。这可能导致振荡功能次佳，并降低语音质量。本研究旨在开发和评估合成模型、植入物和假体，其机械性能与人类声带组织的测量数据非常匹配。喉部的合成模型将得到完善并用于基础研究以及新植入物的测试台。将开发数字图像相关方法，以获得动态、全场应变数据和应力估计，这将有助于量化假体和植入物对机械响应的影响。声带共振频率对张力、气流速率和植入物设计的依赖性将被量化。将测量所选基质蛋白对固有层粘弹性的影响，以便更好地了解组织对外来夹杂物的生物反应的后果。将使用原子力显微镜检查植入物和天然组织之间的结合问题。公共卫生相关性 该研究计划的基础研究和开发模型旨在开发有助于声音障碍的临床和手术治疗的工具。

DESCRIPTION (provided by applicant): The broad objective of the proposed studies is to apply design, dynamic testing, and material testing methods from Mechanical Engineering to better understand the impact of existing and new vocal fold implants and prostheses for vocal fold medialization, partial or total lamina propria reconstruction on the mechanical properties and dynamic response of native laryngeal tissue and, ultimately, voice quality. It is postulated that the systematic application of the proposed methods will eventually help the creation of implants and prostheses with mechanical behavior representative of native tissue that are robust and durable. Much work has been done on the use of vocal fold implants and prostheses for the surgical repair of vocal pathologies involving the lamina propria, such as scarring, sulcus vocalis, and atrophy, which remain challenging clinical problems in laryngology and phonosurgery. Biomaterials used have included specific types of fat, collagen, hyaluronic acid, fascia, and a variety of synthetic materials such as silicone, Gore-Tex, or hydroxyapatite. Previous work has been done without a detailed knowledge of the mechanical properties and response of the synthetic or biological materials used. This may have resulted in sub-optimal oscillatory function, and reduced voice quality. The present study aims at developing and evaluating synthetic models, implants, and prostheses with a set of mechanical properties that closely match measured data for human vocal fold tissue. Synthetic models of the larynx will be perfected and used for fundamental studies, as well as test beds for new implants. Digital image correlation methods will be developed in order to obtain dynamic, full field strain data and stress estimates that will help quantify the influence of prosthesis and implants on mechanical response. The dependence of the vocal folds resonance frequencies on tension, air flow rate, and implant design will be quantified. The influence of selected matrix proteins on the viscoelastic properties of the lamina propria will be measured in order to better under the consequences of the biological response of the tissue to foreign inclusions. The issues of bonding between implants and native tissue will be examined using atomic force microscopy. PUBLIC HEALTH RELEVANCE The basic studies and developing models of this research program are intended to develop tools that will aid the clinical and surgical treatment of voice disorders.