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

声带不对称中涡流、声学和振动之间的关系

• 批准号: 7784575
• 负责人: Siddarth Mitter Khosla
• 金额: $ 61.83万
• 依托单位: UNIVERSITY OF CINCINNATI
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-18 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7784575
• 关键词: Acoustics; Affect; Animal Model; Area; Behavior; Canis familiaris; Cicatrix; Clinical; Clinical Data; Complex; Data; Decision Making; Diagnostic; Diagnostic Procedure; Elasticity; Engineering; Environment; Foundations; Goals; Grant; Health; Height; Human; Image; Intervention; Knowledge; Larynx; Lead; Left; Length; Measures; Medial; Medical; Methodology; Modeling; Modification; Motion; Noise; Operative Surgical Procedures; Outcome; Paralysed; Paresis; Pathology; Patients; Phonation; Polyps; Positioning Attribute; Principal Investigator; Procedures; Production; Qualifying; Relative (related person); Research; Resolution; Restaurants; Severities; Speed; Structure; Surface; Techniques; Technology; Telephone; Testing; Tissues; Voice; Voice Disorders; Work; clinically relevant; clinically significant; effective therapy; improved; in vivo Model; innovation; interest; novel; pressure; public health relevance; sound; vibration; vocal cord

DESCRIPTION (provided by applicant): 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. PUBLIC HEALTH RELEVANCE: The results of the proposed research will provide an approach to clinically study patients with vocal fold asymmetry. Looking forward, the study of phonation at this resolution will synergize well with advancing technologies in laryngeal imaging, such as videokymography (Svec et al) and high speed videography (Delyiski) as available clinical technology allows for more precise and reliable identification of asymmetries. The findings will have far reaching impact in laryngology as the results may be applicable to other conditions in the larynx that result in vocal fold asymmetries , such as vocal fold scarring and vocal fold sulcus. These results will have positive impact, since the new knowledge will result in improved diagnostic and clinical techniques that could not be otherwise developed.

描述(申请人提供)：许多声音障碍以声带结构不对称为特征，例如声带左右位置、高度、长度或僵硬的不同(例如，单侧声带麻痹和瘫痪、声带息肉、声带疤痕等)。当不对称症状轻微时，目前的治疗方法对大多数患者都有效。然而，当不对称性显著或多重时，结果就更不确定了。这类患者代表着一个重要的健康问题，因为他们嗓音障碍的严重程度对他们的身体、心理和经济都有很大影响。在任何领域，有关干预策略的临床决策都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，既因为临床数据有限，又因为问题如此复杂，科学了解结构不对称如何影响声带振动和发声尤为重要。长期以来，人们一直认为喉部气流中存在涡流或旋转运动区，但它们之间的相关性尚不清楚。利用工程学中成熟的实验和理论方法，我们发现了涡旋结构在声带不对称的情况下特别相关的证据。在这项之前的工作中，在K-8拨款给首席研究员的支持下，我们的团队测量了犬喉切除后发声气流的速度场，特别是对涡流的量化感兴趣。我们完成的研究(Khosla等人，2007、2008a和2009；Murugappan，Khosla等人，2009)为这一应用的总体假设提供了支持的基础，即：声门气流包含对声学有重要贡献的某些涡流结构；在某些喉部病理中，这些涡流结构被减少或消除。正是这些涡旋的改变和/或抑制导致了异常声音的产生。最有效地恢复特定涡旋的治疗方法将具有最佳的声音效果。为了验证这一中心假设，我们建议围绕以下具体目标组织我们的研究。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、临床上相关的结构不对称的函数。具体目标3--结构不对称、振动不对称和声学的变化将在单侧声带麻痹的单一程序或以下程序的组合后进行测量：甲状旁路成形术1、内收关节固定术和环甲关节半脱位。 公共卫生相关性：拟议的研究结果将为临床研究声带不对称患者提供一种方法。展望未来，在这种分辨率下发声的研究将与先进的喉部成像技术很好地协同，如视频细胞摄影术(Svec等人)和高速视频摄影术(Delyiski)，因为现有的临床技术可以更准确和可靠地识别不对称。这一发现将对喉科产生深远的影响，因为该结果可能适用于导致声带不对称的其他喉部疾病，如声带疤痕和声带沟。这些结果将产生积极的影响，因为新的知识将导致诊断和临床技术的改进，而这些技术是以其他方式无法开发的。