Numerical analysis and comparison of flow fields in normal larynx and larynx with unilateral vocal fold paralysis

Towards modeling of phonation and its recovery in unilateral vocal fold paralysis by fluid-structure interaction

Introduction

Vocal folds are responsible for sound generation. In unilateral vocal fold paralysis (UVFP), the recurrent laryngeal nerve, which controls the vocal folds, is paralyzed. Medialization laryngoplasty is a surgery in which an implant is inserted to push the paralyzed vocal fold to the centerline to recover phonation.

Methods

Here, a numerical simulation is used to calculate flow-related parameters to give insight into what happens in healthy and treated(implanted) vocal folds and their enhancement. In the present work, airflow over vocal folds is modeled considering fluid-structure interaction (FSI) and varying inlet pressure. The governing equations are discretized for fluid and solid domains and solved using the Galerkin finite element method. The boundary conditions for healthy and unilaterally paralyzed vocal folds were imposed to agree with real cases behavior.

Results

The results showed the effectiveness of medialization laryngoplasty in treating unilateral vocal fold paralysis concerning healthy vocal folds.

Conclusion

This simulation provided a better insight into treatment results for patient-specific cases.

Flow-induced self-sustained oscillations in a straight channel with rigid walls and elastic supports

This work considers the two-dimensional flow field of an incompressible viscous fluid in a parallel-sided channel. In our study, one of the walls is fixed whereas the other one is elastically mounted, and sustained oscillations are induced by the fluid motion. The flow that forces the wall movement is produced as a consequence that one of the ends of the channel is pressurized, whereas the opposite end is at atmospheric pressure. The study aims at reducing the complexity of models for several physiological systems in which fluid-structure interaction produces large deformation of the wall. We report the experimental results of the observed self-sustained oscillations. These oscillations occur at frequencies close to the natural frequency of the system. The vertical motion is accompanied by a slight trend to rotate the moving mass at intervals when the gap height is quite narrow. We propose a simplified analytical model to explore the conditions under which this motion is possible. The analytical approach considers asymptotic solutions of the Navier-Stokes equation with a perturbation technique. The comparison between the experimental pressure measured at the midlength of the channel and the analytical result issued with a model neglecting viscous effects shows a very good agreement. Also, the rotating trend of the moving wall can be explained in terms of the quadratic dependence of the pressure with the streamwise coordinate that is predicted by this simplified model.

Effects of Sulcus Vocalis Depth on Phonation in Three-Dimensional Fluid-Structure Interaction Laryngeal Models

Sulcus vocalis is an indentation parallel to the edge of vocal fold, which may extend into the cover and ligament layer of the vocal fold or deeper. The effects of sulcus vocalis depth d on phonation and the vocal cord vibrations are investigated in this study. The three-dimensional laryngeal models were established for healthy vocal folds (0 mm) and different types of sulcus vocalis with the typical depth of 1 mm, 2 mm, and 3 mm. These models with fluid-structure interaction (FSI) are computed numerically by sequential coupling method, which includes an immersed boundary method (IBM) for modelling the glottal airflow, a finite-element method (FEM) for modelling vocal fold tissue. The results show that a deeper sulcus vocalis in the cover layer decreases the vibrating frequency of vocal folds and expands the prephonatory glottal half-width which increases the phonation threshold pressure. The larger sulcus vocalis depth makes vocal folds difficult to vibrate and phonate. The effects of sulcus vocalis depth suggest that the feature such as phonation threshold pressure could assist in the detection of healthy vocal folds and different types of sulcus vocalis.