Development of an Electromyographically Controlled Electrolarynx Voice Prosthesis

描述（由申请人提供）：喉切除术后言语康复最常见的人工声源是手持式蜂鸣器或电子喉（EL）。这种装置相对容易使用，使大多数喉切除者能够口头交流，但可理解性降低，自然度明显下降。此外，EL语音通常被描述为机器人和单调的，主要归因于缺乏正常的基频（F0）变化/控制和异常的语音源定时（例如，由拇指按钮控制的语音开始和偏移）。先前的研究已经表明，颈部表面肌电信号（EMG）可以作为一个直观和有效的控制源EL语音起始/偏移时间和F0调制。本计画的目标是开发一种有效、实用且使用者友善的肌电语音义肢，可提供更佳的音源时序控制与F0，以获得更清晰自然的电致发光语音。在第一阶段，我们实现了以下具体目标：1）生产了一种适用于EL控制的原型无线EMG传感器; 2）将无线EMG信号接收和处理电路集成到手持式EL中;以及3）通过对两名有EL使用经验的喉切除术患者进行试点测试来评估原型EMG-EL。在这项工作的第二阶段，我们将通过以下方式进一步完善EMG-EL语音假体：1）在实验室中使用额外的EL用户测试该系统，并通过家庭试验进行日常使用，2）设计和构建新版本的EMG-EL假体，该假体可以根据个人用户的EMG信号自动调整F0范围、起始/关闭阈值和EMG伪影抑制，3）用EL用户测试新系统，并使用在线界面由跨越宽年龄范围的大样本听众对其语音结果进行感知评估，4）应用基于视觉和声学的EMG生物反馈来改善EMG控制的语音语调的F0调制，5）与EL用户一起进行新EMG-EL系统的扩展的家庭试验，以及6）创建用户指南和一组临床说明，为EMG-EL系统商业化做准备。

DESCRIPTION (provided by applicant): The most common artificial voice source for post-laryngectomy speech rehabilitation is the hand-held buzzer or electrolarynx (EL). This device is relatively easy to use and enables most laryngectomees to verbally communicate, but with reduced intelligibility and markedly degraded naturalness. In addition, EL speech is often described as robotic and monotone, attributable largely to the lack of normal fundamental frequency (F0) variation/control and abnormal voice source timing (e.g. voice onset and offset controlled by a thumb button). Previous research has demonstrated that neck surface electromyographic (EMG) signals can serve as an intuitive and effective control source for EL voice onset/offset timing and F0 modulation. The goal of this project is to develop an effective, practical, and user-friendly EMG-EL voice prosthesis that can provide improved control over voice source timing and F0 for more intelligible and natural-sounding EL speech. In Phase I we achieved the following specific aims: 1) Produced a prototype wireless EMG sensor appropriate for EL control; 2) integrated wireless EMG signal reception and processing circuitry into a hand-held EL; and 3) evaluated the prototype EMG-EL through pilot testing with two laryngectomy patients experienced in EL use. In Phase II of this effort we will further refine the EMG-EL voice prosthesis by 1) testing the system with additional EL users both in the laboratory and though daily use with an at-home trial, 2) designing and building a new version of the EMG-EL prosthesis that can automatically adjust F0 range, onset/off thresholds, and EMG artifact rejection based on individual user's EMG signals, 3) testing the new system with EL users and performing perceptual assessment of their speech results by a large sample of listeners across a wide age range using an online interface, 4) application of visual and acoustic-based EMG biofeedback to improve EMG-controlled F0 modulation of vocal intonation, 5) conducting an extended at-home trial of the new EMG-EL system with EL users, and 6) creating a user guide and set of clinical instructions in preparation for EMG-EL system commercialization.