Optimization And Therapeutic Translation of Semi-Occluded Vocal Tract Techniques.

项目摘要 半封闭式声带（SOVT）疗法被广泛用于治疗各种嗓音疾病，包括声带 病变和原发性肌肉紧张性发音困难。SOVT治疗的机制尚未完全阐明 研究了增加的声道，通常是一根吸管，改变了声门上声阻抗， 静态声门上压;然而，这些参数如何独立地有助于语音治疗 尚未得到澄清。我们想观察声声门上效应以及声阻抗 独立和定量地影响发声。我们的长期目标是改进目前的方法， 通过探索潜在的机制和找到最佳的SOVT配置， 以最大限度地提高最佳发声质量。该研究由两个独立的 阶段。 在第一阶段，切除的犬喉模型将用于独立的科学评价， SOVT治疗中三个变量的优化：（1）声道延伸长度，（2）声道出口 收缩;（3）调节声门上压力输入。延长长度并收缩出口 声道增加了声阻抗，声阻抗增加了声门上压力， 发声调节压力输入的使用是SOVT治疗的新补充，其允许患者在治疗过程中进行呼吸。 直接控制声门上压。将检查每个SOVT变量的宽范围 以确定每种修饰的最佳水平。发声将系统地 通过相关的空气动力学、电声门图和声学参数进行监测， 效率 在第二阶段，在人类受试者中，我们将独立评估SOVT治疗的三个变量， 受试者有和没有功能亢进的声音障碍。使用离体模型的研究结果 提供的信息仅基于机制，具有未缩放的模式;而第二阶段研究将提供 深入了解人类受试者的动态和行为反应。对有声经济的影响将是 使用空气动力学、电声门图和声学参数作为因变量进行评估。通过 标准化的治疗任务，SOVT治疗的修改的效果可以被隔离。研究 本提案中概述的将通过独立测试评估最佳SOVT治疗配置， 三个SOVT修改。此外，我们还将包括长期和短期的治疗任务。通过测试 每次修改跨越不同的任务持续时间，我们可以确定最小的任务持续时间，以实现 重大利益。通过监测短期和长期影响，可以进一步了解总体影响 这种声音疗法能带来的好处

Project Summary Semi-occluded vocal tract (SOVT) therapy is widely used to treat various voice disorders, including vocal fold lesions and primary muscle tension dysphonia. The mechanism of SOVT therapy has not been thoroughly studied. The added vocal tract, which is often a straw, changes both supraglottal acoustic impedance, and static supraglottal pressure; however, how these parameters independently contribute to the voice therapy have not been clarified. We would like to observe the supraglottal effects as well as the acoustic impedance effects of phonation independently and quantitatively. Our long-term aim is to improve upon current methods of SOVT therapy by exploring the underlying mechanisms and finding the optimal SOVT configurations that allow for the greatest increase in best quality of phonation. The proposed research consists of two independent phases. During Phase I, an excised canine larynx model will be used for the independent scientific evaluation and optimization of three variables in SOVT therapy – (1) length of vocal tract extension, (2) vocal tract outlet constriction, and (3) regulated supraglottal pressure input. Extending the length and constricting the outlet of the vocal tract increases the acoustic impedance which then increases supraglottal pressure and the ease of phonation. The use of a regulated pressure input is a novel addition to SOVT therapy, which allows the supraglottal pressure to be directly controlled. Wide ranges of each SOVT variable will be examined individually to determine the optimal levels of each modification. Vocal phonation will be systematically monitored through dependent aerodynamic, electroglottographic, and acoustic parameters, including vocal efficiency. During Phase II, in human subjects, we will independently assess the three variables of SOVT therapy on subjects with and without hyperfunctional voice disorders. The results from the studies using an ex-vivo model gives information based solely on the mechanism, with an unscaled pattern; whereas, Phase II studies will give insight into the dynamic and behavioral reactions present in human subjects. Effects on vocal economy will be evaluated using aerodynamic, electroglottographic, and acoustic parameters as dependent variables. Through a standardized therapeutic task, the effect of the modifications of SOVT therapy can be isolated. The studies outlined in this proposal will evaluate optimal SOVT therapy configurations through independently testing the three SOVT modifications. Further, we also will include long and short duration therapeutic tasks. By testing each modification across different task durations, we can identify the minimal task duration to achieve significant benefits. Monitoring the immediate and long-term effects allows further insight on the overall impact that this voice therapy can have.