Laryngeal and vocal tract strategies to reduce vocal fold contact pressure

摘要 声音治疗仍然是声音创伤性发声功能亢进的主要治疗选择， 最常发生的影响声音的情况。声音治疗旨在改善功能亢进的声音 通过发声技巧或练习的行为，通常侧重于某些部位的振动感觉。 气道。人们普遍认为，这些技术和练习诱导喉的调整， 提高发声效率和降低声带接触压力声道，这是一个重要的促成因素 声带损伤然而，这种理解主要是基于理论和数值模拟， 而且几乎没有实验数据支持这些假设。此外，虽然语音治疗 可能会导致多个同时喉和声道的调整，有关具体的信息， 调节及其对声带接触压力的影响往往是模糊的。目前，语音治疗的结果 通常基于患者报告和其他次要测量进行评估。迄今为止，没有任何客观措施 已经确定，将允许临床医生可靠地监测和预测语音治疗的进展 其精度比目前可用的更高。本研究的目的是：（1）实验性地 验证先前数值模拟中关于有利喉道和声道的发现和假设 在切除的人喉实验中持续降低声带接触压力的配置;以及 (2)研究声音治疗方法在减少声带接触压力和 引发假设的喉和声道配置这样做，以及这些演习的能力， 来预测声音治疗的效果

ABSTRACT Voice therapy remains the primary treatment option for phonotraumatic vocal hyperfunction, one of the most frequently occurring conditions to affect the voice. Voice therapy aims to modify hyperfunctional vocal behavior through vocal techniques or exercises, often with a focus on vibratory sensations in certain parts of the airway. It is generally believed that these techniques and exercises induce adjustments in the larynx and vocal tract that increase vocal efficiency and lower vocal fold contact pressure, an important contributing factor to vocal fold injury. However, such understanding is largely based on theoretical and numerical simulations, and there have been few experimental data supporting these hypotheses. Additionally, although voice therapy likely leads to multiple simultaneous laryngeal and vocal tract adjustments, information about the specific adjustments and their impact on vocal fold contact pressure is often vague. Currently, voice therapy outcomes are often evaluated based on patient-reported and other secondary measures. To date, no objective measures have been identified that would allow clinicians to reliably monitor and predict the progress of voice therapy with greater accuracy than is currently available. The goals of the proposed research are to (1) experimentally validate findings and hypotheses from previous numerical simulations on favorable laryngeal and vocal tract configurations that consistently reduce vocal fold contact pressures in excised human larynx experiments; and (2) investigate the effectiveness of voice therapy methods in reducing vocal fold contact pressures and in eliciting the hypothesized laryngeal and vocal tract configurations to do so, and the ability of these maneuvers to predict voice therapy outcomes.