The Relationship between Vortices, Acoustics, and Vibration in Vocal Fold Assymet

项目摘要/摘要 许多嗓音障碍的特点是声带结构不对称，例如发声不同。 折叠左右位置、高度、长度或僵硬(例如，单侧声带麻痹和麻痹、发声 褶皱息肉、声带疤痕等)。当不对称性较轻时，目前的治疗方法是有效的。 对大多数病人来说。然而，当不对称性显著或多重时，结果会更多 不确定。这些患者代表着一个重要的健康问题，因为他们声音的严重性 精神障碍对他们的身体、心理和经济都有很大影响。在任何领域、临床 关于干预策略的决策取决于临床结果数据和 对潜在机制的理解。对于这些患者来说，既是因为临床数据是 有限的，因为问题是如此复杂，科学地理解如何结构 不对称会影响声带振动，而发声尤为重要。 长期以来，人们一直认为，漩涡或旋转运动的区域出现在 喉部气流，但它们之间的相关性尚不清楚。使用成熟的实验和 理论方法从工程，我们已经发现证据表明，涡旋结构是 尤其是在声带不对称的情况下。在这项先前的工作中，由K-8支持 授予首席研究员，我们的团队已经测量了发声气流的速度场 切除的犬喉，特别是对涡流的量化感兴趣。我们已完成的研究 (Khosla等人，2007、2008a和2009；Murugappan，Khosla等人，2009)提供支持 这一应用的总体假设的基础是：声门气流包含 对声学有重大贡献的某些涡旋结构；以及在某些情况下 喉部病理，这些旋涡结构被减少或消除。它是 修改和/或抑制这些导致异常声音的涡流 制作。最有效地恢复特定漩涡的治疗方法将拥有最好的声音 结果。 为了检验中心假说，我们建议围绕以下几个方面组织我们的研究 明确的目标。切除的犬喉和人喉将用于所有目的。 具体目标1-使用计算和验证的切除半喉模型，表征 涡旋和组织弹性对声带振动和声学的影响。 具体目标2-涡旋、组织弹性、声带振动和声学将被测量为 不同的、临床相关的结构不对称的功能。 具体目标3-结构不对称、振动不对称和声学方面的变化将是 单侧发声的单一程序或以下程序的组合后测量 折叠麻痹：1型甲状腺成形术、内收关节固定术和环甲状突半脱位

Project Summary/Abstract Many voice disorders feature structural vocal fold asymmetries, such as a difference in vocal fold left-right position, height, length or stiffness (e.g. unilateral vocal fold paresis and paralysis, vocal fold polyps, vocal fold scarring, etc.). When the asymmetries are mild, present therapies are effective for most patients. However, when the asymmetries are significant or multiple, outcomes are more uncertain. Such patients represent an important health problem, because the severity of their voice disorder significantly affects them physically, psychologically and economically. In any field, clinical decision-making about intervention strategies depends on a combination of clinical outcome data and the understanding of underlying mechanisms. For these patients, both because clinical data are limited and because the problems are so complex, scientific understanding of how structural asymmetries affect vocal fold vibration and voice production is particularly important. It has long been acknowledged that vortices, or areas of rotational motion, occur in the laryngeal airflow, but their relevance has not been clear. Using well-established experimental and theoretical approaches from engineering, we have found evidence that vortical structures are particularly relevant in cases of vocal fold asymmetries. In this previous work, supported by a K-8 grant to the principal investigator, our team has measured velocity fields of phonatory airflow in excised canine larynges, with particular interest in quantifying vortices. Our completed studies (Khosla et al., 2007, 2008a and 2009; Murugappan, Khosla et al., 2009) provide a supportive foundation to the overarching hypothesis of this application, which is: glottal airflow contains certain vortical structures that significantly contribute to the acoustics; and that in certain laryngeal pathologies, these vortical structures are reduced or eliminated. It is the modification and/or suppression of these vortices that contribute to abnormal voice production. Treatments that most effectively restore specific vortices will have the best voice outcomes. In order to test the central hypothesis, we propose to organize our study around the following specific aims. Excised canine and human larynges will be used for all aims. Specific Aim 1 - Using computational and validated excised hemilarynx models, characterize the effects of vortices and tissue elasticity on vocal fold vibration and acoustics. Specific Aim 2 - Vortices, tissue elasticity, vocal fold vibration and acoustics will be measured as functions of different, clinically relevant structural asymmetries. Specific Aim 3 -The change in structural asymmetries, vibratory asymmetries and acoustics will be measured after a single procedure or a combination of the following procedures for unilateral vocal fold paralysis: Thyroplasty Type 1, Adduction Arytenopexy and Cricothyroid Subluxation