NORMAL PHYSIOLOGY, PATHOPHYSIOLOGY, AND TREATMENT OF VOICE DISORDERS

生物力学建模：应用高速电视喉镜和分析 两种环状软骨模型的运动轨迹 对环踝关节活动进行评估。仅为以下对象找到支持 环状关节小关节的长轴旋转模型。 关于身体喉部的高分辨率解剖学数据正在 用2特斯拉30厘米口径扫描仪进行MRI扫描。这个 正在对图像进行分割，以开发三维表示 软骨和肌肉。 喉感觉-运动反应的调制：当刺激 喉上神经经皮，作业绩效的影响， 发声和努力闭合对R1和R2感觉-运动反应的影响 在正常清醒的人类身上进行研究。尽管R2在这些过程中变得更小 活动，R1似乎不受任务绩效的影响。结果表明， 这些反应的调节可能不是在脑干发生的 水平，但通过影响传入反应特征。 患者和对照组的神经生理学研究：喉部研究 内收肌痉挛发音障碍的肌肉激活未发现肌肉 当患者不能说话或他们正在说话时多动 产生语音，但没有发声症状。甲颧骨 只有在言语症状期间，肌肉才会过度活跃。 肉毒毒素注射治疗外展性痉挛发音障碍 环踝后肌被证明是有益的，仅 小比例的外展肌痉挛发音困难。

Biomechanical Modeling: Using high speed videolaryngoscopy and analysis of the movement trajectories from the arytenoid cartilages, two models of cricoarytenoid joint action were evaluated. Support was found only for the model of rotation around the long axis of the cricoid articular facet. High resolution anatomical data on cadaveric human larynges are being obtained through MRI scanning with a 2 Tesla 30 cm bore scanner. The images are being segmented to develop 3 dimensional representations of the cartilages and muscles. Modulation of Laryngeal Sensori-Motor Responses: While stimulating the superior laryngeal nerve percutaneously, the effects of task performance, phonation and effort closure, on R1 and R2 sensori-motor responses, were studied in normal awake humans. Although R2 became reduced during these activities, R1 seemed unaffected by task performance. The results suggest that modulation of these responses may not take place at the brain stem level but by affecting afferent response characteristics. Neurophysiological Studies of Patients and Controls: Studies of laryngeal muscle activation in adductor spasmodic dysphonia did not find muscle hyperactivity when patients were not producing speech or when they were producing speech but did not have voice symptoms. The thyroarytenoid muscle was hyperactive only during speech symptoms. Treatment of Abductor Spasmodic Dysphonia: Botulinum toxin injections into the posterior cricoarytenoid muscles have proved beneficial in only a small proportion of the patients with abductor spasmodic dysphonia.