Biomechanical characterization of vocal fold tissues

描述(申请人提供)：该项目代表了一项持续的努力，以量化人类喉部组织的关键生物力学特征，以更好地了解发声的组织机制，与发声过度使用和创伤有关的发声障碍的潜在机械因素，以及声带疤痕的力学表现。长期目标是为改善嗓音障碍的预防、诊断和管理提供机械学激励的指导方针。为了达到这一目标，这一应用的具体目的包括：(1)量化声带固有层细胞外基质(ECM)的线性和非线性粘弹性反应，包括量化导致声带固有层细胞外基质(ECM)累积振动暴露安全极限的组织疲劳反应，以及量化人类声带瘢痕组织的粘弹性剪切特性；(2)表征人喉内肌的主动收缩特性和被动粘弹性特性；(3)建立新的声带固有层和喉内肌的本构模型，以更准确地描述其组织力学；开发用于基频调节和预测的新的生物力学模型，以及将新的经验数据和新的本构模型与现有的声带姿势和发声的计算生物力学模型相结合。这项研究的一个主要好处是改进了声带姿势和发声的计算机模型，使它们变得更准确、更一致，更能代表人类的声音产生。这样的模型有可能成为一种强大的临床工具，可以最大限度地发挥声音外科手术患者的发声功能，这些手术包括甲状腺成形术、注射喉成形术和小切开术，用于治疗各种嗓音障碍。与公共健康相关：每年高达9%的美国人患有某种发声障碍。嗓音障碍的经济影响怎么强调都不为过，因为多达20%的美国劳动力依赖健康、功能正常的嗓音作为其职业的主要工具(Tize等人，1997)。也有充分的证据表明，声音障碍在沟通、社会功能和心理健康方面对生活质量有重大的负面影响。通过提高我们对发声的组织机制、与发声过度使用和创伤相关的发声障碍的潜在机械因素以及声带疤痕的机械表现的了解，本研究可能有助于改进发声障碍的预防、诊断和管理，减轻社会上过高的医疗费用负担。

DESCRIPTION (provided by applicant): This project represents a continual effort to quantify the key biomechanical characteristics of human laryngeal tissues, so as to better understand the tissue mechanics of voice production, the potential mechanical factors responsible for voice disorders related to vocal overuse and trauma, and the mechanical manifestations of vocal fold scarring. The long-term goal is to provide mechanics-motivated guidelines for improving the prevention, diagnosis and management of voice disorders. To achieve this goal, the specific aims of this application include: (1) To quantify the linear and nonlinear viscoelastic response of the vocal fold lamina propria extracellular matrix (ECM), including to quantify the tissue fatigue response contributing to the safety limits of accumulated vibration exposure in the vocal fold ECM, and to quantify the viscoelastic shear properties of human vocal fold scar tissues; (2) To characterize the active contractile properties and passive viscoelastic properties of human intrinsic laryngeal muscles; (3) To develop new constitutive models of the vocal fold lamina propria and the intrinsic laryngeal muscles for more accurate descriptions of their tissue mechanics; and (4) To develop new biomechanical models for fundamental frequency regulation and prediction; as well as to integrate the new empirical data and new constitutive models with existing computational biomechanical models of vocal fold posturing and phonation. A major benefit of this research will be an improvement in the computer models of vocal fold posturing and phonation, such that they will become more accurate, more consistent and more representative of human voice production. Such models can potentially become a powerful clinical tool for maximizing the vocal function of patients undergoing phonosurgical procedures, such as thyroplasty, injection laryngoplasty and minithyrotomy for the treatment of a variety of voice disorders. PUBLIC HEALTH RELEVANCE: Up to 9% of Americans suffer from some kind of voice disorders annually. The economic impact of voice disorders cannot be overstated, as up to around 20% of the U.S. workforce relies on a healthy, functional voice as a major tool for their occupations (Titze et al., 1997). It has also been well documented that voice disorders have a significant negative impact on the quality of life in the areas of communication, social function and psychological health. By improving our understanding of the tissue mechanics of voice production, the potential mechanical factors responsible for voice disorders related to vocal overuse and trauma, and the mechanical manifestations of vocal fold scarring, this research may contribute findings that could improve the prevention, diagnosis and management of voice disorders, reducing the burden of excessive healthcare costs on society.