Aerodynamic Study For Laryngeal Function Assessment Using Airflow Interruption Me

描述（由申请人提供）：声音障碍影响数百万美国人，并已成为国家优先调查的目标。嗓音障碍对语音质量的影响 生命是有意义的;当一个人声音受损时，工作、与朋友和家人联系、参与社会活动以及简单地参与日常生活的能力变得费力，如果不是不可能的话。嗓音障碍的多因素性质要求临床医生了解喉部的功能，以便做出适当的治疗决定。在发声过程中，喉部充当能量转换器，将声门下压力（Ps）和气流形式的空气动力学能量转换成声音形式的声能。无创空气动力学评估是一种客观和定量的方法来评估声音产生的输入。拟议的研究有两个相互关联的部分。在第一部分中，研究将集中在改进我们实验室开发的三种空气动力学测量方法：气流中断;不完全气流中断;和气流重定向。这些方法都被证明是准确的。将作出修改的设备，以允许测量发声阈值流量和发声阈值功率，我们的实验室提出的两个新的参数，已被实验证明是有价值的。还将研究通过增加听觉反馈、视觉反馈、脸颊约束和改进的分析技术来增强这些设备，从而可能减少受试者内变异性。我们还将确定测量Ps的最佳中断长度，并通过将我们的空气动力学评估设备与高速视频成像相结合来确定中断如何影响声带振动。反射的诱发阻碍了气流阻断的广泛临床应用。在气流中观察声带 中断将使我们能够确定这种反射是否发生在喉部，如果是的话，它的精确潜伏期。第一部分的数据将允许选择一种改进的空气动力学评估方法。 在第二部分中，第一部分中开发的最佳系统将用于评估和比较常见语音障碍的治疗方法。将评价息肉和结节大小对空气动力学参数的影响;还将研究空气动力学参数如何随着病变大小的减小而变化。将进行治疗前和治疗后的空气动力学评估，以确定肉毒杆菌注射对痉挛性发声障碍的影响。我们还将比较几种常见的治疗声带麻痹。虽然有许多治疗方法，但尚未开发出最佳治疗方法。将研究术中实时测量发声效率，作为优化内侧喉成形术和杓状软骨内收术的一种手段。我们还将单独确定每个气动参数和所有参数的诊断能力。初步观察表明，空气动力学测量可以改善语音障碍的评估。因此，提高对正常和异常发声的理解的潜力是巨大的。

DESCRIPTION (provided by applicant): Voice disorders affect millions of Americans and have been targeted as a national priority for investigation. The impact of voice disorders on quality of life is significant; the ability to work, relate to friends and family, participate in social activties, and simply engage in everyday life becomes effortful, if not impossible, when one's voice is impaired. The multi-factorial nature of voice disorders necessitates that clinicians understand how the larynx functions in order to make appropriate treatment decisions. During phonation, the larynx serves as an energy transducer, transferring aerodynamic energy in the form of subglottal pressure (Ps) and airflow into acoustic energy in the form of sound. Noninvasive aerodynamic assessment is an objective and quantitative method of evaluating the inputs to voice production. The proposed research has two interrelated parts. In part I, research will focus on improving three methods of aerodynamic measurement developed in our laboratory: airflow interruption; incomplete airflow interruption; and airflow redirection. These methods have all been demonstrated to be accurate. Modifications will be made to the devices to allow for measurement of phonation threshold flow and phonation threshold power, two new parameters proposed by our laboratory that have been experimentally shown to be valuable. Enhancing these devices with additions such as auditory feedback, visual feedback, cheek restraints, and modified analysis techniques will also be investigated, potentially reducing intrasubject variability. We will also determine the optimal interruption length for measurement of Ps and determine how interruption affects vocal fold vibration by combining our aerodynamic assessment devices with high-speed video imaging. Elicitation of a reflex has hindered the widespread clinical application of airflow interruption. Visualizing the vocal folds during airflow interruption will allow us to determine if this reflex occurs at the larynx and if so, its precise latency. Data from part I will allow for selection of an improved method of aerodynamic assessment. In part II, the optimal system developed in part I will be used to evaluate and compare treatments for common voice disorders. The effect of polyp and nodule size on aerodynamic parameters will be evaluated; how aerodynamic parameters change as lesion size decreases will also be investigated. Pre- and post-treatment aerodynamic assessment will be performed to determine the effect of Botox injections on spasmodic dysphonia. We will also compare several common treatments for vocal fold paralysis. Though numerous treatments are available, an optimal treatment has yet to be developed. Real-time intraoperative measurements of vocal efficiency will be investigated as a means to optimize medialization laryngoplasty and arytenoid adduction. We will also determine the diagnostic power of each aerodynamic parameter individually and all parameters collectively. Preliminary observations suggest that aerodynamic measurements can improve assessment of voice disorders. Thus, the potential to improve understanding of normal and disordered voice production is great.