1
|
Avhad A, Wilson A, Sayce L, Li Z, Rousseau B, Doyle JF, Luo H. An Integrated Experimental-Computational Study of Vocal Fold Vibration in Type I Thyroplasty. J Biomech Eng 2024; 146:041006. [PMID: 38319186 PMCID: PMC11005858 DOI: 10.1115/1.4064662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/07/2024]
Abstract
Subject-specific computational modeling of vocal fold (VF) vibration was integrated with an ex vivo animal experiment of type 1 thyroplasty to study the effect of the implant on the vocal fold vibration. In the experiment, a rabbit larynx was used to simulate type 1 thyroplasty, where one side of the vocal fold was medialized with a trans-muscular suture while the other side was medialized with a silastic implant. Vocal fold vibration was then achieved by flowing air through the larynx and was filmed with a high-speed camera. The three-dimensional computational model was built upon the pre-operative scan of the laryngeal anatomy. This subject-specific model was used to simulate the vocal fold medialization and then the fluid-structure interaction (FSI) of the vocal fold. Model validation was done by comparing the vocal fold displacement with postoperative scan (for medialization), and by comparing the vibratory characteristics with the high-speed images (for vibration). These comparisons showed the computational model successfully captured the effect of the implant and thus has the potential for presurgical planning.
Collapse
Affiliation(s)
- Amit Avhad
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN 37221
- Vanderbilt University
| | - Azure Wilson
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA 15260
- University of Pittsburgh
| | - Lea Sayce
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA 15260
- University of Pittsburgh
| | - Zheng Li
- Mechatronics Engineering Department, Morgan State University, Baltimore, MD 21251
- Morgan State University
| | - Bernard Rousseau
- Doisy College of Health Sciences, Saint Louis University, Saint Louis, MO 63103
- Saint Louis University
| | - James F Doyle
- School of Aeronautics and Astronautics, Purdue University, West Lafayette, IN 47907
- Purdue University West Lafayette
| | - Haoxiang Luo
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN 37235-1592
| |
Collapse
|
2
|
Zhang Z. The influence of source-filter interaction on the voice source in a three-dimensional computational model of voice production. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 154:2462-2475. [PMID: 37855666 PMCID: PMC10589054 DOI: 10.1121/10.0021879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/20/2023]
Abstract
The goal of this computational study is to quantify global effects of vocal tract constriction at various locations (false vocal folds, aryepiglottic folds, pharynx, oral cavity, and lips) on the voice source across a large range of vocal fold conditions. The results showed that while inclusion of a uniform vocal tract had notable effects on the voice source, further constricting the vocal tract only had small effects except for conditions of extreme constriction, at which constrictions at any location along the vocal tract decreased the mean and peak-to-peak amplitude of the glottal flow waveform. Although narrowing in the epilarynx increased the normalized maximum flow declination rate, vocal tract constriction in general slightly reduced the source strength and high-frequency harmonic production at the glottis, except for a limited set of vocal fold conditions (e.g., soft, long vocal folds subject to relatively high pressure). This suggests that simultaneous laryngeal and vocal tract adjustments are required to maximize source-filter interaction. While vocal tract adjustments are often assumed to improve voice production, our results indicate that such improvements are mainly due to changes in vocal tract acoustic response rather than improved voice production at the glottis.
Collapse
Affiliation(s)
- Zhaoyan Zhang
- UCLA School of Medicine, 31-24 Rehabilitation Center, 1000 Veteran Avenue, Los Angeles, California 90095-1794, USA
| |
Collapse
|
3
|
Li Z, Wilson A, Sayce L, Ding A, Rousseau B, Luo H. Subject-Specific Modeling of Implant Placement for Type I Thyroplasty Surgery. Ann Biomed Eng 2023; 51:2182-2191. [PMID: 37261591 PMCID: PMC11066887 DOI: 10.1007/s10439-023-03250-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 05/16/2023] [Indexed: 06/02/2023]
Abstract
Type I thyroplasty is widely used to improve voice production in patients affected by unilateral vocal fold paralysis. Almost two-thirds of laryngologists report using Silastic® implants to medialize the vocal fold, with implant size, shape, and location determined experientially. However, post-surgical complications arising from this procedure (extrusion, migration, resizing) necessitate revision in 4.5-16% of patients. To improve initial surgical outcomes, we have developed a subject-specific modeling tool, PhonoSim, which uses model reconstruction from MRI scans to predict the optimal implantation location. Eleven vocal fold sample sides from eight larynges of New Zealand white rabbits were randomized to two groups: PhonoSim informed (n = 6), and control (no model guidance, n = 5). Larynges were scanned ex vivo in the abducted configuration using a vertical-bore 11.7 T microimaging system, and images were used for subject-specific modeling. The PhonoSim tool simulated vocal fold adduction for multiple implant location placements to evaluate vocal fold adduction at the medial surface. The best implant placement coordinates were output for the 6 samples in the PhonoSim group. Control placements were determined by the same surgeon based on anatomical landmarks. Post-surgical MRI scans were performed for all samples to evaluate medialization in implanted vocal folds. Results show that PhonoSim-guided implantation achieved higher vocal fold medialization relative to controls (28 to 55% vs. - 29 to 39% respectively, in the glottal area reduction), suggesting that this tool has the potential to improve outcomes and revision rates for type I thyroplasty.
Collapse
Affiliation(s)
- Zheng Li
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA
- Mechatronics Engineering Department, Morgan State University, Baltimore, MD, USA
| | - Azure Wilson
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lea Sayce
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alice Ding
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA
- Nuclear Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Bernard Rousseau
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA, USA
- Doisy College of Health Sciences, Saint Louis University, St Louis, MO, USA
| | - Haoxiang Luo
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA.
| |
Collapse
|
4
|
Wu L, Zhang Z. Impact of the Paraglottic Space on Voice Production in an MRI-Based Vocal Fold Model. J Voice 2023; 37:633.e15-633.e23. [PMID: 33752927 PMCID: PMC8449798 DOI: 10.1016/j.jvoice.2021.02.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE While the vocal fold is in direct contact anteriorly with the thyroid cartilage, posteriorly the vocal fold connects to the thyroid cartilage through a soft tissue layer in the paraglottic space. Currently the paraglottic space is often neglected in computational models of phonation, in which a fixed boundary condition is often imposed on the lateral surface of the vocal fold. The goal of this study was to investigate the effect of the paraglottic space on voice production in an MRI-based vocal fold model, and how this effect may be counteracted by vocal fold stiffening due to laryngeal muscle activation. METHODS Parametric simulation study using an MRI-based computational vocal fold model. RESULTS The results showed that the presence of the paraglottic space increased the mean and amplitude of the glottal area waveform, decreased the phonation frequency and closed quotient. For the particular vocal fold geometry used in this study, the presence of the paraglottic space also reduced the occurrence of irregular vocal fold vibration. These effects of the paraglottic space became smaller with increasing paraglottic space stiffness and to a lesser degree with vocal fold stiffening. CONCLUSIONS The results suggest that the paraglottic space may be neglected in qualitative evaluations of normal phonation, but needs to be included in simulations of pathological phonation or vocal fold posturing.
Collapse
Affiliation(s)
- Liang Wu
- Department of Head and Neck Surgery, University of California, Los Angeles, California
| | - Zhaoyan Zhang
- Department of Head and Neck Surgery, University of California, Los Angeles, California.
| |
Collapse
|
5
|
Avhad A, Li Z, Wilson A, Sayce L, Chang S, Rousseau B, Luo H. Subject-Specific Computational Fluid-Structure Interaction Modeling of Rabbit Vocal Fold Vibration. FLUIDS 2022; 7. [PMID: 35480340 PMCID: PMC9040707 DOI: 10.3390/fluids7030097] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
A full three-dimensional (3D) fluid-structure interaction (FSI) study of subject-specific vocal fold vibration is carried out based on the previously reconstructed vocal fold models of rabbit larynges. Our primary focuses are the vibration characteristics of the vocal fold, the unsteady 3D flow field, and comparison with a recently developed 1D glottal flow model that incorporates machine learning. The 3D FSI model applies strong coupling between the finite-element model for the vocal fold tissue and the incompressible Navier-Stokes equation for the flow. Five different samples of the rabbit larynx, reconstructed from the magnetic resonance imaging (MRI) scans after the in vivo phonation experiments, are used in the FSI simulation. These samples have distinct geometries and a different inlet pressure measured in the experiment. Furthermore, the material properties of the vocal fold tissue were determined previously for each individual sample. The results demonstrate that the vibration and the intraglottal pressure from the 3D flow simulation agree well with those from the 1D flow model based simulation. Further 3D analyses show that the inferior and supraglottal geometries play significant roles in the FSI process. Similarity of the flow pattern with the human vocal fold is discussed. This study supports the effective usage of rabbit larynges to understand human phonation and will help guide our future computational studies that address vocal fold disorders.
Collapse
Affiliation(s)
- Amit Avhad
- Department of Mechanical Engineering, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37235, USA
| | - Zheng Li
- Department of Mechanical Engineering, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37235, 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
| | - Siyuan Chang
- Department of Mechanical Engineering, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37235, 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, Nashville, TN 37235, USA
- Correspondence: ; Tel.: +1-615-322-2079
| |
Collapse
|
6
|
Hadwin PJ, Erath BD, Peterson SD. The influence of flow model selection on finite element model parameter estimation using Bayesian inference. JASA EXPRESS LETTERS 2021; 1:045204. [PMID: 34136884 PMCID: PMC8182970 DOI: 10.1121/10.0004260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/18/2021] [Indexed: 06/12/2023]
Abstract
Recently, Bayesian estimation coupled with finite element modeling has been demonstrated as a viable tool for estimating vocal fold material properties from kinematic information obtained via high-speed video recordings. In this article, the sensitivity of the parameter estimations to the employed fluid model is explored by considering Bernoulli and one-dimensional viscous fluid flow models. Simulation results indicate that prescribing an ad hoc separation location for the Bernoulli flow model can lead to large estimate biases, whereas including the separation location as an estimated parameter leads to results comparable to that of the viscous fluid flow model.
Collapse
Affiliation(s)
- Paul J Hadwin
- Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada
| | - Byron D Erath
- Department of Mechanical and Aeronautical Engineering, Clarkson University, Potsdam, New York 13699, USA , ,
| | - Sean D Peterson
- Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada
| |
Collapse
|
7
|
Li Z, Chen Y, Chang S, Rousseau B, Luo H. A one-dimensional flow model enhanced by machine learning for simulation of vocal fold vibration. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 149:1712. [PMID: 33765799 PMCID: PMC7954577 DOI: 10.1121/10.0003561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 06/02/2023]
Abstract
A one-dimensional (1D) unsteady and viscous flow model that is derived from the momentum and mass conservation equations is described, and to enhance this physics-based model, a machine learning approach is used to determine the unknown modeling parameters. Specifically, an idealized larynx model is constructed and ten cases of three-dimensional (3D) fluid-structure interaction (FSI) simulations are performed. The flow data are then extracted to train the 1D flow model using a sparse identification approach for nonlinear dynamical systems. As a result of training, we obtain the analytical expressions for the entrance effect and pressure loss in the glottis, which are then incorporated in the flow model to conveniently handle different glottal shapes due to vocal fold vibration. We apply the enhanced 1D flow model in the FSI simulation of both idealized vocal fold geometries and subject-specific anatomical geometries reconstructed from the magnetic resonance imaging images of rabbits' larynges. The 1D flow model is evaluated in both of these setups and shown to have robust performance. Therefore, it provides a fast simulation tool that is superior to the previous 1D models.
Collapse
Affiliation(s)
- Zheng Li
- Department of Mechanical Engineering, Vanderbilt University, 2301 Vanderbilt Place, Nashville, Tennessee 37235-1592, USA
| | - Ye Chen
- Department of Mechanical Engineering, Vanderbilt University, 2301 Vanderbilt Place, Nashville, Tennessee 37235-1592, USA
| | - Siyuan Chang
- Department of Mechanical Engineering, Vanderbilt University, 2301 Vanderbilt Place, Nashville, Tennessee 37235-1592, USA
| | - Bernard Rousseau
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA
| | - Haoxiang Luo
- Department of Mechanical Engineering, Vanderbilt University, 2301 Vanderbilt Place, Nashville, Tennessee 37235-1592, USA
| |
Collapse
|
8
|
Wilson A, Kimball EE, Sayce L, Luo H, Khosla SM, Rousseau B. Medialization Laryngoplasty: A Review for Speech-Language Pathologists. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:481-490. [PMID: 33524276 PMCID: PMC8632480 DOI: 10.1044/2020_jslhr-20-00344] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/18/2020] [Accepted: 11/17/2020] [Indexed: 05/26/2023]
Abstract
Purpose The purpose of this study is to familiarize speech-language-pathologists with the current state of the science regarding medialization laryngoplasty in the treatment of voice disorders, with emphasis on current evidence-based practice, voice outcomes, and future directions for research. Method A literature review was performed in PubMed and Embase using the keywords vocal fold/cord and laryngoplasty, thyroplasty, augmentation, or laryngeal framework. Articles published between 2010 and 2020 were reviewed for data about clinical applications, technical approach, voice-related outcomes, and basic science or clinical innovations with the potential to improve patient care. A synthesis of data was performed from articles meeting the outlined search criteria. Conclusions As key members in the multidisciplinary care of voice disorders, speech-language pathologists need to be informed of current research in medialization laryngoplasty, a procedure commonly used for patients with glottic insufficiency. Advances in anesthetic technique, office-based procedures, and the development of materials with increased bio-tolerability over the past decade have led to innovations in treatment and improved patient outcomes. Recent applications of computational and bioengineering approaches have the potential to provide new directions in the refinement of currently available techniques and the improvement of patient-based treatment outcomes.
Collapse
Affiliation(s)
- Azure Wilson
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA
| | - Emily E. Kimball
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN
| | - Lea Sayce
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA
| | - Haoxiang Luo
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN
| | - Sid M. Khosla
- Department of Otolaryngology Head and Neck Surgery, University of Cincinnati College of Medicine, OH
- Neurosensory Disorder Center at UC Gardner Neuroscience Institute, Cincinnati, OH
| | - Bernard Rousseau
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA
| |
Collapse
|
9
|
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: 8] [Impact Index Per Article: 2.7] [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
|
10
|
Chen Y, Li Z, Chang S, Rousseau B, Luo H. A reduced-order flow model for vocal fold vibration: from idealized to subject-specific models. JOURNAL OF FLUIDS AND STRUCTURES 2020; 94:102940. [PMID: 32210520 PMCID: PMC7093056 DOI: 10.1016/j.jfluidstructs.2020.102940] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We present a reduced-order model for fluid-structure interaction (FSI) simulation of vocal fold vibration during phonation. This model couples the three-dimensional (3D) tissue mechanics and a one-dimensional (1D) flow model that is derived from the momentum and mass conservation equations for the glottal airflow. The effects of glottal entrance and pressure loss in the glottis are incorporated in the flow model. We consider both idealized vocal fold geometries and subject-specific anatomical geometries segmented from the MRI images of rabbits. For the idealized vocal fold geometries, we compare the simulation results from the 1D/3D hybrid FSI model with those from the full 3D FSI simulation based on an immersed-boundary method. For the subject-specific geometries, we incorporate previously estimated tissue properties for individual samples and compare the results with those from the high-speed imaging experiment of in vivo phonation. In both setups, the comparison shows good agreement in the vibration frequency, amplitude, phase delay, and deformation pattern of the vocal fold, which suggests potential application of the present approach for future patient-specific modeling.
Collapse
Affiliation(s)
- Ye Chen
- Department of Mechanical Engineering, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37235-1592
| | - Zheng Li
- Department of Mechanical Engineering, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37235-1592
| | - Siyuan Chang
- Department of Mechanical Engineering, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37235-1592
| | - Bernard Rousseau
- Department of Communication Science and Disorders, University of Pittsburgh
| | - Haoxiang Luo
- Department of Mechanical Engineering, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37235-1592
| |
Collapse
|