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Clinical measurement of vocal fold impact stress in children

儿童声带冲击应力的临床测量

基本信息

批准号：
8384862
负责人：
Rita R Patel
金额：
$ 12.49万
依托单位：
TRUSTEES OF INDIANA UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-12-01 至 2014-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8384862
关键词：
12 year old Acceleration Adult Aftercare Age Biomechanics Caring Child Childhood Chronic Clinic Clinical Clinical assessments Coupled Custom Development Developmental Process Diagnosis Disease Dysphonia Early identification Endoscopes Ensure Foundations Goals Growth Growth and Development function Health Hoarseness Image Imagery Individual Investigation Knowledge Laboratories Larynx Lasers Lead Length Lesion Loudness Measurement Measures Mechanics Methodology Methods Modeling Motion Movement Nodule Outcome Pathology Pattern Phonation Physiology Population Predisposing Factor Production Recruitment Activity Relative (related person)Research Risk Shapes Speed Stress Structure System Therapeutic Translating Trauma Treatment outcome Voice Voice Disorders Work base burden of illness clinical application digital imaging disability effective therapy glottis high standard imaging modality improved innovation insight kinematics novel programs prototype psychologic restoration spatiotemporal stress disorder theories tool trend vibration vocal cord

项目摘要

DESCRIPTION (provided by applicant): Nationwide over one million or 6-9%1 of all children suffer from dysphonia. Dysphonia can be detrimental to children both psychologically and academically, hence early identification and restoration of optimal vocal health is critical. Direct visualization of vocal fold vibratory patterns is fundamental to appropriate diagnosis and treatment of vocal fold pathology. Objective assessments of vocal fold physiology are non-existent in the field of pediatric voice care, leading to delayed diagnosis and deferred development of effective treatments. The long term goal of the proposed research is to improve treatment outcomes and early identification in children with hoarseness by establishing age appropriate quantitative measurements of immature vocal fold function that contribute to voice disorders. To accomplish this goal, it is necessary to quantify vocal fold vibrations resulting from differences in the multilayered vocal fold structure of children compared with adults. Most voice problems in children are thought to be caused by mechanical trauma to the vocal folds manifested as high impact stress, leading to the development of vocal nodules. The specific goal of this project is to identify the impact of growth and development of the layered structure of the vocal folds on vocal physiology and the relationship of these factors to the development of vocal fold nodules in children. This research proposes 1 milestone-driven aim and 2 hypotheses-driven aims. Therefore, the specific aims of this application are: 1) to optimize a 2-point laser projection system developed in our laboratory for precision and to compute expected measurement variability to fully translate use of this system to children, 2) to quantify the relationship between short vocal fold length and increased vibratory amplitude during the developmental process in children with and without nodules, and 3) to quantify spatiotemporal features of vocal fold impact stress in children as a function of age and pathology. A total of 80 children will be recruited to participate (ages: 5-12), 40 with and 40 without nodules. Forty adults (21-45 years) will be recruited to obtain the developmental end point for maturation of vibratory motion because adults have a well-defined layered structure of the vocal folds. The following spatiotemporal features of vocal fold vibrations will be measured using a novel 2-point pediatric laser high speed digital imaging system to identify impact stress: mid membranous amplitude-to-length ratio, peak vocal fold acceleration(mm/sec2), peak closing velocity (mm/sec), open quotient, and vibratory stiffness (ratio of maximum velocity by maximum displacement) and closed quotient. The proposed research is significant in filling a gap in knowledge concerning the most effective methods for assessing vibratory function and identifying predisposing factors in children with hoarseness. The fundamental knowledge of vibratory function obtained from this work will directly translate to the clinic by producing meaningful findings and measures that can be applied to pediatric vocal health outcomes and will thus reduce the burden of illness and disability caused by voice disorders in children.

描述（由申请人提供）：全国超过一百万或所有儿童的6-9%1患有发音困难。发声障碍对儿童的心理和学业都是有害的，因此早期识别和恢复最佳的声音健康至关重要。声带振动模式的直接可视化是正确诊断和治疗声带病变的基础。在儿科嗓音护理领域，不存在对声带生理的客观评估，导致诊断延迟和有效治疗方法的开发延迟。拟议研究的长期目标是通过建立与年龄相适应的定量测量导致嗓音障碍的不成熟声带功能来改善治疗结果和早期识别儿童声嘶。为了实现这一目标，有必要量化声带振动的多层声带结构的儿童相比，成人的差异。大多数儿童的声音问题被认为是由机械创伤引起的声带表现为高冲击应力，导致声带小结的发展。该项目的具体目标是确定声带的分层结构的生长和发育对发声生理的影响，以及这些因素与儿童声带结节发育的关系。本研究提出了1个里程碑驱动的目标和2个假设驱动的目标。因此，本申请的具体目的是：1）优化我们实验室开发的2点激光投影系统的精度，并计算预期的测量可变性，以将该系统的使用完全转化为儿童，2）量化在有和没有结节的儿童的发育过程中短声带长度和增加的振动幅度之间的关系，3）量化儿童声带冲击应力的时空特征作为年龄和病理的函数。共招募80名儿童参加（年龄：5-12岁），40名有结节，40名无结节。将招募40名成年人（21-45岁），以获得振动运动成熟的发育终点，因为成年人具有明确的声带分层结构。将使用新型2点小儿激光高速数字成像系统测量声带振动的以下时空特征，以识别冲击应力：中膜振幅-长度比、峰值声带加速度（mm/sec 2）、峰值闭合速度（mm/sec）、开放商和振动刚度（最大速度与最大位移的比值）和闭合商。这项研究对于填补有关评估振动功能的最有效方法和识别儿童声音嘶哑的诱发因素的知识空白具有重要意义。从这项工作中获得的振动功能的基本知识将通过产生有意义的发现和措施直接转化为临床，这些发现和措施可以应用于儿科声乐健康结果，从而减少儿童嗓音障碍引起的疾病和残疾的负担。