Development of an Electromyographically Controlled Electrolarynx Voice Prosthesis

描述（由申请人提供）：喉切除术后语言康复最常见的人工声音源是手持式蜂鸣器或电喉器（EL）。该装置相对容易使用，使大多数喉切除术患者能够进行口头交流，但清晰度降低，自然度明显下降。此外，EL语音通常被描述为机器人和单调，主要归因于缺乏正常的基频（F0）变化/控制和异常的声源时序（例如，由拇指按钮控制的语音开始和偏移）。先前的研究表明，颈表肌电图（EMG）信号可以作为EL语音开始/偏移时间和F0调制的直观有效的控制源。该项目的目标是开发一种有效、实用、用户友好的肌电图-肌电图语音假体，该假体可以提供对声源时序和F0的改进控制，从而实现更清晰、更自然的肌电图语音。在第一阶段，我们实现了以下具体目标：1)生产出适合EL控制的无线肌电传感器原型；2)将无线肌电信号接收和处理电路集成到手持式EL中；3)通过对两名有过EL使用经验的喉切除术患者进行先导测试，评估原型肌电图。在这项工作的第二阶段，我们将进一步完善肌电图-EL语音假体：1)在实验室和日常使用的家庭试验中测试系统，2)设计和构建一个新版本的肌电图-EL假体，它可以根据个人用户的肌电图信号自动调整F0范围、起始/关闭阈值和肌电图伪信号抑制。3)测试新系统与EL用户和执行感知评估他们的演讲由大样本结果听众的年龄范围使用一个网络接口,4)应用程序的视觉和acoustic-based EMG生物反馈改善EMG-controlled F0调制的声音语调,5)进行扩展新EMG-EL家庭试验系统与EL用户,和6)创建一个用户指南和临床指导准备EMG-EL系统商业化。

DESCRIPTION (provided by applicant): The most common artificial voice source for post-laryngectomy speech rehabilitation is the hand-held buzzer or electrolarynx (EL). This device is relatively easy to use and enables most laryngectomees to verbally communicate, but with reduced intelligibility and markedly degraded naturalness. In addition, EL speech is often described as robotic and monotone, attributable largely to the lack of normal fundamental frequency (F0) variation/control and abnormal voice source timing (e.g. voice onset and offset controlled by a thumb button). Previous research has demonstrated that neck surface electromyographic (EMG) signals can serve as an intuitive and effective control source for EL voice onset/offset timing and F0 modulation. The goal of this project is to develop an effective, practical, and user-friendly EMG-EL voice prosthesis that can provide improved control over voice source timing and F0 for more intelligible and natural-sounding EL speech. In Phase I we achieved the following specific aims: 1) Produced a prototype wireless EMG sensor appropriate for EL control; 2) integrated wireless EMG signal reception and processing circuitry into a hand-held EL; and 3) evaluated the prototype EMG-EL through pilot testing with two laryngectomy patients experienced in EL use. In Phase II of this effort we will further refine the EMG-EL voice prosthesis by 1) testing the system with additional EL users both in the laboratory and though daily use with an at-home trial, 2) designing and building a new version of the EMG-EL prosthesis that can automatically adjust F0 range, onset/off thresholds, and EMG artifact rejection based on individual user's EMG signals, 3) testing the new system with EL users and performing perceptual assessment of their speech results by a large sample of listeners across a wide age range using an online interface, 4) application of visual and acoustic-based EMG biofeedback to improve EMG-controlled F0 modulation of vocal intonation, 5) conducting an extended at-home trial of the new EMG-EL system with EL users, and 6) creating a user guide and set of clinical instructions in preparation for EMG-EL system commercialization.