Aerodynamic Study For Laryngeal Function Assessment Using Airflow Interruption Me

描述(由申请者提供)：嗓音障碍影响着数百万美国人，并已被列为国家重点调查对象。发声障碍对发音质量的影响 生活是有意义的；当一个人的声音受损时，工作、与朋友和家人相处、参与社会活动和简单地参与日常生活的能力变得困难，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化为声音形式的声能。非侵入性空气动力学评估是一种客观、定量地评估发声输入的方法。这项拟议的研究有两个相互关联的部分。在第一部分中，研究将集中于改进我们实验室开发的三种气动测量方法：气流中断、不完全气流中断和气流重定向。这些方法都已被证明是准确的。将对设备进行改进，以允许测量发声阈值流量和发声阈值功率，这两个新参数由我们实验室提出，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、面颊约束和改进的分析技术来增强这些设备，潜在地减少对象内的可变性。我们还将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，确定测量Ps的最佳中断长度，并确定中断如何影响声带振动。反射的激发阻碍了气流阻断在临床上的广泛应用。气流过程中声带的可视化 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，它的准确潜伏期。来自第一部分的数据将允许选择一种改进的空气动力评估方法。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嗓音障碍的治疗方法。将评估息肉和结节大小对空气动力学参数的影响；还将研究随着病变大小的减小，空气动力学参数如何变化。治疗前和治疗后将进行空气动力学评估，以确定肉毒杆菌注射对痉挛性发音困难的影响。我们还将比较几种常见的声带麻痹治疗方法。虽然有许多治疗方法可用，但还没有开发出最佳的治疗方法。术中发声效率的实时测量将作为优化中性化喉成形术和颧骨内收的一种手段进行研究。我们还将单独确定每个气动参数的诊断能力，并共同确定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对嗓音障碍的评估。因此，提高对正常和无序声音产生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.