Physiology & Measurement of Vocal Fold Vibration

生物力学研究方法提供了声带振动的信息，这对临床决策变得重要。然而，临床医生可获得的日益复杂的外科技术将使提高对特定声带异常的科学基础的理解变得至关重要。本申请请求支持喉生理学、病理生理学和生物力学相关领域的研究继续发展。本实验工作的长期目标是更好地理解正常和病理发声，并有助于发展有效、全面和无创的临床可行的发声生理表征和测量方法。这个建议有两个相关的部分。第一篇论述了特定声带病理的生理学，以及特定的生物力学变化如何引起病理性发声。切除喉模型将用于刺激声带机械特性的异常变化，如刚度、张力、近似变化和声带覆盖垂直张力的变化。该研究将测量硬度的影响，变化的上下唇内收的褶皱和声门的不对称性和声带张力。声带肿块变化的结果，手术增加声带的具体效果和声带脱水相关的变化将被检查。测量声带硬度、声带振动振幅和粘膜上皮波。附加措施将评估振动的稳定性和效率、发声阈压、声带接触面积以及接触面积和声门内应力的空间分布。作为切除喉模型的补充，将研究有限元分析（FEA）计算机模型和粘膜波模型。这些一系列系统测量特定生物力学变量影响的目的是为了更好地理解导致异常发音的机制。本提案的第二部分侧重于开发一种多测量方法，以非侵入性地评估声带振动模式的特征。本部分研究将结合高速视频、PGG和EGG的数据，在系统分析的基础上改进声带振动的测量。使用非侵入性方法的测量将与病理条件下切除喉部模型的直接测量进行比较，以建立非侵入性测量的有效性和校准。来自这些对照实验研究的数据将与来自一个大型数据库的数据进行比较，该数据库同时记录了来自已知喉部病变患者的多次测量。

Biomechanical research approaches have contributed information about vocal fold vibration that has become important to clinical decision making. However, the increasingly sophisticated surgical techniques available to clinicians will make it critical to improve the scientific base understanding specific abnormalities of vocal production. This application requests support to continue development of research in the related fields of laryngeal physiology, pathophysiology and biomechanics. The long- range goals of this experimental work are to better understand both normal and pathological phonation and to contribute to the development of valid, comprehensive and noninvasive clinically feasible methods of representing and measuring the physiology of phonation. This proposal has two related parts. The first addresses the physiology of specific vocal fold pathologies and how particular biomechanical variations cause pathological phonation. An excised larynx model will be used to stimulate abnormal variations in vocal fold mechanical properties such as stiffness, tension, variations in approximation, and alterations in the vertical tension of vocal fold cover. The studies will measure the effects of stiffness, variations in the adduction of upper and lower lips of the folds and asymmetry of the glottis and of vocal fold tension. The results of vocal fold mass changes, the specific effects of surgical augmentation of the vocal folds and changes associated with dehydration of the vocal folds will be examined. Measurements will be made of vocal fold stiffness, amplitude of vocal fold vibration and mucosal epithelial wave. Additional measures will assess stability and efficiency of vibration, phonation threshold pressure, vocal fold contact area and the spatial distribution of the contact area and intraglottal stress. As a supplement to the excised larynx model, a finite element analysis (FEA) computer model and a mucosal wave model will be studied. The purpose of these series of systematic measurements of the effects of specific biomechanical variables is to better understand the mechanisms that result in abnormal phonation. The second part of this proposal focuses on development of a multiple-measurement approach in order to non-invasively evaluate the characteristics of vocal fold vibration patterns. This part of the study will integrate data from high-speed video, PGG and EGG to improve the measurement of vocal fold vibration based upon system analyses. Measurements using non-invasive methodologies will be compared with direct measurements in the excised larynx model of pathological conditions in order to establish validity and calibration for the noninvasive measures. The data from these controlled experimental studies will be compared to data from a large database of simultaneously recorded multiple measurements from patients with known laryngeal pathologies.