Development of Voice Neural Prosthesis Technology

描述（由申请人提供）：接受全喉切除术治疗晚期喉癌的患者中，约有一半依靠手持式人工电子喉（EL）进行交流。不幸的是，使用一只手来控制EL的需要在物理上是有限的，并且这些设备产生听起来非人类的语音，具有降低的可理解性和响度，并且引起用户的不期望的注意。该项目的主要目的是开发一种改进的人工电子喉通信系统，更接近正常的声音和语音生产。这将在喉切除术患者中通过开发神经接口来实现，以提供对改进的EL声源的免提控制，即，语音神经假体我们将进行一项前瞻性的手术方案，以保留发声相关的信号，从两个正常支配的带状肌肉和带状肌肉已被喉返神经再支配。这些信号将使用表面EMG电极进行检测，并将由基于DSP的系统进行处理，该系统将控制线性免提EL传感器，以产生更人性化的语音。喉切除术后，将使用电生理和成像方法对患者进行系统随访，以更好地了解潜在的解剖和生理因素如何影响神经假体发声的发展。喉神经形态将在手术标本中进行研究，以帮助解释恢复的EMG信号。将采用术后培训方案，以确保最大限度地熟练掌握新系统，并正式评估培训在使用语音神经假体方面的作用。一个主要目标是正式比较语音通信使用两种不同的神经支配源和传统的手动控制。此外，正在进行的迭代开发工作也将尝试使用更先进的信号处理方法，以进一步改善/优化系统性能接近个体患者正常语音产生的程度。从长远来看，一旦建立了基本的方法，我们计划利用这一新技术的各个方面，为更广泛的喉切除术的人口，并作为未来努力的基础，开发额外的假体修复/神经修复方法的声音和语言康复。

DESCRIPTION (provided by applicant): About half of the patients who undergo total laryngectomy to treat advanced laryngeal cancer rely on a handheld artificial electrolarynx (EL) for communication. Unfortunately, the need to use one hand to control an EL is physically limiting, and these devices produce speech that sounds non-human, has reduced intelligibility and loudness, and draws undesirable attention to the user. The primary aim of this project is to develop an improved artificial electrolarynx communication system that more closely approximates normal voice and speech production. This will be accomplished in laryngectomy patients by developing a neural interface to provide hands-free control of an improved EL sound source, i.e., a voice neural prosthesis. We will carry out a prospective surgical protocol to preserve phonation-related signals from both normally innervated strap muscles and from strap muscles that have been reinnervated by the recurrent laryngeal nerve. The signals will be detected using surface EMG electrodes and will be processed by a DSP-based system that will control a linear, hands-free EL transducer to produce more human-sounding speech. Patients will be systematically followed post-laryngectomy using electrophysiological and imaging approaches to better understand how underlying anatomical and physiological factors influence the development of neural prosthetic voice. Laryngeal nerve morphology will be studied in surgical specimens to help interpret recovered EMG signals. A post-surgical training protocol will be employed to ensure development of maximum proficiency with the new system, and to formally assess the role of training in the use of a voice neural prosthesis. A main goal is to formally compare speech communication using the two different innervation sources and conventional manual control. In addition, an ongoing iterative development effort will also attempt to use more advanced signal processing approaches to further improve/optimize the degree to which system performance approximates normal speech production in individual patients. In the long-term, once the fundamental approaches have been established, we plan to utilize aspects of this new technology for a broader laryngectomy population, and as a foundation for future efforts to develop additional surgical-prosthetic/neuroprosthetic approaches to voice and speech rehabilitation.