1
|
Yi KH, Lee S, Lee JH, Lee HJ. Observation of Anatomical Structures in the Human Larynx Using Micro-Computed Tomography with Lugol's Solution Enhancement. Diagnostics (Basel) 2023; 13:3005. [PMID: 37761372 PMCID: PMC10530111 DOI: 10.3390/diagnostics13183005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023] Open
Abstract
Histological and naked-eye dissections are frequently used to investigate human anatomy. However, limitations of conventional methods include tissue damage and difficulty in observing structures, rendering findings limited. Micro-computed tomography (micro-CT) allows for a three-dimensional observation with whole-mount staining for contrast enhancement. A precise anatomical understanding of the larynx is essential for both the medical and surgical fields; however, the larynx is difficult to dissect because of its minuscule and complex structures. Therefore, we aimed to clarify the detailed anatomy of the larynx using micro-CT. The study was conducted on twelve specimens of cadavers using Lugol-based-contrast micro-CT. Using Lugol-micro-CT, relevant information on human structures was obtained. Consequently, we successfully employed the Lugol-micro-CT technique in the analysis of specific human soft tissue structures that are challenging to analyze using conventional methods.
Collapse
Affiliation(s)
- Kyu-Ho Yi
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOURProject, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seoul 03722, Republic of Korea;
- Maylin Clinic (Apgujeong), Seoul 07335, Republic of Korea
| | - Siyun Lee
- Department of Cancer Biology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02215, USA;
| | - Ji-Hyun Lee
- Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, Seongnam 13120, Republic of Korea
| | - Hyung-Jin Lee
- Department of Anatomy, Catholic Institute for Applied Anatomy, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| |
Collapse
|
2
|
Henri IV of France's larynx 3D reconstitution. Eur Arch Otorhinolaryngol 2023; 280:919-924. [PMID: 36149490 DOI: 10.1007/s00405-022-07643-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 09/02/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVES King Henri IV of France (reign from 1589 to 1610) was one of the most important kings of France. Embalmed and buried in Saint-Denis, his remains were beheaded in 1793. His head (including his larynx) survived in successive private collections until its definitive identification in 2010. The purpose of the study was to provide a morphologic study of the larynx with a 3D reconstitution. METHODS A flexible endoscopy was performed via the mouth and via the trachea. Measures of the larynx (vocal folds lengths, thickness, width, larynx height) were collected from the CT-scan by a panel of experts blind each other. The segmentation of the laryngeal anatomical components (vocal folds, cartilages) was performed using 3DSlicer®. Mesh smoothing and 3D reconstitution were performed using Fusion 360®. Reconstitution was discussed between the experts. Decision was made by consensus after discussion. RESULTS Cricoid, thyroid, arytenoid cartilages, vocal folds and hyoid bone were identified and a computed 3D reconstitution of the larynx was made. The laryngeal 3D model appeared morphologically similar to a living subject. Measures were similar but smaller than those of a modern subject. CONCLUSIONS The 3D reconstitution of the larynx of Henri IV of France was conducted from the CT-scan of his mummified head. This work constitutes a first valuable morphologic analysis of a larynx from an embalmed individual. This anatomical work is the first step towards the reconstruction of the voice of this historical character, which we hope to concretize with computer modeling tools in a second step. LEVEL OF EVIDENCE V based on experiential and non-research evidence.
Collapse
|
3
|
Yang Y, Xu X, Lacke M, Zhuang P. Using Diffusion Tensor Imaging to Explore the Changes in the Microstructure of Canine Vocal Fold Scar Tissue. J Voice 2023:S0892-1997(23)00002-4. [PMID: 36725407 DOI: 10.1016/j.jvoice.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/31/2022] [Accepted: 01/03/2023] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To apply diffusion tensor imaging (DTI) in measurement of the diffusion characteristics of water molecules in vocal fold scar tissue, combined with the analysis of textural characteristics of collagen fibers in the cover layer of the vocal folds to explore the feasibility of DTI in the qualitative and quantitative diagnosis of vocal fold scars and the evaluation of microstructural changes of vocal fold scar tissue. METHODS A unilateral injury was created using micro-cup forceps in the left vocal fold of six beagles. The contralateral normal vocal fold was used as a self-control. Five months postinjury, the larynges were excised and placed into a magnetic resonance imaging (MRI) system (9.4T BioSpec MRI, Bruker, German) for scanning and extraction of the diffusion parameters, fractional anisotropy (FA) and tensor trace in the anterior, middle, and posterior portions of the vocal fold cover layer. These parameters were then analyzed for statistical significance between the scarred vocal fold and the normal vocal fold. After MRI scanning, the tissue of the vocal folds was divided into anterior, middle, and posterior parts for sectioning and staining with hematoxylin and eosin, and samples were subsequently digitally scanned for texture analysis. The irregularity parameters, energy, contrast, correlation, and homogeneity, of collagen fibers of the vocal folds and the mean gray value of collagen fibers were calculated by the gray-level co-occurrence matrix (GLCM) texture analysis method. The differences in the mean value of the two sides of the vocal fold were compared. In addition, Pearson correlation analysis was performed between DTI parameters and irregularity parameters. RESULTS The FA of the left vocal fold cover layer was significantly lower compared to the self-control group (P = 0.0366), and the tensor trace value on the left vocal fold cover layer was significantly higher compared to the self-control group (P = 0.0353). The FA was significantly higher in the anterior part of the right vocal fold cover layer compared to the middle and posterior parts of the same side (P = 0.0352), and the tensor trace was significantly lower in the anterior part of the right vocal fold cover layer compared to the middle and posterior parts of the same side (P = 0.0298). There were no significant differences in FA and tensor trace between the middle and posterior parts of the vocal fold cover layer. The mean gray value of the left vocal folds cover layer was significantly smaller than the right vocal fold cover layer (P = 0.0219), the energy of the left vocal fold cover layer was significantly smaller than that of the right vocal fold cover layer (P < 0.0001), the contrast of the left vocal folds cover layer was significantly larger than that of the right vocal fold cover layer (P = 0.0002), the correlation of the left vocal folds cover layer was significantly smaller than the right vocal fold cover layer (P = 0.0002), and the homogeneity of the left vocal folds cover layer was significantly smaller than the right vocal fold cover layer (P = 0.0003). Pearson correlation analysis yielded values of r = 0.926, P = 0.000 between the FA and mean gray value; r = -0.918, P = 0.000 between FA and energy; r = -0.924, P = 0.000 between the FA and homogeneity, r = -0.949, P = 0.000 between tensor trace and mean gray value; r = 0.893, P = 0.000 between the tensor trace and energy; and r = 0.929, P = 0.000 between the tensor trace and homogeneity. CONCLUSION FA and tensor trace can be used as effective parameters to reflect microstructural changes in vocal fold scars. DTI is an objective and quantitative method of analyzing vocal fold scarring, and it noninvasively evaluates the microstructure of vocal fold collagen fibers.
Collapse
Affiliation(s)
- Yang Yang
- Department of Voice, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Xinlin Xu
- Department of Voice, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Margaret Lacke
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Peiyun Zhuang
- Department of Voice, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
| |
Collapse
|
4
|
MEYER D, RUSHO RZ, ALAM W, CHRISTENSEN GE, HOWARD DM, ATHA J, HOFFMAN EA, STORY B, TITZE IR, LINGALA SG. High-Resolution Three-Dimensional Hybrid MRI + Low Dose CT Vocal Tract Modeling: A Cadaveric Pilot Study. J Voice 2022. [DOI: 10.1016/j.jvoice.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
5
|
Investigation of the Upper Respiratory Tract of a Male Smoker with Laryngeal Cancer by Inhaling Air Associated with Various Physical Activity Levels. ATMOSPHERE 2022. [DOI: 10.3390/atmos13050717] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Smokers are at a higher risk of laryngeal cancer, which is a type of head and neck cancer in which cancer cells proliferate and can metastasize to other tissues after a tumor has formed. Cigarette smoke greatly reduces the inhaled air quality and can also lead to laryngeal cancer. In this study, the upper airway of a 70-year-old smoker with laryngeal cancer was reconstructed by taking a CT scan using Mimics software. To solve the governing equations, computational fluid dynamics (CFD) with a pressure base approach was used with the help of Ansys 2021 R1 software. As a result, the maximum turbulence intensity occurred in the larynx. At 13 L/min, 55 L/min, and 100 L/min, the maximum turbulence intensity was 1.1, 3.5, and 6.1, respectively. The turbulence intensity in the respiratory system is crucial because it demonstrates the ability to transfer energy. The maximum wall shear stress (WSS) also occurred in the larynx. At 13 L/min, 55 L/min, and 100 L/min, the maximum WSS was 0.62 Pa, 5.4 Pa, and 12.4 Pa, respectively. The WSS index cannot be calculated in vivo and should be calculated in vitro. Excessive WSS in the epiglottis is inappropriate and can lead to an airway obstruction. Furthermore, real mathematical modeling outcomes provide an approach for future prevention, treatment, and management planning by forecasting the zones prone to an acceleration of disease progression. In this regard, accurate computational modeling leads to pre-visualization in surgical planning to define the best reformative techniques to determine the most probable patient condition consequences.
Collapse
|
6
|
Movahhedi M, Geng B, Xue Q, Zheng X. A computational framework for patient-specific surgical planning of type 1 thyroplasty. JASA EXPRESS LETTERS 2021; 1:125203. [PMID: 36154377 DOI: 10.1121/10.0009084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A computational framework is proposed for virtual optimization of implant configurations of type 1 thyroplasty based on patient-specific laryngeal structures reconstructed from MRI images. Through integration of a muscle mechanics-based laryngeal posturing model, a flow-structure-acoustics interaction voice production model, a real-coded genetic algorithm, and virtual implant insertion, the framework acquires the implant configuration that achieves the optimal acoustic objectives. The framework is showcased by successfully optimizing an implant that restores acoustic features of a diseased voice resulted from unilateral vocal fold paralysis (UVFP) in producing a sustained vowel utterance. The sound intensity is improved from 62 dB (UVFP) to 81 dB (post-correction).
Collapse
Affiliation(s)
- Mohammadreza Movahhedi
- Department of Mechanical Engineering, University of Maine, Orono, Maine 04473, USA , , ,
| | - Biao Geng
- Department of Mechanical Engineering, University of Maine, Orono, Maine 04473, USA , , ,
| | - Qian Xue
- Department of Mechanical Engineering, University of Maine, Orono, Maine 04473, USA , , ,
| | - Xudong Zheng
- Department of Mechanical Engineering, University of Maine, Orono, Maine 04473, USA , , ,
| |
Collapse
|
7
|
Ishikawa H, Niwa A, Kato S, Ii Y, Shindo A, Matsuura K, Nishiguchi Y, Tamura A, Taniguchi A, Maeda M, Hashizume Y, Tomimoto H. Micro-MRI improves the accuracy of clinical diagnosis in cerebral small vessel disease. Brain Commun 2021; 3:fcab070. [PMID: 33997783 PMCID: PMC8111066 DOI: 10.1093/braincomms/fcab070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/17/2021] [Accepted: 03/01/2021] [Indexed: 11/29/2022] Open
Abstract
Even with postmortem pathological examination, only limited information is provided of the foci of in vivo clinical information. Cerebral small vessel disease, which is associated with ageing, dementia and stroke, highlights the difficulty in arriving at a definitive diagnosis of the lesions detected on in vivo radiological examination. We performed a radiological−pathological comparative study using ex vivo MRI to examine small cerebral lesions. Four patients with small vessel disease lesions detected on in vivo MRI were studied. Exact pathological findings of in vivo MRI-detected lesions were revealed. The ischaemic lesion after 17 days from onset showed positivity for peroxiredoxin, cluster of differentiation 204 and glial fibrillary acidic protein, indicating sterile inflammation and neuroprotective reaction. Cortical microinfarcts beneath the cortical superficial siderosis were associated with inflammation from the superficial layer in a patient with cerebral amyloid angiopathy; in this patient, a bilinear track-like appearance of the cortical superficial siderosis on the ex vivo MRI was compatible with iron deposition on the pia matter and within cortical layers II–III. An in vivo MRI-detected cerebral microbleed was revealed to be heterogeneous. An in vivo MRI-detected cerebral microbleed was revealed to be a venous angioma. Furthermore, a neuropathologically confirmed embolic cerebral microbleed was firstly detected using this method. Our results suggest that in vivo MRI-detected lobar cerebral microbleeds can be caused by non-cerebral amyloid angiopathy aetiologies, such as microembolism and venous angioma. Venous angioma and embolic microbleeds may mimic cerebral amyloid angiopathy markers on in vivo MRI. To clarify the clinical importance of these lesions, we should investigate their rate and frequency in a large cohort of healthy individuals and patients with cardiac risk factors. Thus, we provide evidence that ex vivo micro-MRI improves the clinical diagnosis of small vessel diseases.
Collapse
Affiliation(s)
- Hidehiro Ishikawa
- Department of Neurology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Atsushi Niwa
- Department of Neurology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Shinya Kato
- Radioisotope Facilities for Medical Science, Advanced Science Research Promotion Center, Mie University, Tsu, Mie, 514-8507, Japan
| | - Yuichiro Ii
- Department of Neurology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Akihiro Shindo
- Department of Neurology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Keita Matsuura
- Department of Neurology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Yamato Nishiguchi
- Department of Neurology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Asako Tamura
- Department of Neurology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Akira Taniguchi
- Department of Neurology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Masayuki Maeda
- Department of Neuroradiology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Yoshio Hashizume
- Department of Neuropathology, Fukushimura Hospital, Aichi 441-8124, Japan
| | - Hidekazu Tomimoto
- Department of Neurology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| |
Collapse
|
8
|
Li Z, Wilson A, Sayce L, Avhad A, Rousseau B, Luo H. Numerical and experimental investigations on vocal fold approximation in healthy and simulated unilateral vocal fold paralysis. APPLIED SCIENCES-BASEL 2021; 11. [PMID: 34671486 DOI: 10.3390/app11041817] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We have developed a novel surgical/computational model for the investigation of unilateral vocal fold paralysis (UVFP) which will be used to inform future in silico approaches to improve surgical outcomes in type I thyroplasty. Healthy phonation (HP) was achieved using cricothyroid suture approximation on both sides of the larynx to generate symmetrical vocal fold closure. Following high-speed videoendoscopy (HSV) capture, sutures on the right side of the larynx were removed, partially releasing tension unilaterally and generating asymmetric vocal fold closure characteristic of UVFP (sUVFP condition). HSV revealed symmetric vibration in HP, while in sUVFP the sutured side demonstrated a higher frequency (10 - 11%). For the computational model, ex vivo magnetic resonance imaging (MRI) scans were captured at three configurations: non-approximated (NA), HP, and sUVFP. A finite-element method (FEM) model was built, in which cartilage displacements from the MRI images were used to prescribe the adduction and the vocal fold deformation was simulated before the eigenmode calculation. The results showed that the frequency comparison between the two sides were consistent with observations from HSV. This alignment between the surgical and computational models supports the future application of these methods for the investigation of treatment for UVFP.
Collapse
Affiliation(s)
- Zheng Li
- Department of Mechanical Engineering, Vanderbilt University, 2301 Vanderbilt Place PMB 401592, Nashville, TN, 37240, USA
| | - Azure Wilson
- Department of Communication Science and Disorders, University of Pittsburgh, 4200 Fifth Avenue, Pittsburgh, PA, 15260, USA
| | - Lea Sayce
- Department of Communication Science and Disorders, University of Pittsburgh, 4200 Fifth Avenue, Pittsburgh, PA, 15260, USA
| | - Amit Avhad
- Department of Mechanical Engineering, Vanderbilt University, 2301 Vanderbilt Place PMB 401592, Nashville, TN, 37240, USA
| | - Bernard Rousseau
- Department of Communication Science and Disorders, University of Pittsburgh, 4200 Fifth Avenue, Pittsburgh, PA, 15260, USA
| | - Haoxiang Luo
- Department of Mechanical Engineering, Vanderbilt University, 2301 Vanderbilt Place PMB 401592, Nashville, TN, 37240, USA
| |
Collapse
|
9
|
Benboujja F, Hartnick C. Quantitative evaluation of the human vocal fold extracellular matrix using multiphoton microscopy and optical coherence tomography. Sci Rep 2021; 11:2440. [PMID: 33510352 PMCID: PMC7844040 DOI: 10.1038/s41598-021-82157-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 01/11/2021] [Indexed: 02/07/2023] Open
Abstract
Identifying distinct normal extracellular matrix (ECM) features from pathology is of the upmost clinical importance for laryngeal diagnostics and therapy. Despite remarkable histological contributions, our understanding of the vocal fold (VF) physiology remains murky. The emerging field of non-invasive 3D optical imaging may be well-suited to unravel the complexity of the VF microanatomy. This study focused on characterizing the entire VF ECM in length and depth with optical imaging. A quantitative morphometric evaluation of the human vocal fold lamina propria using two-photon excitation fluorescence (TPEF), second harmonic generation (SHG), and optical coherence tomography (OCT) was investigated. Fibrillar morphological features, such as fiber diameter, orientation, anisotropy, waviness and second-order statistics features were evaluated and compared according to their spatial distribution. The evidence acquired in this study suggests that the VF ECM is not a strict discrete three-layer structure as traditionally described but instead a continuous assembly of different fibrillar arrangement anchored by predominant collagen transitions zones. We demonstrated that the ECM composition is distinct and markedly thinned in the anterior one-third of itself, which may play a role in the development of some laryngeal diseases. We further examined and extracted the relationship between OCT and multiphoton imaging, promoting correspondences that could lead to accurate 3D mapping of the VF architecture in real-time during phonosurgeries. As miniaturization of optical probes is consistently improving, a clinical translation of OCT imaging and multiphoton imaging, with valuable qualitative and quantitative features, may have significant implications for treating voice disorders.
Collapse
Affiliation(s)
- Fouzi Benboujja
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA
| | - Christopher Hartnick
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA.
| |
Collapse
|
10
|
A new simple brain segmentation method for extracerebral intracranial tumors. PLoS One 2020; 15:e0230754. [PMID: 32302315 PMCID: PMC7164623 DOI: 10.1371/journal.pone.0230754] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 03/07/2020] [Indexed: 12/01/2022] Open
Abstract
Normal brain segmentation is available via FreeSurfer, Vbm, and Ibaspm software. However, these software packages cannot perform segmentation of the brain for patients with brain tumors. As we know, damage from extracerebral tumors to the brain occurs mainly by way of pushing and compressing while leaving the structure of the brain intact. Three-dimensional (3D) imaging, augmented reality (AR), and virtual reality (VR) technology have begun to be applied in clinical practice. The free medical open-source software 3D Slicer allows us to perform 3D simulations on a computer and requires little user interaction. Moreover, 3D Slicer can integrate with the third-party software mentioned above. The relationship between the tumor and surrounding brain tissue can be judged, but accurate brain segmentation cannot be performed using 3D Slicer. In this study, we combine 3D Slicer and FreeSurfer to provide a novel brain segmentation method for extracerebral tumors. This method can help surgeons identify the “real” relationship between the lesion and adjacent brain tissue before surgery and improve preoperative planning.
Collapse
|
11
|
Geng B, Pham N, Xue Q, Zheng X. A three-dimensional vocal fold posturing model based on muscle mechanics and magnetic resonance imaging of a canine larynx. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2020; 147:2597. [PMID: 32359330 DOI: 10.1121/10.0001093] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 03/27/2020] [Indexed: 06/11/2023]
Abstract
In this work, a high-fidelity three-dimensional continuum model of the canine laryngeal framework was developed for simulating laryngeal posturing. By building each muscle and cartilage from magnetic resonance imaging (MRI), the model is highly realistic in anatomy. The muscle mechanics is modeled using the finite-element method. The model was tested by simulating vocal fold postures under systematic activations of individual as well as groups of laryngeal muscles, and it accurately predicted vocal fold posturing parameters reported from in vivo canine larynges. As a demonstration of its application, the model was then used to investigate muscle controls of arytenoid movements, medial surface morphology, and vocal fold abduction. The results show that the traditionally categorized adductor and abductor muscles can have opposite effects on vocal fold posturing, making highly complex laryngeal adjustments in speech and singing possible. These results demonstrate that a realistic comprehensive larynx model is feasible, which is a critical step toward a causal physics-based model of voice production.
Collapse
Affiliation(s)
- Biao Geng
- Department of Mechanical Engineering, University of Maine, Orono, Maine 04473, USA
| | - Ngoc Pham
- Department of Mechanical Engineering, University of Maine, Orono, Maine 04473, USA
| | - Qian Xue
- Department of Mechanical Engineering, University of Maine, Orono, Maine 04473, USA
| | - Xudong Zheng
- Department of Mechanical Engineering, University of Maine, Orono, Maine 04473, USA
| |
Collapse
|
12
|
Rios G, Morrison RJ, Song Y, Fernando SJ, Wootten C, Gelbard A, Luo H. Computational Fluid Dynamics Analysis of Surgical Approaches to Bilateral Vocal Fold Immobility. Laryngoscope 2019; 130:E57-E64. [PMID: 30883777 DOI: 10.1002/lary.27925] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/04/2019] [Accepted: 02/20/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Bilateral vocal fold immobility (BVFI) is a rare and life-threatening condition in which both vocal folds are fixed, resulting in airway obstruction associated with life-threatening respiratory compromise. Treatment of BVFI is largely surgical and remains an unsatisfactory compromise between voice, breathing, and swallowing. No comparisons between currently employed techniques currently exist. We sought to employ computational fluid dynamics (CFD) modeling to delineate the optimal surgical approach for BVFI. METHODS Utilizing clinical computed tomography of BVFI subjects, coupled with image analytics employing CFD models and subject pulmonary function data, we compared the airflow features in the baseline pathologic states and changes seen between endoscopic cordotomy, endoscopic suture lateralization, and posterior cricoid expansion. RESULTS CFD modeling demonstrated that the greatest airflow velocity occurs through the posterior glottis on inspiration and anterior glottis on expiration in both the normal condition and in BVFI. Glottic airflow velocity and resistance were significantly higher in the BVFI condition compared to normal. Geometric indices (cross-sectional area of airway) were lower in posterior cricoid expansion surgery when compared to alternate surgical approaches. CFD measures (airflow velocity and resistance) improved with all surgical approaches but were superior with posterior cricoid expansion. CONCLUSION CFD modeling can provide discrete, quantitative assessment of the airflow through the laryngeal inlet, and offers insights into the pathophysiology and changes that occur after surgery for BVFI. LEVEL OF EVIDENCE NA. Laryngoscope, 130:E57-E64, 2020.
Collapse
Affiliation(s)
- Gabriel Rios
- Department of Mechanical Engineering, School of Engineering, Vanderbilt University, Nashville, Tennessee
| | - Robert J Morrison
- Department of Otolaryngology, School of Medicine, Vanderbilt University, Nashville, Tennessee.,Department of Otolaryngology-Head & Neck Surgery, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, U.S.A
| | - Yi Song
- Department of Mechanical Engineering, School of Engineering, Vanderbilt University, Nashville, Tennessee
| | - Shanik J Fernando
- Department of Otolaryngology, School of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Christopher Wootten
- Department of Otolaryngology, School of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Alexander Gelbard
- Department of Otolaryngology, School of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Haoxiang Luo
- Department of Mechanical Engineering, School of Engineering, Vanderbilt University, Nashville, Tennessee
| |
Collapse
|
13
|
King RE, Steed K, Rivera AE, Wisco JJ, Thibeault SL. Magnetic resonance imaging quantification of dehydration and rehydration in vocal fold tissue layers. PLoS One 2018; 13:e0208763. [PMID: 30521642 PMCID: PMC6283588 DOI: 10.1371/journal.pone.0208763] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/20/2018] [Indexed: 01/18/2023] Open
Abstract
Clinicians commonly recommend increased hydration to patients with voice disorders. However, effects on clinical voice outcome measures have been inconsistent. Hydration-induced change within different layers of vocal fold tissue is currently unknown. Magnetic Resonance Imaging (MRI) is a promising method of noninvasively measuring water content in vocal folds. We sought to image and quantify changes in water content within vocal fold mucosa and thyroarytenoid muscle after dehydration and rehydration. Excised porcine larynges were imaged using proton density (PD) weighted MRI (1) at baseline and (2) after immersion in one of five hypertonic, isotonic, or hypotonic solutions or in dry air. Larynges dehydrated in hypertonic solutions or dry air were rehydrated and imaged a third time. Scans revealed fluid-rich vocal fold mucosa that was distinct from muscle at baseline. Baseline normalized signal intensity in mucosa and muscle varied by left vs. right vocal fold (p < 0.01) and by anterior, middle, or posterior location (p < 0.0001). Intensity changes in the middle third of vocal fold mucosa differed by solution after immersion (p < 0.01). Hypertonic solutions dehydrated the middle third of mucosa by over 30% (p < 0.001). No difference from baseline was found in anterior or posterior mucosa or in muscle after immersion. No association was found between intensity change in mucosa and muscle after immersion. After rehydration, intensity did not differ by solution in any tissue, and was not different from baseline, but post-rehydration intensity was correlated with post-immersion intensity in both mucosa and muscle (p < 0.05), suggesting that degree of change in vocal fold water content induced by hypertonic solutions ex vivo persists after rehydration. These results indicate that PD-MRI can be used to visualize large mammalian vocal fold tissue layers and to quantify changes in water content within vocal fold mucosa and thyroarytenoid muscle independently.
Collapse
Affiliation(s)
- Renee E. King
- Division of Otolaryngology, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Kevin Steed
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, United States of America
| | - Ana E. Rivera
- Division of Otolaryngology, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- School of Medicine, Ponce Health Sciences University, Ponce, Puerto Rico, United States of America
| | - Jonathan J. Wisco
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, United States of America
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts, United States of America
- Department of Neurobiology and Anatomy, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Susan L. Thibeault
- Division of Otolaryngology, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| |
Collapse
|
14
|
Bailly L, Cochereau T, Orgéas L, Henrich Bernardoni N, Rolland du Roscoat S, McLeer-Florin A, Robert Y, Laval X, Laurencin T, Chaffanjon P, Fayard B, Boller E. 3D multiscale imaging of human vocal folds using synchrotron X-ray microtomography in phase retrieval mode. Sci Rep 2018; 8:14003. [PMID: 30228304 PMCID: PMC6143640 DOI: 10.1038/s41598-018-31849-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 07/29/2018] [Indexed: 12/15/2022] Open
Abstract
Human vocal folds possess outstanding abilities to endure large, reversible deformations and to vibrate up to more than thousand cycles per second. This unique performance mainly results from their complex specific 3D and multiscale structure, which is very difficult to investigate experimentally and still presents challenges using either confocal microscopy, MRI or X-ray microtomography in absorption mode. To circumvent these difficulties, we used high-resolution synchrotron X-ray microtomography with phase retrieval and report the first ex vivo 3D images of human vocal-fold tissues at multiple scales. Various relevant descriptors of structure were extracted from the images: geometry of vocal folds at rest or in a stretched phonatory-like position, shape and size of their layered fibrous architectures, orientation, shape and size of the muscle fibres as well as the set of collagen and elastin fibre bundles constituting these layers. The developed methodology opens a promising insight into voice biomechanics, which will allow further assessment of the micromechanics of the vocal folds and their vibratory properties. This will then provide valuable guidelines for the design of new mimetic biomaterials for the next generation of artificial larynges.
Collapse
Affiliation(s)
- Lucie Bailly
- Univ. Grenoble Alpes, CNRS, Grenoble INP, 3SR, Grenoble, F-38000, France.
| | - Thibaud Cochereau
- Univ. Grenoble Alpes, CNRS, Grenoble INP, 3SR, Grenoble, F-38000, France.,Univ. Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, Grenoble, F-38000, France
| | - Laurent Orgéas
- Univ. Grenoble Alpes, CNRS, Grenoble INP, 3SR, Grenoble, F-38000, France
| | | | | | - Anne McLeer-Florin
- Univ. Grenoble Alpes, CHU Grenoble Alpes, CNRS, Grenoble INP, IAB, Grenoble, F-38000, France
| | - Yohann Robert
- Univ. Grenoble Alpes, CHU Grenoble Alpes, LADAF, Grenoble, F-38000, France
| | - Xavier Laval
- Univ. Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, Grenoble, F-38000, France
| | - Tanguy Laurencin
- Univ. Grenoble Alpes, CNRS, Grenoble INP, 3SR, Grenoble, F-38000, France
| | - Philippe Chaffanjon
- Univ. Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, Grenoble, F-38000, France.,Univ. Grenoble Alpes, CHU Grenoble Alpes, LADAF, Grenoble, F-38000, France
| | | | - Elodie Boller
- ID19 beamline, ESRF - European Synchrotron Radiation Facility, CS40220, Grenoble, 38043, France
| |
Collapse
|
15
|
Wang R, Bao H, Xu X, Piotrowski D, Zhang Y, Zhuang P. The Effect of Vocal Fold Inferior Surface Hypertrophy on Voice Function in Excised Canine Larynges. J Voice 2017; 32:396-402. [PMID: 28826980 DOI: 10.1016/j.jvoice.2017.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 06/17/2017] [Accepted: 06/20/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aimed to explore the changes in vocal fold inferior surface hypertrophy (VFISH) on vocal fold vibration by aerodynamic and acoustic analysis. The present study allows us to gain new insights into the subglottal convergence angle (SCA), which will change with VFISH. STUDY DESIGN The study is prospective, and designed for repeated measures with each excised canine larynx serving as own control. SUBJECTS AND METHODS Three degrees of VFISH, initial, mild, and severe, were simulated by injecting different doses of fructose injections into the inferior surface of the vocal folds of 10 excised canine larynges. Computed tomographic images of the larynx were gathered, and three-dimensional models of the airway and vocal folds were reconstructed using the Mimics software. The SCA was measured from the reconstructed models. Phonation threshold flow (PTF), phonation threshold pressure (PTP), and mean flow rate (MFR) were recorded directly in the excised canine larynx phonation setup. Glottal resistance (GR), sound pressure level (SPL), fundamental frequency (F0), and formants 1-4 (F1-4) were measured when subglottal pressure (Psub) was at 1.5 kPa or 2.5 kPa, separately. Using ordinary one-way analysis of variance, we compared the aerodynamic outcomes and voice quality among the three groups of hypertrophy. RESULTS The SCA, PTP, and PTF increased with the degree of VFISH. When the Psub was controlled at 1.5 kPa or 2.5 kPa, F0 also increased significantly with the degree of VFISH of the excised canine larynges. The MFR, GR, SPL, and F1-4 had little change between the three groups and were not significantly different. CONCLUSION The VFISH makes onset phonation more difficult, increases the SCA, and increases the F0 in sustained phonation.
Collapse
Affiliation(s)
- Ruiqing Wang
- Medical College of Xiamen University, Xiamen, Fujian, China
| | - Huijing Bao
- Department of ENT, Xiamen University Zhongshan Hospital, Xiamen, Fujian, China
| | - Xinlin Xu
- Department of ENT, Xiamen University Zhongshan Hospital, Xiamen, Fujian, China
| | - David Piotrowski
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Yu Zhang
- Key Laboratory of Underwater Acoustic Communication and Marine Information Technology of the Ministry of Education, Xiamen University, Xiamen, Fujian, China
| | - Peiyun Zhuang
- Department of ENT, Xiamen University Zhongshan Hospital, Xiamen, Fujian, China.
| |
Collapse
|
16
|
Ferrara SD, Cecchetto G, Cecchi R, Favretto D, Grabherr S, Ishikawa T, Kondo T, Montisci M, Pfeiffer H, Bonati MR, Shokry D, Vennemann M, Bajanowski T. Back to the Future - Part 2. Post-mortem assessment and evolutionary role of the bio-medicolegal sciences. Int J Legal Med 2017; 131:1085-1101. [PMID: 28444439 DOI: 10.1007/s00414-017-1585-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 03/29/2017] [Indexed: 02/06/2023]
Abstract
Part 2 of the review "Back to the Future" is dedicated to the evolutionary role of the bio-medicolegal sciences, reporting the historical profiles, the state of the art, and prospects for future development of the main related techniques and methods of the ancillary disciplines that have risen to the role of "autonomous" sciences, namely, Genetics and Genomics, Toxicology, Radiology, and Imaging, involved in historic synergy in the "post-mortem assessment," together with the mother discipline Legal Medicine, by way of its primary fundament, universally denominated as Forensic Pathology. The evolution of the scientific research and the increased accuracy of the various disciplines will be oriented towards the elaboration of an "algorithm," able to weigh the value of "evidence" placed at the disposal of the "justice system" as real truth and proof.
Collapse
Affiliation(s)
- Santo Davide Ferrara
- Department of Legal and Occupational Medicine, Toxicology and Public Health, University-Hospital of Padova, Padua, Italy.
| | - Giovanni Cecchetto
- Department of Legal and Occupational Medicine, Toxicology and Public Health, University-Hospital of Padova, Padua, Italy
| | - Rossana Cecchi
- Department of Biomedical, Biotechnological and Translational Medicine, University of Parma, Parma, Italy
| | - Donata Favretto
- Department of Legal and Occupational Medicine, Toxicology and Public Health, University-Hospital of Padova, Padua, Italy
| | - Silke Grabherr
- University Center of Legal Medicine Lausanne-Geneva, University of Lausanne, Lausanne, Switzerland
| | - Takaki Ishikawa
- Department of Legal Medicine, Osaka City University Medical School, Osaka, Japan
| | - Toshikazu Kondo
- Department of Forensic Medicine, Wakayama Medical University, Wakayama, Japan
| | - Massimo Montisci
- Department of Legal and Occupational Medicine, Toxicology and Public Health, University-Hospital of Padova, Padua, Italy
| | - Heidi Pfeiffer
- Institute of Legal Medicine, University-Hospital Münster, Münster, Germany
| | - Maurizio Rippa Bonati
- Department of Cardiac, Thoracic and Vascular Sciences, Section of Medical Humanities, University of Padova, Padua, Italy
| | - Dina Shokry
- Department of Forensic Medicine and Clinical Toxicology, University of Cairo, Cairo, Egypt
| | - Marielle Vennemann
- Institute of Legal Medicine, University-Hospital Münster, Münster, Germany
| | - Thomas Bajanowski
- Institute of Legal Medicine, University-Hospital Essen, Essen, Germany
| |
Collapse
|
17
|
Kishimoto AO, Kishimoto Y, Young DL, Zhang J, Rowland IJ, Welham NV. High- and ultrahigh-field magnetic resonance imaging of naïve, injured and scarred vocal fold mucosae in rats. Dis Model Mech 2016; 9:1397-1403. [PMID: 27638667 PMCID: PMC5117232 DOI: 10.1242/dmm.026526] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 09/10/2016] [Indexed: 12/16/2022] Open
Abstract
Subepithelial changes to the vocal fold mucosa, such as fibrosis, are difficult to identify using visual assessment of the tissue surface. Moreover, without suspicion of neoplasm, mucosal biopsy is not a viable clinical option, as it carries its own risk of iatrogenic injury and scar formation. Given these challenges, we assessed the ability of high- (4.7 T) and ultrahigh-field (9.4 T) magnetic resonance imaging to resolve key vocal fold subepithelial tissue structures in the rat, an important and widely used preclinical model in vocal fold biology. We conducted serial in vivo and ex vivo imaging, evaluated an array of acquisition sequences and contrast agents, and successfully resolved key anatomic features of naïve, acutely injured, and chronically scarred vocal fold mucosae on the ex vivo scans. Naïve lamina propria was hyperintense on T1-weighted imaging with gadobenate dimeglumine contrast enhancement, whereas chronic scar was characterized by reduced lamina propria T1 signal intensity and mucosal volume. Acutely injured mucosa was hypointense on T2-weighted imaging; lesion volume steadily increased, peaked at 5 days post-injury, and then decreased – consistent with the physiology of acute, followed by subacute, hemorrhage and associated changes in the magnetic state of hemoglobin and its degradation products. Intravenous administration of superparamagnetic iron oxide conferred no T2 contrast enhancement during the acute injury period. These findings confirm that magnetic resonance imaging can resolve anatomic substructures within naïve vocal fold mucosa, qualitative and quantitative features of acute injury, and the presence of chronic scar. Summary: Magnetic resonance imaging is shown to allow the nondestructive assessment of acute injury and scar formation in vocal fold mucosa, as demonstrated ex vivo using a preclinical rat model.
Collapse
Affiliation(s)
- Ayami Ohno Kishimoto
- Department of Surgery, Division of Otolaryngology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
| | - Yo Kishimoto
- Department of Surgery, Division of Otolaryngology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
| | - David L Young
- Department of Surgery, Division of Otolaryngology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
| | - Jinjin Zhang
- Department of Radiology and Center for Magnetic Resonance Research, University of Minnesota-Twin Cities, Minneapolis, MN 55455, USA
| | - Ian J Rowland
- Department of Entomology, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Nathan V Welham
- Department of Surgery, Division of Otolaryngology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
| |
Collapse
|
18
|
Vampola T, Horáček J, Klepáček I. Computer simulation of mucosal waves on vibrating human vocal folds. Biocybern Biomed Eng 2016. [DOI: 10.1016/j.bbe.2016.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
19
|
Hampala V, Laukkanen AM, Guzman MA, Horáček J, Švec JG. Vocal Fold Adjustment Caused by Phonation Into a Tube: A Double-Case Study Using Computed Tomography. J Voice 2015; 29:733-42. [DOI: 10.1016/j.jvoice.2014.10.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 10/09/2014] [Indexed: 10/23/2022]
|
20
|
Klepacek I, Jirak D, Duskova Smrckova M, Janouskova O, Vampola T. The Human Vocal Fold Layers. Their Delineation Inside Vocal Fold as a Background to Create 3D Digital and Synthetic Glottal Model. J Voice 2015; 30:529-37. [PMID: 26432357 DOI: 10.1016/j.jvoice.2015.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 08/04/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To distinguish the layers of the vocal fold at the submacroscopic level and determine their boundaries, thereby creating a basis for the construction of a digital 3D model of the human vocal folds. STUDY DESIGN The submacroscopic delineation of individual layers of fixed vocal ligaments based on their structural differences. METHODS Following tasks were performed: (1) Submicroscopic dissection of the vocal folds fixed in a solution with a low concentration of fixation substance (in this case, the muscular parts of the vocal folds were removed); (2) Using the CT and micro-MRI methods, we determined the position of the dense parts of the vocal folds; and (3) Using a modified plastination method, we preserved macroscopically natural appearance of all ligamentous and muscular layers. RESULTS The vocal ligament is composed of several volumes of connective tissue. It is surrounded by layers of fibrous material permeated by liquid. Individual fibers stretch all the way to the fibrous casing (fascia) of the vocal muscle. The vocal fold layer surrounding the ligament externally has a stratified character. CONCLUSIONS According to our findings, we infer that this ligament is a complex of several fibrous bundles which are surrounded by a thin layer of connective tissue. Below the surface of epithelium of the vocal fold run several separate bands which are closely adjacent to it. Therefore, we propose using the term ligamentous complex involving closely adjacent structures, instead of the vocal ligament only. We feel that it better reflects the functional and structural character of the whole formation.
Collapse
Affiliation(s)
- Ivo Klepacek
- Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Daniel Jirak
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | | | - Olga Janouskova
- Institute of Macromolecular Chemistry Academy of Sciences, Prague, Czech Republic
| | - Tomas Vampola
- Department of Mechanics, Biomechanics and Mechanotronics, CTU in Prague, Prague, Czech Republic
| |
Collapse
|
21
|
Bakhshaee H, Moro C, Kost K, Mongeau L. Three-dimensional reconstruction of human vocal folds and standard laryngeal cartilages using computed tomography scan data. J Voice 2013; 27:769-77. [PMID: 24119643 DOI: 10.1016/j.jvoice.2013.06.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 06/05/2013] [Indexed: 11/17/2022]
Abstract
Three-dimensional (3D) computer models of the human larynx are useful tools for research and for eventual clinical applications. Recently, computed tomography (CT) scanning and magnetic resonance imaging (MRI) have been used to recreate realistic models of human larynx. In the present study, CT images were used to create computer models of vocal folds, vocal tract, and laryngeal cartilages, and the procedure to create solid models are explained in details. Vocal fold and vocal tract 3D models of healthy and postsurgery larynges during phonation and respiration were created and morphometric parameters were quantified. The laryngeal framework of eight patients was also reconstructed from CT scan images. For each cartilage, morphometric landmarks were measured on the basis of their importance for biomechanical modeling. A quantitative comparison was made between measured values from the reconstructions and those from human excised larynges in literature. The good agreement between these measurements supports the accuracy of CT scan-based 3D models. Generic standard models of the laryngeal framework were created using known features in modeling softwares. They were created based on the morphometric landmark dimensions previously defined, preserving all biomechanically important dimensions. These models are accessible, subject independent, easy to use for computational simulations, and make the comparisons between different studies possible.
Collapse
Affiliation(s)
- Hani Bakhshaee
- Department of Mechanical Engineering, Biomechanics Lab, McGill University, Montreal, Quebec, Canada.
| | | | | | | |
Collapse
|
22
|
Liu K, Fang B, Wu Y, Li Y, Jin J, Tan L, Zhang S. Anatomical education and surgical simulation based on the Chinese Visible Human: a three-dimensional virtual model of the larynx region. Anat Sci Int 2013; 88:254-8. [PMID: 23801001 DOI: 10.1007/s12565-013-0186-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 06/14/2013] [Indexed: 11/26/2022]
Abstract
Anatomical knowledge of the larynx region is critical for understanding laryngeal disease and performing required interventions. Virtual reality is a useful method for surgical education and simulation. Here, we assembled segmented cross-section slices of the larynx region from the Chinese Visible Human dataset. The laryngeal structures were precisely segmented manually as 2D images, then reconstructed and displayed as 3D images in the virtual reality Dextrobeam system. Using visualization and interaction with the virtual reality modeling language model, a digital laryngeal anatomy instruction was constructed using HTML and JavaScript languages. The volume larynx models can thus display an arbitrary section of the model and provide a virtual dissection function. This networked teaching system of the digital laryngeal anatomy can be read remotely, displayed locally, and manipulated interactively.
Collapse
Affiliation(s)
- Kaijun Liu
- Institute of Computing Medicine, Third Military Medical University, Chongqing, 400038, People's Republic of China
| | | | | | | | | | | | | |
Collapse
|