The Relationship Between Vortices, Acoustics, and Vibration in Vocal Fold Asymmetries

项目总结。 单侧声带麻痹(UVFP)的常见手术，如甲状腺成形术1型， 改善发声效率(VE)--通过缩小正常人和正常人之间的膜间隙 瘫痪的褶皱。VE测量声门下空气动力转换为 声学功率。然而，即使在手术治疗后，一些患者报告的症状 在嘈杂的环境中，声音疲劳、投影减少和清晰度降低。 这些顽固不化的症状将与相对于正常声音的VE减少有关， 提示加强VE可进一步改善这些症状。我们之前在 切除的犬喉表明这种进一步的改善肯定是可能的。 对程序的修改。例如，我们发现了一个令人惊讶的结果 褶皱下方的组织(声门下区)导致的VE高于褶皱的中段。 声门本身(声门)，尽管两种手术都关闭了内侧-外侧膜间隙。 此外，与声门下中化相比，包括颧骨内收可增加VE。 独自一人。然而，要将这些在动物身上的外科发现转化为患者，需要更深层次的研究 了解各种治疗修改如何以及为什么会影响VE。在之前的工作中，我们 发现在关闭过程中，褶皱之间会发生旋转运动(漩涡)。这些漩涡 产生负压，导致折叠更快地闭合，从而增加 声强和VE。我们知道褶皱的底部比上部坚硬。 这被称为垂直刚度梯度(VSG)。我们还发现，较低的 VSG产生较弱的涡旋并降低VE。在第一个目标中，我们将进一步研究 VSG对VE的影响。在第二个和第三个目标中，我们将研究如何以及为什么不同 UVFP的治疗影响VE。该应用为VE的临床应用奠定了基础，并 用于优化UVFP的临床治疗。

Project summary. Common operations for unilateral vocal fold paralysis (UVFP), such as Thyroplasty Type 1, improve vocal efficiency (VE) by closing the membranous gap between the normal and paralyzed fold. VE measures the degree to which subglottal aerodynamic power is translated to acoustic power. However, even after surgical treatment, some patients report symptoms such as vocal fatigue, decreased projection, and decreased intelligibility in noisy environments. These recalcitrant symptoms will be associated with reduced VE relative to normal voice, suggesting that enhancing VE could further ameliorate these symptoms. Our previous work in the excised canine larynx suggests that this further improvement is possible by certain modifications to the procedure. For example, we found the surprising result that medialization of the tissue below the fold (infraglottal region) results in higher VE than medialization of the fold itself (glottal) even though both operations close the medial-lateral membranous gap. Additionally, inclusion of arytenoid adduction increased VE relative to infraglottal medialization alone. However, to translate these surgical findings in animals to patients requires a deeper understanding about how and why various treatment modifications affect VE. In prior work we found that rotational motion (vortices) occur between the folds during closing. These vortices produce negative pressures that cause the folds to close together faster, which increase acoustic intensity and VE. We know that the bottom part of the folds is stiffer than the upper part; this is referred to as the vertical stiffness gradient (VSG). We have also found that lower VSG produces weaker vortices and decreased VE. In the first aim, we will further examine the effect of the VSG on VE. In the second and third aim, we will look at how and why different treatments for UVFP affect VE. This application lays the foundation for using VE clinically, and for optimizing clinical treatments for UVFP.