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Deng JJ, Peterson SD. Sensitivity of Phonation Onset Pressure to Vocal Fold Stiffness Distribution. J Biomech Eng 2024; 146:081003. [PMID: 38345603 DOI: 10.1115/1.4064718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Indexed: 03/22/2024]
Abstract
Phonation onset is characterized by the unstable growth of vocal fold (VF) vibrations that ultimately results in self-sustained oscillation and the production of modal voice. Motivated by histological studies, much research has focused on the role of the layered structure of the vocal folds in influencing phonation onset, wherein the outer "cover" layer is relatively soft and the inner "body" layer is relatively stiff. Recent research, however, suggests that the body-cover (BC) structure over-simplifies actual stiffness distributions by neglecting important spatial variations, such as inferior-superior (IS) and anterior-posterior gradients and smooth transitions in stiffness from one histological layer to another. Herein, we explore sensitivity of phonation onset to stiffness gradients and smoothness. By assuming no a priori stiffness distribution and considering a second-order Taylor series sensitivity analysis of phonation onset pressure with respect to stiffness, we find two general smooth stiffness distributions most strongly influence onset pressure: a smooth stiffness containing aspects of BC differences and IS gradients in the cover, which plays a role in minimizing onset pressure, and uniform increases in stiffness, which raise onset pressure and frequency. While the smooth stiffness change contains aspects qualitatively similar to layered BC distributions used in computational studies, smooth transitions in stiffness result in higher sensitivity of onset pressure than discrete layering. These two general stiffness distributions also provide a simple, low-dimensional, interpretation of how complex variations in VF stiffness affect onset pressure, enabling refined exploration of the effects of stiffness distributions on phonation onset.
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Affiliation(s)
- Jonathan J Deng
- Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Sean D Peterson
- Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
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2
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Schlegel P, Rhyn Chung H, Döllinger M, Chhetri DK. Reconstruction of Vocal Fold Medial Surface 3D Trajectories: Effects of Neuromuscular Stimulation and Airflow. Laryngoscope 2024; 134:1249-1257. [PMID: 37672673 PMCID: PMC10915101 DOI: 10.1002/lary.31029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 08/12/2023] [Accepted: 08/22/2023] [Indexed: 09/08/2023]
Abstract
INTRODUCTION Analysis of medial surface dynamics of the vocal folds (VF) is critical to understanding voice production and treatment of voice disorders. We analyzed VF medial surface vibratory dynamics, evaluating the effects of airflow and nerve stimulation using 3D reconstruction and empirical eigenfunctions (EEF). STUDY DESIGN In vivo canine hemilarynx phonation. METHODS An in vivo canine hemilarynx was phonated while graded stimulation of the recurrent and superior laryngeal nerves (RLN and SLN) was performed. For each phonatory condition, vibratory cycles were 3D reconstructed from tattooed landmarks on the VF medial surface at low, medium, and high airflows. Parameters describing medial surface trajectory shape were calculated, and underlying patterns were emphasized using EEFs. Fundamental frequency and smoothed cepstral peak prominence (CPPS) were calculated from acoustic data. RESULTS Convex-hull area of landmark trajectories increased with increasing flow and decreasing nerve activation level. Trajectory shapes observed included circular, ellipsoid, bent, and figure-eight. They were more circular on the superior and anterior VF, and more elliptical and line-like on the inferior and posterior VF. The EEFs capturing synchronal opening and closing (EEF1) and alternating convergent/divergent (EEF2) glottis shapes were mostly unaffected by flow and nerve stimulation levels. CPPS increased with higher airflow except for low RLN activation and very dominant SLN stimulation. CONCLUSION We analyzed VF vibration as a function of neuromuscular stimulation and airflow levels. Oscillation patterns such as figure-eight and bent trajectories were linked to high nerve activation and flow. Further studies investigating longer sections of 3D reconstructed oscillations are needed. LEVEL OF EVIDENCE N/A, Basic Science Laryngoscope, 134:1249-1257, 2024.
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Affiliation(s)
- Patrick Schlegel
- Department of Head and Neck Surgery, University of California, Los Angeles; Los Angeles, CA
| | - Hye Rhyn Chung
- Department of Head and Neck Surgery, University of California, Los Angeles; Los Angeles, CA
| | - Michael Döllinger
- Division of Phoniatrics and Pediatric Audiology, Department of Head and Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Dinesh K. Chhetri
- Department of Head and Neck Surgery, University of California, Los Angeles; Los Angeles, CA
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Chung HR, Lee Y, Reddy NK, Zhang Z, Chhetri DK. Effects of Thyroarytenoid Activation Induced Vibratory Asymmetry on Voice Acoustics and Perception. Laryngoscope 2024; 134:1327-1332. [PMID: 37676064 DOI: 10.1002/lary.31046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 06/25/2023] [Accepted: 08/22/2023] [Indexed: 09/08/2023]
Abstract
INTRODUCTION Asymmetry of vocal fold (VF) vibration is common in patients with voice complaints and also observed in 10% of normophonic individuals. Although thyroarytenoid (TA) muscle activation plays a crucial role in regulating VF vibration, how TA activation asymmetry relates to voice acoustics and perception is unclear. We evaluated the relationship between TA activation asymmetry and the resulting acoustics and perception. METHODS An in vivo canine model of phonation was used to create symmetric and increasingly asymmetric VF vibratory conditions via graded stimulation of bilateral TA muscles. Naïve listeners (n = 89) rated the perceptual quality of 100 unique voice samples using a visual sort-and-rate task. For each phonatory condition, cepstral peak prominence (CPP), harmonic amplitude (H1-H2), and root-mean-square (RMS) energy of the voice were measured. The relationships between these metrics, vibratory asymmetry, and perceptual ratings were evaluated. RESULTS Increasing levels of TA asymmetry resulted in declining listener preference. Furthermore, only severely asymmetric audio samples were perceptually distinguishable from symmetric and mildly asymmetric conditions. CPP was negatively correlated with TA asymmetry: voices produced with larger degrees of asymmetry were associated with lower CPP values. Listeners preferred audio samples with higher values of CPP, high RMS energy, and lower H1-H2 (less breathy). CONCLUSION Listeners are sensitive to changes in voice acoustics related to vibratory asymmetry. Although increasing vibratory asymmetry is correlated with decreased perceptual ratings, mild asymmetries are perceptually tolerated. This study contributes to our understanding of voice production and quality by identifying perceptually salient and clinically meaningful asymmetry. LEVEL OF EVIDENCE N/A (Basic Science Study) Laryngoscope, 134:1327-1332, 2024.
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Affiliation(s)
- Hye Rhyn Chung
- David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, California, U.S.A
| | - Yoonjeong Lee
- Department of Head & Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A
- Department of Linguistics, University of Michigan, Ann Arbor, Michigan, U.S.A
| | - Neha K Reddy
- David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, California, U.S.A
| | - Zhaoyan Zhang
- Department of Head & Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A
| | - Dinesh K Chhetri
- Department of Head & Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A
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Chung HR, Reddy NK, Manzoor D, Schlegel P, Zhang Z, Chhetri DK. Histologic Examination of Vocal Fold Mucosal Wave and Vibration. Laryngoscope 2024; 134:264-271. [PMID: 37522475 PMCID: PMC10828106 DOI: 10.1002/lary.30928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/29/2023] [Accepted: 07/18/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVES Despite gross anatomic and histologic differences between human and canine vocal folds, similar wave patterns have been described yet not fully characterized. We reconstructed vocal fold (VF) vibration in a canine hemilarynx and performed histologic examination of the same vocal fold. We demonstrate comparable wave patterns while exploring the importance of certain anatomic architectures. METHODS An in vivo canine hemilarynx was phonated against a glass prism at low and high muscle activation conditions. Vibration was captured using high-speed video, and trajectories of VF medial surface tattooed landmarks were 3D-reconstructed. The method of empirical eigenfunctions was used to capture the essential dynamics of vibratory movement. Histologic examination of the hemilarynx was performed. RESULTS Oscillation patterns were highly similar between the in vivo canine and previous reports of ex vivo human models. The two most dominant eigenfunctions comprised over 90% of total variance of movement, representing opening/closing and convergent/divergent movement patterns, respectively. We demonstrate a vertical phase difference during the glottal cycle. The time delay between the inferior and superior VF was greater during opening than closing for both activation conditions. Histological examination of canine VF showed not only a thicker lamina propria layer superiorly but also a distinct pattern of thyroarytenoid muscle fibers and fascicles as described in human studies. CONCLUSIONS Histologic and vibratory examination of the canine vocal fold demonstrated human vocal fold vibratory patterns despite certain microstructural differences. This study suggests that the multilayered lamina propria may not be fundamental to vibratory patterns necessary for human-like voice production. LEVEL OF EVIDENCE NA (Basic science study) Laryngoscope, 134:264-271, 2024.
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Affiliation(s)
- Hye Rhyn Chung
- University of California, Los Angeles, David Geffen School of Medicine
| | - Neha K. Reddy
- University of California, Los Angeles, David Geffen School of Medicine
| | - Daniel Manzoor
- Department of Pathology, University of California, Los Angeles
| | - Patrick Schlegel
- Department of Head and Neck Surgery, University of California, Los Angeles
| | - Zhaoyan Zhang
- Department of Head and Neck Surgery, University of California, Los Angeles
| | - Dinesh K. Chhetri
- Department of Head and Neck Surgery, University of California, Los Angeles
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Heaton JT, Kobler JB, Otten DM, Tynan MA, Petrillo RH, Ottensmeyer MP, Slate AR, Hillman RE, Zeitels SM. Electrical Stimulation of Vocal Fold Adduction Triggered by Laryngeal Electromyography Using a Custom Implant. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4812-4827. [PMID: 37971489 DOI: 10.1044/2023_jslhr-23-00377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
PURPOSE Medialization procedures for unilateral vocal fold (VF) paralysis generally improve voice but do not fully replace dynamic VF adduction. Paralyzed VFs typically experience synkinetic reinnervation, which makes it feasible to elicit movement through electrical stimulation. We tested a novel laryngeal pacing implant capable of providing closed-loop (automatic) stimulation of a VF triggered by electromyography (EMG) potentials from the contralateral VF. METHOD A custom, battery-powered, microprocessor-based stimulator was tested in eight dogs with bipolar electrodes implanted for recording EMG from the left VF and stimulating adduction of the right VF. A cuff electrode on the left recurrent laryngeal nerve (RLN) stimulated unilateral VF adduction, modeling voluntary control in anesthetized animals. Closed-loop stimulation was tested in both acute and chronic experiments. Synkinetic reinnervation was created in two animals by right RLN transection and suture repair to model unilateral VF paralysis. RESULTS In all animals, left VF activation through RLN stimulation generated a robust EMG response that rapidly triggered stimulation of contralateral thyroarytenoid and lateral cricoarytenoid muscles, causing nearly simultaneous bilateral adduction. Optimal triggering of VF stimulation from elicited EMG was achieved using independent onset and offset thresholds. Real-time artifact blanking allowed closed-loop stimulation without self-perpetuating feedback, despite the proximity of recording and stimulation electrodes. CONCLUSIONS Using a custom implant system, we demonstrated real-time closed-loop stimulation of one VF triggered by the activation of the contralateral VF. This approach could potentially restore dynamic glottic closure for reflexive behaviors or phonation in cases of unilateral VF paralysis with synkinetic reinnervation. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24492133.
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Affiliation(s)
- James T Heaton
- Department of Surgery, Harvard Medical School, Boston, MA
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston
| | - James B Kobler
- Department of Surgery, Harvard Medical School, Boston, MA
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston
| | - David M Otten
- Laboratory for Electromagnetic and Electronic Systems, Massachusetts Institute of Technology, Cambridge
| | - Monica A Tynan
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston
| | - Robert H Petrillo
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston
| | | | - Andrea R Slate
- Center for Comparative Medicine, Massachusetts General Hospital, Boston
| | - Robert E Hillman
- Department of Surgery, Harvard Medical School, Boston, MA
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston
| | - Steven M Zeitels
- Department of Surgery, Harvard Medical School, Boston, MA
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston
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Serry MA, Alzamendi GA, Zañartu M, Peterson SD. An Euler-Bernoulli-type beam model of the vocal folds for describing curved and incomplete glottal closure patterns. J Mech Behav Biomed Mater 2023; 147:106130. [PMID: 37774440 PMCID: PMC10787517 DOI: 10.1016/j.jmbbm.2023.106130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/30/2023] [Accepted: 09/16/2023] [Indexed: 10/01/2023]
Abstract
Incomplete glottal closure is a laryngeal configuration wherein the glottis is not fully obstructed prior to phonation. It has been linked to inefficient voice production and voice disorders. Various incomplete glottal closure patterns can arise and the mechanisms driving them are not well understood. In this work, we introduce an Euler-Bernoulli composite beam vocal fold (VF) model that produces qualitatively similar incomplete glottal closure patterns as those observed in experimental and high-fidelity numerical studies, thus offering insights into the potential underlying physical mechanisms. Refined physiological insights are pursued by incorporating the beam model into a VF posturing model that embeds the five intrinsic laryngeal muscles. Analysis of the combined model shows that co-activating the lateral cricoarytenoid (LCA) and interarytenoid (IA) muscles without activating the thyroarytenoid (TA) muscle results in a bowed (convex) VF geometry with closure at the posterior margin only; this is primarily attributed to the reactive moments at the anterior VF margin. This bowed pattern can also arise during VF compression (due to extrinsic laryngeal muscle activation for example), wherein the internal moment induced passively by the TA muscle tissue is the predominant mechanism. On the other hand, activating the TA muscle without incorporating other adductory muscles results in anterior and mid-membranous glottal closure, a concave VF geometry, and a posterior glottal opening driven by internal moments induced by TA muscle activation. In the case of initial full glottal closure, the posterior cricoarytenoid (PCA) muscle activation cancels the adductory effects of the LCA and IA muscles, resulting in a concave VF geometry and posterior glottal opening. Furthermore, certain maneuvers involving co-activation of all adductory muscles result in an hourglass glottal shape due to a reactive moment at the anterior VF margin and moderate internal moment induced by TA muscle activation. These findings have implications regarding potential laryngeal maneuvers in patients with voice disorders involving imbalances or excessive tension in the laryngeal muscles such as muscle tension dysphonia.
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Affiliation(s)
- Mohamed A Serry
- Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada
| | - Gabriel A Alzamendi
- Institute for Research and Development on Bioengineering and Bioinformatics (IBB), CONICET-UNER, Oro Verde, Entre Ríos 3100, Argentina
| | - Matías Zañartu
- Department of Electronic Engineering, Universidad Técnica Federico Santa María, Valparaíso, Chile
| | - Sean D Peterson
- Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada.
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Serry MA, Alzamendi GA, Zañartu M, Peterson SD. Modeling the influence of the extrinsic musculature on phonation. Biomech Model Mechanobiol 2023; 22:1365-1378. [PMID: 37169957 PMCID: PMC10529543 DOI: 10.1007/s10237-023-01724-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 04/11/2023] [Indexed: 05/13/2023]
Abstract
Neck muscles play important roles in various physiological tasks, including swallowing, head stabilization, and phonation. The mechanisms by which neck muscles influence phonation are not well understood, with conflicting reports on the change in fundamental frequency for ostensibly the same neck muscle activation scenarios. In this work, we introduce a reduced-order muscle-controlled vocal fold model, comprising both intrinsic muscle control and extrinsic muscle effects. The model predicts that when the neck muscles pull the thyroid cartilage in the superior-anterior direction (with a sufficiently large anterior component), inferior direction, or inferior-anterior direction, tension in the vocal folds increases, leading to fundamental frequency rise during sustained phonation. On the other hand, pulling in the superior direction, superior-posterior direction, or inferior-posterior direction (with a sufficiently large posterior component) tends to decrease vocal fold tension and phonation fundamental frequency. Varying the pulling force location alters the posture and phonation biomechanics, depending on the force direction. These findings suggest potential roles of particular neck muscles in modulating phonation fundamental frequency, with implications for vocal hyperfunction.
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Affiliation(s)
- Mohamed A Serry
- Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Gabriel A Alzamendi
- Institute for Research and Development on Bioengineering and Bioinformatics (IBB), CONICET-UNER, Oro Verde, Entre Ríos, 3100, Argentina
| | - Matías Zañartu
- Department of Electronic Engineering, Universidad Técnica Federico Santa María, Valparaíso, Chile
| | - Sean D Peterson
- Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada.
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Serry MA, Alzamendi GA, Zañartu M, Peterson SD. An Euler-Bernoulli-Type Beam Model of the Vocal Folds for Describing Curved and Incomplete Glottal Closure Patterns. ARXIV 2023:arXiv:2307.02463v1. [PMID: 37461411 PMCID: PMC10350104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
Abstract
Incomplete glottal closure is a laryngeal configuration wherein the glottis is not fully obstructed prior to phonation. In this work, we introduce an Euler-Bernoulli composite beam vocal fold (VF) model that produces qualitatively similar incomplete glottal closure patterns as those observed in experimental and high-fidelity numerical studies, thus offering insights in to the potential underlying physical mechanisms. Refined physiological insights are pursued by incorporating the beam model into a VF posturing model that embeds the five intrinsic laryngeal muscles. Analysis of the combined model shows that co-activating the lateral cricoarytenoid (LCA) and interarytenoid (IA) muscles without activating the thyroarytenoid (TA) muscle results in a bowed (convex) VF geometry with closure at the posterior margin only; this is primarily attributed to the reactive moments at the anterior VF margin. This bowed pattern can also arise during VF compression (due to extrinsic laryngeal muscle activation for example), wherein the internal moment induced passively by the TA muscle tissue is the predominant mechanism. On the other hand, activating the TA muscle without incorporating other adductory muscles results in anterior and mid-membranous glottal closure, a concave VF geometry, and a posterior glottal opening driven by internal moments induced by TA muscle activation. In the case of initial full glottal closure, the posterior cricoarytenoid (PCA) muscle activation cancels the adductory effects of the LCA and IA muscles, resulting in a concave VF geometry and posterior glottal opening. Furthermore, certain maneuvers involving co-activation of all adductory muscles result in an hourglass glottal shape due to a reactive moment at the anterior VF margin and moderate internal moment induced by TA muscle activation.
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Affiliation(s)
- Mohamed A Serry
- Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada
| | - Gabriel A Alzamendi
- Institute for Research and Development on Bioengineering and Bioinformatics (IBB), CONICET-UNER, Oro Verde, Entre Ríos 3100, Argentina
| | - Matías Zañartu
- Department of Electronic Engineering, Universidad Técnica Federico Santa María, Valparaíso, Chile
| | - Sean D Peterson
- Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada
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Pillutla P, Reddy NK, Schlegel P, Zhang Z, Chhetri DK. Control of Pre-phonatory Glottal Shape by Intrinsic Laryngeal Muscles. Laryngoscope 2023; 133:1690-1697. [PMID: 36129162 PMCID: PMC10027621 DOI: 10.1002/lary.30403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/23/2022] [Accepted: 08/29/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Surgical manipulations to treat glottic insufficiency aim to restore the physiologic pre-phonatory glottal shape. However, the physiologic pre-phonatory glottal shape as a function of interactions between all intrinsic laryngeal muscles (ILMs) has not been described. Vocal fold posture and medial surface shape were investigated across concurrent activation and interactions of thyroarytenoid (TA), cricothyroid (CT), and lateral cricoarytenoid/interarytenoid (LCA/IA) muscles. STUDY DESIGN In vivo canine hemilarynx model. METHODS The ILMs were stimulated across combinations of four graded levels each from low-to-high activation. A total of 64 distinct medial surface postures (4 TA × 4 CT × 4 LCA/IA levels) were captured using high-speed video. Using a custom 3D interpolation algorithm, the medial surface shape was reconstructed. RESULTS Combined activation of ILMs yielded a range of unique pre-phonatory postures. Both LCA/IA and TA activation adducted the vocal fold but with greater contribution from TA. The transition from a convergent to a rectangular glottal shape was primarily mediated by TA muscle activation but LCA/IA and TA together resulted in a smooth rectangular glottis compared to TA alone, which caused rectangular glottis with inferomedial bulging. CT activation resulted in a lengthened but slightly abducted glottis. CONCLUSIONS TA was primarily responsible for the rectangular shape of the adducted glottis with synergistic contribution from the LCA/IA. CT contributed minimally to vocal fold medial shape but elongated the glottis. These findings further refine laryngeal posture goals in surgical correction of glottic insufficiency. LEVEL OF EVIDENCE NA, Basic science Laryngoscope, 133:1690-1697, 2023.
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Affiliation(s)
- Pranati Pillutla
- Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Neha K Reddy
- Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Patrick Schlegel
- Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Zhaoyan Zhang
- Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Dinesh K Chhetri
- Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
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Schlegel P, Yan K, Upadhyaya S, Buyens W, Wong K, Chen A, Faull KF, Al-Hiyari Y, Long J. Tissue-engineered vocal fold replacement in swine: Methods for functional and structural analysis. PLoS One 2023; 18:e0284135. [PMID: 37083641 PMCID: PMC10120936 DOI: 10.1371/journal.pone.0284135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/24/2023] [Indexed: 04/22/2023] Open
Abstract
We have developed a cell-based outer vocal fold replacement (COVR) as a potential therapy to improve voice quality after vocal fold (VF) injury, radiation, or tumor resection. The COVR consists of multipotent human adipose-derived stem cells (hASC) embedded within a three-dimensional fibrin scaffold that resembles vocal fold epithelium and lamina propria layers. Previous work has shown improved wound healing in rabbit studies. In this pilot study in pigs, we sought to develop methods for large animal implantation and phonatory assessment. Feasibility, safety, and structural and functional outcomes of the COVR implant are described. Of eight pigs studied, six animals underwent COVR implantation with harvest between 2 weeks and 6 months. Recovery of laryngeal tissue structure was assessed by vibratory and histologic analyses. Recovery of voice function was assessed by investigating acoustic parameters that were derived specifically for pigs. Results showed improved lamina propria qualities relative to an injured control animal at 6 months. Acoustic parameters reflected voice worsening immediately after surgery as expected; acoustics displayed clear voice recovery in the animal followed for 6 months after COVR. These methods form the basis for a larger-scale long-term pre-clinical safety and efficacy study.
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Affiliation(s)
- Patrick Schlegel
- Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, California, United States of America
| | - Kenneth Yan
- Department of Otolaryngology/Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, United States of America
| | - Sreenivasa Upadhyaya
- Department of Computer Science, Katholieke Universiteit Leuven, Leuven, Belgium
- SoundTalks N.V, Leuven, Belgium
| | | | - Kirsten Wong
- Department of Medicine, David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, California, United States of America
| | - Anthony Chen
- Department of Medicine, David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, California, United States of America
| | - Kym F. Faull
- Department of Psychiatry & Biobehavioral Sciences, Pasarow Mass Spectrometry Laboratory, Jane & Terry Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, California, United States of America
| | - Yazeed Al-Hiyari
- Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, California, United States of America
| | - Jennifer Long
- Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, California, United States of America
- Surgery and Perioperative Careline, Greater Los Angeles VA Healthcare System, Los Angeles, California, United States of America
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Zhang Z. Vocal Fold Vertical Thickness in Human Voice Production and Control: A Review. J Voice 2023:S0892-1997(23)00078-4. [PMID: 36964073 PMCID: PMC10514229 DOI: 10.1016/j.jvoice.2023.02.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 03/26/2023]
Abstract
While current voice research often focuses on laryngeal adjustments in a two-dimensional plane from a superior endoscopic view, recent computational simulations showed that vocal control is three-dimensional and the medial surface vertical thickness plays an important role in regulating the glottal closure pattern and the spectral shape of the produced voice. In contrast, while a small glottal gap is required to initiate and sustain phonation, further changes in the glottal gap within this small range have only small effects on glottal closure and spectral shape. Vocal fold stiffness, particularly along the anterior-posterior direction, plays an important role in pitch control but has only a small effect on glottal closure and spectral shape. These results suggest that voice research should pay more attention to medial surface shape in the vertical dimension. Future studies in a large population of both normal speakers and patients are needed to better characterize the three-dimensional medial surface shape, its variability between speakers, changes throughout the life span, and how it is impacted by voice disorders and clinical interventions. The implications for voice pedagogy and clinical intervention are discussed.
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Li Q, Millard K, Tetnowski J, Narayana S, Cannito M. Acoustic Analysis of Intonation in Persons With Parkinson's Disease Receiving Transcranial Magnetic Stimulation and Intensive Voice Treatment. J Voice 2023; 37:203-214. [PMID: 33461880 DOI: 10.1016/j.jvoice.2020.12.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 11/16/2022]
Abstract
Intonation is one of the prosodic features manifested acoustically in the fundamental frequency (f0). Intonation abnormality is common and prominent in the speech of persons with Parkinson's disease (PD). The current research investigated acoustically five intonational features including f0 declination, f0 resetting, sentence stress, terminal fall, and syntactic prejunctural fall in 20 PD participants, receiving Lee Silverman Voice Treatment (LSVT)-LOUD alone, or combined with transcranial magnetic stimulation delivered to the left or right primary laryngeal motor cortex. The results revealed that f0 declination, sentence stress, and terminal fall changed significantly from pre- to post-treatment, and the changes of declination and terminal fall were maintained at the follow-up evaluations. The observed changes in intonation were attributed to LSVT alone, which caused large changes of f0 magnitude. f0 resetting and syntactic prejunctural fall did not change significantly following treatment, probably because these intonational features need very precise fine motor control of the intrinsic laryngeal muscles to make small-range, rapid f0 adjustments, which were not improved by LSVT in the present PD participants. Difficulties with syntactic processing previously reported in PD may have also contributed to the lack of improvement in resetting and prejunctural fall, since these f0 features are used to mark syntactic boundaries within utterances.
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Affiliation(s)
- Qiang Li
- Department of Communication Sciences and Disorders, Fort Hays State University, Hays, Kansas.
| | - Kelly Millard
- Department of Communicative Disorders, University of Louisiana at Lafayette, Lafayette, Louisiana
| | - John Tetnowski
- Department of Communicative Disorders, University of Louisiana at Lafayette, Lafayette, Louisiana
| | - Shalini Narayana
- Department of Pediatrics, Department of Anatomy and Neurology, University of Tennessee Health Science Center, Memphis, Tennesse
| | - Michael Cannito
- Department of Communicative Disorders, University of Louisiana at Lafayette, Lafayette, Louisiana
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13
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Serry MA, Stepp CE, Peterson SD. Exploring the mechanics of fundamental frequency variation during phonation onset. Biomech Model Mechanobiol 2023; 22:339-356. [PMID: 36370231 PMCID: PMC10369356 DOI: 10.1007/s10237-022-01652-8] [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: 03/25/2022] [Accepted: 10/20/2022] [Indexed: 11/15/2022]
Abstract
Fundamental frequency patterns during phonation onset have received renewed interest due to their promising application in objective classification of normal and pathological voices. However, the associated underlying mechanisms producing the wide array of patterns observed in different phonetic contexts are not yet fully understood. Herein, we employ theoretical and numerical analyses in an effort to elucidate the potential mechanisms driving opposing frequency patterns for initial/isolated vowels versus vowels preceded by voiceless consonants. Utilizing deterministic lumped-mass oscillator models of the vocal folds, we systematically explore the roles of collision and muscle activation in the dynamics of phonation onset. We find that an increasing trend in fundamental frequency, as observed for initial/isolated vowels, arises naturally through a progressive increase in system stiffness as collision intensifies as onset progresses, without the need for time-varying vocal fold tension or changes in aerodynamic loading. In contrast, reduction in cricothyroid muscle activation during onset is required to generate the decrease in fundamental frequency observed for vowels preceded by voiceless consonants. For such phonetic contexts, our analysis shows that the magnitude of reduction in the cricothyroid muscle activation and the activation level of the thyroarytenoid muscle are potential factors underlying observed differences in (relative) fundamental frequency between speakers with healthy and hyperfunctional voices. This work highlights the roles of sometimes competing laryngeal factors in producing the complex array of observed fundamental frequency patterns during phonation onset.
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Affiliation(s)
- Mohamed A Serry
- Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Cara E Stepp
- Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA, 02215, USA
| | - Sean D Peterson
- Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, ON, N2L 3G1, Canada.
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14
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Aerodynamic Performance and Neuromuscular Control in Patients with Unilateral Vocal Fold Paralysis. Diagnostics (Basel) 2022; 12:diagnostics12123124. [PMID: 36553131 PMCID: PMC9777229 DOI: 10.3390/diagnostics12123124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/24/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
Unilateral vocal fold paralysis (UVFP) causes glottal incompetence and poor vocal efficiency. The influence of laryngeal neuromuscular control on aerodynamics in UVFP remains unclear. This study investigated the relationship between laryngeal muscle activities using quantitative laryngeal electromyography (LEMG) and aerodynamics in UVFP. This prospective study recruited patients with UVFP, and the diagnosis was confirmed with videolaryngostroboscopy and LEMG. The patient received aerodynamic assessment and LEMG of the thyroarytenoid-lateral cricoarytenoid (TA-LCA) muscle complex and the cricothyroid (CT) muscle. The relationship between quantitative LEMG and aerodynamic parameters was analyzed. A total of 134 UVFP patients without concurrent CT muscle involvement were enrolled. Compared with the normal side, the peak turn frequency of the lesioned side was lower in the TA-LCA (p < 0.001) and CT (p = 0.048) muscles. Stepwise linear regression revealed that the turn ratio of TA-LCA muscles was a robust factor in the decrease in peak expiratory airflow (β = −0.34, p = 0.036), mean airflow during voicing (β = −0.28, p = 0.014), and aerodynamic power (β = −0.42, p = 0.019), and an increase in aerodynamic efficiency (β = 27.91, p = 0.012). In addition, the turn ratio of CT muscles was a potent factor in inducing an increase in aerodynamic resistance (β = 14.93, p = 0.029). UVFP without CT involvement still showed suppression of CT muscles on the lesioned side, suggesting that neurological impairment of the TA-LCA complex could cause asymmetrical compensation of CT muscles, further impeding aerodynamics. The residual function of TA-LCA muscle complexes facilitates less air leakage and power dissipation, enhancing aerodynamic efficiency. On the other hand, the symmetrical compensation of the CT muscles improves aerodynamic resistance.
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15
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Westermann B, Lotze M, Varra L, Versteeg N, Domin M, Nicolet L, Obrist M, Klepzig K, Marbot L, Lämmler L, Fiedler K, Wattendorf E. When laughter arrests speech: fMRI-based evidence. Philos Trans R Soc Lond B Biol Sci 2022; 377:20210182. [PMID: 36126674 PMCID: PMC9489293 DOI: 10.1098/rstb.2021.0182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Who has not experienced that sensation of losing the power of speech owing to an involuntary bout of laughter? An investigation of this phenomenon affords an insight into the neuronal processes that underlie laughter. In our functional magnetic resonance imaging study, participants were made to laugh by tickling in a first condition; in a second one they were requested to produce vocal utterances under the provocation of laughter by tickling. This investigation reveals increased neuronal activity in the sensorimotor cortex, the anterior cingulate gyrus, the insula, the nucleus accumbens, the hypothalamus and the periaqueductal grey for both conditions, thereby replicating the results of previous studies on ticklish laughter. However, further analysis indicates the activity in the emotion-associated regions to be lower when tickling is accompanied by voluntary vocalization. Here, a typical pattern of activation is identified, including the primary sensory cortex, a ventral area of the anterior insula and the ventral tegmental field, to which belongs to the nucleus ambiguus, namely, the common effector organ for voluntary and involuntary vocalizations. During the conflictual voluntary-vocalization versus laughter experience, the laughter-triggering network appears to rely heavily on a sensory and a deep interoceptive analysis, as well as on motor effectors in the brainstem. This article is part of the theme issue ‘Cracking the laugh code: laughter through the lens of biology, psychology and neuroscience’.
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Affiliation(s)
- B Westermann
- Department of Neurosurgery, University Hospital Basel, Basel, Switzerland
| | - M Lotze
- Faculty of Medicine, University of Greifswald, Greifswald, Germany
| | - L Varra
- Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - N Versteeg
- Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - M Domin
- Faculty of Medicine, University of Greifswald, Greifswald, Germany
| | - L Nicolet
- College of Health Sciences Fribourg, Fribourg, Switzerland
| | - M Obrist
- College of Health Sciences Fribourg, Fribourg, Switzerland
| | - K Klepzig
- College of Health Sciences Fribourg, Fribourg, Switzerland
| | - L Marbot
- Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - L Lämmler
- Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - K Fiedler
- Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - E Wattendorf
- Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland.,College of Health Sciences Fribourg, Fribourg, Switzerland
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16
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Tindell RK, McPhail MJ, Myers CE, Neubauer J, Hintze JM, Lott DG, Holloway JL. Trilayered Hydrogel Scaffold for Vocal Fold Tissue Engineering. Biomacromolecules 2022; 23:4469-4480. [DOI: 10.1021/acs.biomac.1c01149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- R. Kevin Tindell
- Chemical Engineering; School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
| | - Michael J. McPhail
- Head and Neck Regenerative Medicine Laboratory, Mayo Clinic Arizona, Scottsdale, Arizona 85259-5499, United States
| | - Cheryl E. Myers
- Head and Neck Regenerative Medicine Laboratory, Mayo Clinic Arizona, Scottsdale, Arizona 85259-5499, United States
| | - Juergen Neubauer
- Head and Neck Regenerative Medicine Laboratory, Mayo Clinic Arizona, Scottsdale, Arizona 85259-5499, United States
| | - Justin M. Hintze
- Head and Neck Regenerative Medicine Laboratory, Mayo Clinic Arizona, Scottsdale, Arizona 85259-5499, United States
| | - David G. Lott
- Head and Neck Regenerative Medicine Laboratory, Mayo Clinic Arizona, Scottsdale, Arizona 85259-5499, United States
- Division of Laryngology, Mayo Clinic Arizona, Phoenix, Arizona 85054, United States
| | - Julianne L. Holloway
- Chemical Engineering; School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
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17
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Baertsch HC, Bhatt NK, Giliberto JP, Dixon C, Merati AL, Sauder C. Quantification of Vocal Fold Atrophy in Age‐Related and Parkinson's Disease‐Related Vocal Atrophy. Laryngoscope 2022; 133:1462-1469. [PMID: 36111826 DOI: 10.1002/lary.30394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/07/2022] [Accepted: 08/18/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Vocal fold atrophy (VFA) is associated with aging and Parkinson's disease (PD). Clinical diagnosis of VFA depends on several visual-perceptual laryngostroboscopy findings that are inherently subjective. The purpose of this study was to use quantitative measurements to; (1) examine the relationships between VFA and dysphonia severity and (2) evaluate differences in VFA in patients with age-related VFA versus PD. METHODS Thirty-six patients >60 years of age with VFA were included in this retrospective cohort study. Demographic information, medical history, Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V), Voice Handicap Index-10 (VHI-10), and still images from the stroboscopic exam were obtained. Image J™ was used to measure VFA, including bowing index (BI), normalized glottal gap area, and normalized mucosal wave amplitude. Pearson's correlation was used to evaluate the relationship between VFA, CAPE-V, and VHI-10. t-Tests and multivariate linear regression were used to compare VFA measures by dysphonia severity (CAPE-V <30 vs. >30) and diagnosis (age-related vocal atrophy [ARVA] and PD). RESULTS BI was positively correlated with CAPE-V. Patients with CAPE-V >30 had a significantly larger BI compared to those with CAPE-V <30. Patients with PD had significantly larger BI than those with ARVA. Diagnosis of PD also predicted a larger BI after controlling for age and CAPE-V. CONCLUSION Quantitative measures supported an association between bowing severity and dysphonia severity in patients with PD and ARVA. A PD diagnosis significantly predicted more severe BI. These findings demonstrate the potential utility of BI. Quantitative VFA measures might also provide insight into the mechanisms of ARVA and dysphonia. LEVEL OF EVIDENCE 3 Laryngoscope, 133:1462-1469, 2023.
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Affiliation(s)
- Hans C. Baertsch
- Keck School of Medicine University of Southern California Los Angeles California U.S.A
| | - Neel K. Bhatt
- Division of Laryngology, Department Otolaryngology Head and Neck Surgery University of Washington Seattle Washington U.S.A
| | - John P. Giliberto
- Division of Laryngology, Department Otolaryngology Head and Neck Surgery University of Washington Seattle Washington U.S.A
| | - Connor Dixon
- Elson S Floyd College of Medicine Washington State University Spokane Washington U.S.A
| | - Albert L. Merati
- Division of Laryngology, Department Otolaryngology Head and Neck Surgery University of Washington Seattle Washington U.S.A
| | - Cara Sauder
- Division of Laryngology, Department Otolaryngology Head and Neck Surgery University of Washington Seattle Washington U.S.A
- Speech and Hearing Sciences University of Washington Seattle Washington U.S.A
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18
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Schlegel P, Berry DA, Chhetri DK. Analysis of vibratory mode changes in symmetric and asymmetric activation of the canine larynx. PLoS One 2022; 17:e0266910. [PMID: 35421159 PMCID: PMC9009716 DOI: 10.1371/journal.pone.0266910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 03/29/2022] [Indexed: 12/02/2022] Open
Abstract
Investigations of neuromuscular control of voice production have primarily focused on the roles of muscle activation levels, posture, and stiffness at phonation onset. However, little work has been done investigating the stability of the phonation process in regards to spontaneous changes in vibratory mode of vocal fold oscillation as a function of neuromuscular activation. We evaluated 320 phonatory conditions representing combinations of superior and recurrent laryngeal nerve (SLN and RLN) activations in an in vivo canine model of phonation. At each combination of neuromuscular input, airflow was increased linearly to reach phonation onset and beyond from 300 to 1400 mL/s. High-speed video and acoustic data were recorded during phonation, and spectrograms and glottal-area-based parameters were calculated. Vibratory mode changes were detected based on sudden increases or drops of local fundamental frequency. Mode changes occurred only when SLNs were concurrently stimulated and were more frequent for higher, less asymmetric RLN stimulation. A slight increase in amplitude and cycle length perturbation usually preceded the changes in the vibratory mode. However, no inherent differences between signals with mode changes and signals without were found.
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Affiliation(s)
- Patrick Schlegel
- Department of Head & Neck Surgery, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, United States of America
- * E-mail:
| | - David A. Berry
- Department of Head & Neck Surgery, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, United States of America
| | - Dinesh K. Chhetri
- Department of Head & Neck Surgery, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, United States of America
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19
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Håkansson J, Jiang W, Xue Q, Zheng X, Ding M, Agarwal AA, Elemans CPH. Aerodynamics and motor control of ultrasonic vocalizations for social communication in mice and rats. BMC Biol 2022; 20:3. [PMID: 34996429 PMCID: PMC8742360 DOI: 10.1186/s12915-021-01185-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 11/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rodent ultrasonic vocalizations (USVs) are crucial to their social communication and a widely used translational tool for linking gene mutations to behavior. To maximize the causal interpretation of experimental treatments, we need to understand how neural control affects USV production. However, both the aerodynamics of USV production and its neural control remain poorly understood. RESULTS Here, we test three intralaryngeal whistle mechanisms-the wall and alar edge impingement, and shallow cavity tone-by combining in vitro larynx physiology and individual-based 3D airway reconstructions with fluid dynamics simulations. Our results show that in the mouse and rat larynx, USVs are produced by a glottal jet impinging on the thyroid inner wall. Furthermore, we implemented an empirically based motor control model that predicts motor gesture trajectories of USV call types. CONCLUSIONS Our results identify wall impingement as the aerodynamic mechanism of USV production in rats and mice. Furthermore, our empirically based motor control model shows that both neural and anatomical components contribute to USV production, which suggests that changes in strain specific USVs or USV changes in disease models can result from both altered motor programs and laryngeal geometry. Our work provides a quantitative neuromechanical framework to evaluate the contributions of brain and body in shaping USVs and a first step in linking descending motor control to USV production.
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Affiliation(s)
- Jonas Håkansson
- Department of Biology, University of Southern Denmark, 5230, Odense M, Denmark
| | - Weili Jiang
- Department of Mechanical Engineering, University of Maine, Orono, ME, 04469, USA
| | - Qian Xue
- Department of Mechanical Engineering, University of Maine, Orono, ME, 04469, USA
| | - Xudong Zheng
- Department of Mechanical Engineering, University of Maine, Orono, ME, 04469, USA
| | - Ming Ding
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, 5000, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, 5000, Odense C, Denmark
| | - Anurag A Agarwal
- Department of Engineering, University of Cambridge, Cambridge, CB2 1TN, UK
| | - Coen P H Elemans
- Department of Biology, University of Southern Denmark, 5230, Odense M, Denmark.
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20
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Alzamendi GA, Peterson SD, Erath BD, Hillman RE, Zañartu M. Triangular body-cover model of the vocal folds with coordinated activation of the five intrinsic laryngeal muscles. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 151:17. [PMID: 35105008 PMCID: PMC8727069 DOI: 10.1121/10.0009169] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 11/24/2021] [Accepted: 12/06/2021] [Indexed: 05/26/2023]
Abstract
Poor laryngeal muscle coordination that results in abnormal glottal posturing is believed to be a primary etiologic factor in common voice disorders such as non-phonotraumatic vocal hyperfunction. Abnormal activity of antagonistic laryngeal muscles is hypothesized to play a key role in the alteration of normal vocal fold biomechanics that results in the dysphonia associated with such disorders. Current low-order models of the vocal folds are unsatisfactory to test this hypothesis since they do not capture the co-contraction of antagonist laryngeal muscle pairs. To address this limitation, a self-sustained triangular body-cover model with full intrinsic muscle control is introduced. The proposed scheme shows good agreement with prior studies using finite element models, excised larynges, and clinical studies in sustained and time-varying vocal gestures. Simulations of vocal fold posturing obtained with distinct antagonistic muscle activation yield clear differences in kinematic, aerodynamic, and acoustic measures. The proposed tool is deemed sufficiently accurate and flexible for future comprehensive investigations of non-phonotraumatic vocal hyperfunction and other laryngeal motor control disorders.
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Affiliation(s)
- Gabriel A Alzamendi
- Institute for Research and Development on Bioengineering and Bioinformatics (IBB), CONICET-UNER, Oro Verde, Entre Ríos 3100, Argentina
| | - Sean D Peterson
- Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Byron D Erath
- Department of Mechanical and Aerospace Engineering, Clarkson University, Potsdam, New York 13699, USA
| | - Robert E Hillman
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
| | - Matías Zañartu
- Department of Electronic Engineering, Universidad Técnica Federico Santa María, Valparaíso 2390123, Chile
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21
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Pillutla P, Zhang Z, Kreiman J, Wilhalme H, Chhetri DK. Effects of Laryngeal Vibratory Asymmetry and Neuromuscular Compensation on Voice Quality. Laryngoscope 2022; 132:130-134. [PMID: 34216152 PMCID: PMC8671147 DOI: 10.1002/lary.29724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/02/2021] [Accepted: 06/23/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Vibratory asymmetry and neuromuscular compensation are often seen in laryngeal neuromuscular pathology. However, the ramifications of these findings on voice quality are unclear. This study investigated the effects of varying levels of vibratory asymmetry and neuromuscular compensation on cepstral peak prominence (CPP), an analog of voice quality. STUDY DESIGN In vivo canine phonation model. METHODS Varying degrees of vocal fold vibratory asymmetry were achieved by stimulating one recurrent laryngeal nerve (RLN) over 11 levels from threshold to maximal muscle activation. For each of these levels, phonation was induced at systematically varied combinations of neuromuscular compensation: three levels each of contralateral RLN stimulation (80%, 90%, and 100% of maximal), superior laryngeal nerve (SLN) activation (0%, 50%, and 100% of maximal), and airflow levels (500, 700, and 900 mL/s). Vocal fold symmetry was determined by assessing the opening phase of the vibratory cycle in high-speed video recordings. Voice quality was estimated acoustically by calculating CPP for each voice sample. RESULTS Eight hundred twenty-two phonatory conditions with varying degrees of vibratory asymmetry were evaluated. CPP was highest at vibratory symmetry. Increasing levels of asymmetry resulted in significant decreases in CPP. CPP increased significantly with increasing contralateral RLN activation. CPP was significantly higher at 50% SLN activation than 0% or 100% SLN activation. CONCLUSION Voice quality, as approximated by CPP, is best at vibratory symmetry and deteriorates with increasing degrees of asymmetry. Voice quality may be improved with neuromuscular compensation by increased adduction of the contralateral vocal fold or increased vocal fold tension at mid-levels of SLN activation. LEVEL OF EVIDENCE NA, Basic Science Laryngoscope, 132:130-134, 2022.
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Affiliation(s)
- Pranati Pillutla
- Department of Head and Neck Surgery, University of California, Los Angeles; Los Angeles, CA
| | - Zhaoyan Zhang
- Department of Head and Neck Surgery, University of California, Los Angeles; Los Angeles, CA
| | - Jody Kreiman
- Department of Head and Neck Surgery, University of California, Los Angeles; Los Angeles, CA.,Department of Linguistics, University of California, Los Angeles; Los Angeles, CA
| | - Holly Wilhalme
- Department of Medicine, Statistics Core, University of California, Los Angeles; Los Angeles, CA
| | - Dinesh K. Chhetri
- Department of Head and Neck Surgery, University of California, Los Angeles; Los Angeles, CA
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22
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Azar SS, Chhetri DK. Phonation Threshold Pressure Revisited: Effects of Intrinsic Laryngeal Muscle Activation. Laryngoscope 2021; 132:1427-1432. [PMID: 34784055 DOI: 10.1002/lary.29944] [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: 06/08/2021] [Revised: 10/29/2021] [Accepted: 11/05/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Phonation threshold pressure (Pth ) is the minimum subglottic pressure required to reach phonation onset and is considered a marker for vocal efficiency and health. We investigated the effects of intrinsic laryngeal muscle (ILM) activation on Pth . STUDY DESIGN In vivo animal study. METHODS In an in vivo canine phonation model, laryngeal adductor muscles were activated together by stimulation of the recurrent laryngeal nerves (RLNs) and individually via stimulation of respective terminal nerve branches. Cricothyroid (CT) muscles were activated via stimulation of the superior laryngeal nerves. ILMs were activated in a graded manner at various combinations as transglottal airflow was gradually increased. Aerodynamic and glottal posture parameters were measured at phonation onset. RESULTS Graded RLN stimulation decreased glottal distance and increased Pth . Thyroarytenoid (TA) muscle activation alone increased Pth . Lateral cricoarytenoid (LCA) muscle activation alone had minimal effects. However, graded TA activation as a function of LCA activation level revealed a synergistic relationship between the two muscles in increasing Pth . Effects of CT activation were dependent on adductor stimulation level: CT activation increased Pth at low RLN stimulation levels and decreased Pth at high RLN levels. CONCLUSIONS The effects of ILM activation on Pth were consistent with their expected effects on vocal fold stiffness and tension. TA was the primary adductor controlling Pth . While LCA alone had minimal effects on Pth , it enhanced the role of TA in controlling Pth . TA and CT have antagonistic roles in controlling Pth . These relationships should be considered in clinical efforts to improve ease of phonation and vocal efficiency. LEVEL OF EVIDENCE N/A, basic science Laryngoscope, 2021.
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Affiliation(s)
- Shaghauyegh S Azar
- Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Dinesh K Chhetri
- Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
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23
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Geng B, Movahhedi M, Xue Q, Zheng X. Vocal fold vibration mode changes due to cricothyroid and thyroarytenoid muscle interaction in a three-dimensional model of the canine larynx. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 150:1176. [PMID: 34470336 DOI: 10.1121/10.0005883] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 07/26/2021] [Indexed: 06/13/2023]
Abstract
Using a continuum model based on magnetic resonance imaging of a canine larynx, parametric simulations of the vocal fold vibration during phonation were conducted with the cricothyroid muscle (CT) and the thyroarytenoid muscle (TA) independently activated from zero to full activation. The fundamental frequency (f0) first increased and then experienced a downward jump as TA activity gradually increased under moderate to high CT activation. Proper orthogonal decomposition analysis revealed that the vocal fold vibrations were dominated by two modes representing a lateral motion and rotational motion, respectively, and the f0 drop was associated with a switch on the order of the two modes. In another parametric set where only the vocalis was active, f0 increased monotonically with both TA and CT activity and the mode switch did not occur. The results suggested that the active stress in the TA, which causes large stress differences between the body and cover, is essential for the occurrence of the rotational mode and mode switch. Relatively greater TA activity tends to promote the rotational mode, while relatively greater CT activity tends to promote the lateral mode. The results also suggested that the vibration modes affected f0 by affecting the contribution of the TA stress to the effective stiffness. The switch in the dominant mode caused the non-monotonic change of f0.
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Affiliation(s)
- 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
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Movahhedi M, Geng B, Xue Q, Zheng X. Effects of cricothyroid and thyroarytenoid interaction on voice control: Muscle activity, vocal fold biomechanics, flow, and acoustics. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 150:29. [PMID: 34340476 DOI: 10.1121/10.0005275] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 05/21/2021] [Indexed: 06/13/2023]
Abstract
An MRI-based three-dimensional computer model of a canine larynx was used to investigate the effect of cricothyroid (CT) and thyroarytenoid (TA) muscle activity on vocal fold pre-phonatory posturing and glottic dynamics during voice production. Static vocal fold posturing in the full activation space of CT and TA muscles was first simulated using a laryngeal muscle mechanics model; dynamic flow-structure-acoustics interaction (FSAI) simulations were then performed to predict glottal flow and voice acoustics. The results revealed that TA activation decreased the length and increased the bulging, height, and contact area of the vocal fold. CT activation increased the length and contact area and decreased the height of the vocal fold. Both CT and TA activations increased the vocal fold stress, stiffness, and closure quotient; and only slightly affected the flow rate and voice intensity. Furthermore, CT and TA showed a complex control mechanism on the fundamental frequency pattern, which highly correlated with a combination of the stress, stiffness, and stretch of the vocal fold.
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Affiliation(s)
| | - 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
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Park Y, Wang F, Díaz-Cádiz M, Vojtech JM, Groll MD, Stepp CE. Vocal fold kinematics and relative fundamental frequency as a function of obstruent type and speaker age. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 149:2189. [PMID: 33940922 PMCID: PMC8018794 DOI: 10.1121/10.0003961] [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: 05/16/2020] [Revised: 03/02/2021] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Abstract
The acoustic measure, relative fundamental frequency (RFF), has been proposed as an objective metric for assessing vocal hyperfunction; however, its underlying physiological mechanisms have not yet been fully characterized. This study aimed to characterize the relationship between RFF and vocal fold kinematics. Simultaneous acoustic and high-speed videoendoscopic (HSV) recordings were collected as younger and older speakers repeated the utterances /ifi/ and /iti/. RFF values at voicing offsets and onsets surrounding the obstruents were estimated from acoustic recordings, whereas glottal angles, durations of voicing offset and onset, and a kinematic estimate of laryngeal stiffness (KS) were obtained from HSV images. No differences were found between younger and older speakers for any measure. RFF did not differ between the two obstruents at voicing offset; however, fricatives necessitated larger glottal angles and longer durations to devoice. RFF values were lower and glottal angles were greater for stops relative to fricatives at voicing onset. KS values were greater in stops relative to fricatives. The less adducted vocal folds with greater KS and lower RFF at voicing onset for stops relative to fricatives in this study were in accordance with prior speculations that decreased vocal fold contact area and increased laryngeal stiffness may decrease RFF.
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Affiliation(s)
- Yeonggwang Park
- Department of Speech, Language, and Hearing Sciences, Boston University, 635 Commonwealth Avenue, Boston, Massachusetts 02215, USA
| | - Feng Wang
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, Massachusetts 02215, USA
| | - Manuel Díaz-Cádiz
- Department of Speech, Language, and Hearing Sciences, Boston University, 635 Commonwealth Avenue, Boston, Massachusetts 02215, USA
| | - Jennifer M Vojtech
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, Massachusetts 02215, USA
| | - Matti D Groll
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, Massachusetts 02215, USA
| | - Cara E Stepp
- Department of Speech, Language, and Hearing Sciences, Boston University, 635 Commonwealth Avenue, Boston, Massachusetts 02215, USA
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Zhao EE, Nguyen SA, Salvador CD, O'Rourke AK. A Meta-Analysis of the Association Between the Voice Handicap Index and Objective Voice Analysis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:3461-3471. [PMID: 32955998 DOI: 10.1044/2020_jslhr-20-00209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose Dysphonia can be evaluated by both patient-reported quality of life instruments and objective acoustic and aerodynamic analyses. However, less is known about the association between the two metrics. The goal of this study was to perform a meta-analysis of the correlation of the Voice Handicap Index (VHI-30) with the following objective parameters: fundamental frequency, jitter, shimmer, harmonics to noise ratio, noise to harmonic ratio, maximum phonation time, and the Dysphonia Severity Index. Method A literature search was performed in the PubMed, Scopus, and Cumulative Index of Nursing and Allied Health Literature databases. Inclusion criteria were subjects age 18 years and older with voice complaints and assessed by both VHI-30 and objective voice analysis. Results A literature search resulted in 1,297 unique articles, of which 310 underwent full-text review and 17 studies were included in quantitative analysis. Significant pooled correlation was observed for VHI-30 total with jitter (.301 [.177; .416]), shimmer (.255 [.162; .344]), noise to harmonic ratio (.200 [.111; .285]), maximum phonation time (-.227 [-.352; -.094]), and Dysphonia Severity Index (-.254[-.455; -.0286]). Significant correlations were observed in 4/7 objective parameters with the Physical subscale, 3/7 with the Functional subscale, and 2/7 with the Emotional subscale. All significant correlations were negligible (0-.3) or low (.3-.5). Conclusions Results from meta-analysis showed that correlations between objective voice parameters and the VHI-30 were negligible or low. Further study is needed to determine if correlations vary by patient demographics or specific pathology.
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Affiliation(s)
- Elise E Zhao
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Craig D Salvador
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Ashli K O'Rourke
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
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Zhang Z. Laryngeal strategies to minimize vocal fold contact pressure and their effect on voice production. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2020; 148:1039. [PMID: 32873018 PMCID: PMC7455307 DOI: 10.1121/10.0001796] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The goal of this study is to identify laryngeal strategies that minimize vocal fold contact pressure while producing a target sound pressure level (SPL) using a three-dimensional voice production model. The results show that while the subglottal pressure and transverse stiffness can be manipulated to reduce the peak contact pressure, such manipulations also reduce the SPL, and are thus less effective in reducing contact pressure in voice tasks targeting a specific SPL level. In contrast, changes in the initial glottal angle and vocal fold vertical thickness that reduce the contact pressure also increase the SPL. Thus, in voice tasks targeting a specific SPL, such changes in the initial glottal angle and vertical thickness also lower the subglottal pressure, which further reduces the peak contact pressure. Overall the results show that for voice tasks with a target SPL level, vocal fold contact pressure can be significantly reduced by adopting a barely abducted glottal configuration or reducing the vocal fold vertical thickness. Aerodynamic measures are effective in identifying voice production with large initial glottal angles, but by themselves alone are not useful in differentiating hyperadducted vocal folds from barely abducted vocal folds, which may be better differentiated by closed quotient and voice type measures.
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Affiliation(s)
- Zhaoyan Zhang
- Department of Head and Neck surgery, University of California, Los Angeles, 31-24 Rehabilitation Center, 1000 Veteran Avenue, Los Angeles, California 90095-1794, USA
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Pillutla P, Zhang Z, Chhetri DK. Effects of Arytenoid Adduction Suture Position on Voice Production and Quality. Laryngoscope 2020; 131:846-852. [PMID: 32710654 DOI: 10.1002/lary.28903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/17/2020] [Accepted: 06/09/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS Arytenoid adduction (AA) is performed to treat unilateral vocal fold paralysis with a large posterior glottal gap. However, the voice effects of AA suture position remain unclear. This study aimed to evaluate voice production and quality as a function of AA suture position on the thyroid ala in a neuromuscularly intact in vivo larynx. STUDY DESIGN Animal model. METHODS Unilateral recurrent laryngeal nerve and vagal paralysis were modeled in two canines. AA suture position was varied across five equidistant positions on the anterior inferior thyroid ala, from a paramedian position anteriorly to the oblique line posteriorly. Phonation was performed over 8 × 8 graded level combinations of recurrent and superior laryngeal nerve stimulation per suture position. The primary outcome was percent successful phonatory conditions. Secondary outcomes included fundamental frequency (F0), phonation onset pressure (PTP), cepstral peak prominence (CPP), and laryngeal posture. RESULTS Anterior suture positions resulted in a greater percentage of successful phonatory conditions compared to posterior sutures. Suture position 2, located at the anterior inferior thyroid ala, resulted in the highest percentage of successful phonatory conditions, lowest PTP, and lower muscle activation levels to achieve higher CPP. Posterior sutures resulted in wider glottal gap and more effective F0 and vocal fold strain increase with cricothyroid muscle contraction, but with fewer successful phonatory conditions and higher PTP. Trends were consistent across both paralysis types. CONCLUSIONS AA suture placed in the anterior inferior thyroid ala resulted in the best acoustic, aerodynamic, and voice quality outcomes. This study provides scientific evidence for maintaining current clinical practice. LEVEL OF EVIDENCE NA Laryngoscope, 131:846-852, 2021.
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Affiliation(s)
- Pranati Pillutla
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, U.S.A
| | - Zhaoyan Zhang
- Department of Head and Neck Surgery, University of California, Los Angeles, California, U.S.A
| | - Dinesh K Chhetri
- Department of Head and Neck Surgery, University of California, Los Angeles, California, U.S.A
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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.
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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
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High-fidelity continuum modeling predicts avian voiced sound production. Proc Natl Acad Sci U S A 2020; 117:4718-4723. [PMID: 32054784 DOI: 10.1073/pnas.1922147117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Voiced sound production is the primary form of acoustic communication in terrestrial vertebrates, particularly birds and mammals, including humans. Developing a causal physics-based model that ultimately links descending vocal motor control to tissue vibration and sound requires embodied approaches that include realistic representations of voice physiology. Here, we first implement and then experimentally test a high-fidelity three-dimensional (3D) continuum model for voiced sound production in birds. Driven by individual-based physiologically quantifiable inputs, combined with noninvasive inverse methods for tissue material parameterization, our model accurately predicts observed key vibratory and acoustic performance traits. These results demonstrate that realistic models lead to accurate predictions and support the continuum model approach as a critical tool toward a causal model of voiced sound production.
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Wu L, Zhang Z. Voice production in a MRI-based subject-specific vocal fold model with parametrically controlled medial surface shape. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 146:4190. [PMID: 31893687 PMCID: PMC6901357 DOI: 10.1121/1.5134784] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/24/2019] [Accepted: 10/30/2019] [Indexed: 05/18/2023]
Abstract
The goal of this study was to investigate how realistic changes in medial surface shape, as occur in human phonation, affect voice production. In a parametric magnetic resonance imaging-based three-dimensional vocal fold model, the superior and inferior portions of the medial surface were systematically manipulated to produce different medial surface contours similar to those observed in previous excised larynx and in vivo canine larynx experiments. Voice simulations were performed to investigate the differences in the resulting voice production. The results showed that both superior-medial bulging and inferior-medial bulging of the medial surface, which led to an increased vertical thickness and a more rectangular glottal configuration, increased the closed quotient of vocal fold vibration. Changes in medial surface shape also had significant effects on the phonation threshold pressure. The degree of these effects of changes in medial surface shape was larynx specific, and varied significantly depending on the vocal fold cross-sectional geometry and its variation along the anterior-posterior direction. The results suggest that, in addition to vocal fold approximation, surgical interventions of voice disorders should also aim at restoring a rectangular and sufficiently thick medial surface.
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Affiliation(s)
- Liang Wu
- Department of Head and Neck Surgery, University of California, Los Angeles (UCLA), 31-24 Rehabilitation Center, 1000 Veteran Avenue, Los Angeles, California 90095-1794, USA
| | - Zhaoyan Zhang
- Department of Head and Neck Surgery, University of California, Los Angeles (UCLA), 31-24 Rehabilitation Center, 1000 Veteran Avenue, Los Angeles, California 90095-1794, USA
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Palaparthi A, Smith S, Titze IR. Mapping Thyroarytenoid and Cricothyroid Activations to Postural and Acoustic Features in a Fiber-Gel Model of the Vocal Folds. APPLIED SCIENCES (BASEL, SWITZERLAND) 2019; 9:4671. [PMID: 35265343 PMCID: PMC8903205 DOI: 10.3390/app9214671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Any specific vowel sound that humans produce can be represented in terms of four perceptual features in addition to the vowel category. They are pitch, loudness, brightness, and roughness. Corresponding acoustic features chosen here are fundamental frequency (fo ), sound pressure level (SPL), normalized spectral centroid (NSC), and approximate entropy (ApEn). In this study, thyroarytenoid (TA) and cricothyroid (CT) activations were varied computationally to study their relationship with these four specific acoustic features. Additionally, postural and material property variables such as vocal fold length (L) and fiber stress (σ) in the three vocal fold tissue layers were also calculated. A fiber-gel finite element model developed at National Center for Voice and Speech was used for this purpose. Muscle activation plots were generated to obtain the dependency of postural and acoustic features on TA and CT muscle activations. These relationships were compared against data obtained from previous in vivo human larynx studies and from canine laryngeal studies. General trends are that fo and SPL increase with CT activation, while NSC decreases when CT activation is raised above 20%. With TA activation, acoustic features have no uniform trends, except SPL increases uniformly with TA if there is a co-variation with CT activation. Trends for postural variables and material properties are also discussed in terms of activation levels.
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Affiliation(s)
- Anil Palaparthi
- National Center for Voice and Speech, The University of Utah, 1901 S Campus Dr, Suite 2120, Salt Lake City, UT 84112, USA
- Department of Bioengineering, The University of Utah, Salt Lake City, UT 84112, USA
| | - Simeon Smith
- National Center for Voice and Speech, The University of Utah, 1901 S Campus Dr, Suite 2120, Salt Lake City, UT 84112, USA
| | - Ingo R. Titze
- National Center for Voice and Speech, The University of Utah, 1901 S Campus Dr, Suite 2120, Salt Lake City, UT 84112, USA
- Department of Bioengineering, The University of Utah, Salt Lake City, UT 84112, USA
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Mavrea S, Regan J. The Diagnostic Accuracy of the Pitch Glide to Identify Aspiration in Patients with Respiratory Diseases: A Pilot Study. Folia Phoniatr Logop 2019; 72:331-340. [PMID: 31514185 DOI: 10.1159/000501451] [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: 01/14/2019] [Accepted: 06/11/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Initial research has been conducted to determine the diagnostic accuracy of the pitch glide during the clinical swallow evaluation to identify aspiration in adults after stroke. Findings suggest that reduced pitch glide can predict aspiration in patients with dysphagia after stroke. This study aimed to identify the diagnostic accuracy of the pitch glide in detecting aspiration, pharyngeal residue and hyo-laryngeal excursion during swallowing in adults with respiratory diseases. MATERIAL AND METHODS 17 adults (9 males and 8 females) with dysphagia who had a background of respiratory diseases (chronic obstructive pulmonary disease = 11; lower respiratory tract infection = 6) were consecutively recruited in an acute hospital setting. Participants completed two pitch glide tasks (/a/ and /i/) immediately before a videofluoroscopic swallowing study (VFSS). Pitch glide recordings were analysed by blinded researchers both acoustically (Praat software) to obtain maximum F0, pitch range and auditory-perceptually using a binary scale ("normal" or "abnormal"). Clinicians blinded to pitch glide ratings rated 5 mL, 10 mL and a sip of liquid swallows during VFSS using the Penetration-Aspiration Scale, Bolus Residue Scale and hyolaryngeal component of the MBS Measurement Tool for Swallow Impairment. Receiver operating characteristic curve, Pearson correlations and independent sample t tests were used to address the research questions. RESULTS Maximum F0 of sound /a/ had high sensitivity and specificity in identifying aspiration on 10 mL of liquids during VFSS. Both pitch glides (/a/ and /i/) had moderate sensitivity and specificity in predicting aspiration on a sip of liquids. However, auditory-perceptual measures of pitch glide had weak accuracy in identifying people who were aspirating during VFSS. Finally, all pitch glide measures (acoustic and auditory-perceptual) had low accuracy in predicting pharyngeal residue and hyolaryngeal excursion. CONCLUSION Based on this initial pilot study, acoustic pitch glide of sound /a/ is an accurate way to predict aspiration on 10 mL of liquids in patients with respiratory diseases. Based on findings from this study, both auditory-perceptual and acoustic analyses of pitch glide could not identify residue and hyolaryngeal excursion.
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Affiliation(s)
- Sofia Mavrea
- Department of Clinical Speech and Language Studies,Trinity College Dublin, Dublin, Ireland,
| | - Julie Regan
- Department of Clinical Speech and Language Studies,Trinity College Dublin, Dublin, Ireland
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Ning LH. The effects of age and pitch level on electroglottographic measures during sustained phonation. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 146:640. [PMID: 31370629 DOI: 10.1121/1.5119127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/03/2019] [Indexed: 06/10/2023]
Abstract
The aim of the present study was to use electroglottography (EGG) to explore the effects of age and pitch level on sustained vowel phonation. Thirty female individuals (10 young, 10 middle-aged, and 10 older speakers) without voice disorders or training in singing participated in this study. Eight EGG parameters were measured during sustained vowel production with a high, mid, or low pitch: fundamental frequency, contact quotient, contacting-time quotient, decontacting-time quotient, speed quotient with a midslope criterion (SQ-mid), jitter, shimmer, and the harmonics-to-noise ratio. Age was found to be a significant factor in fundamental frequency, contact quotient, contacting-time quotient, decontacting-time quotient, and SQ-mid. With increasing age, the mean fundamental frequency decreased while the contact quotient increased. The middle-aged and older speakers had more asymmetrical vocal fold vibratory patterns than the young speakers. As for pitch level, the high pitch had a significantly less decontacting-time quotient and greater SQ-mid than low and mid pitches. The lack of significant interaction between age and pitch level indicates that the effects of age and pitch level could be additive. Finally, the discriminant analyses show that contact quotient is an important factor in predicting the age of a voice.
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Affiliation(s)
- Li-Hsin Ning
- Department of English, National Taiwan Normal University, 162 Heping East Road, Daan District, Taipei City 106, Taiwan
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Manríquez R, Peterson SD, Prado P, Orio P, Galindo GE, Zañartu M. Neurophysiological Muscle Activation Scheme for Controlling Vocal Fold Models. IEEE Trans Neural Syst Rehabil Eng 2019; 27:1043-1052. [PMID: 30908260 PMCID: PMC6557719 DOI: 10.1109/tnsre.2019.2906030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A physiologically-based scheme that incorporates inherent neurological fluctuations in the activation of intrinsic laryngeal muscles into a lumped-element vocal fold model is proposed. Herein, muscles are activated through a combination of neural firing rate and recruitment of additional motor units, both of which have stochastic components. The mathematical framework and underlying physiological assumptions are described, and the effects of the fluctuations are tested via a parametric analysis using a body-cover model of the vocal folds for steady-state sustained vowels. The inherent muscle activation fluctuations have a bandwidth that varies with the firing rate, yielding both low and high-frequency components. When applying the proposed fluctuation scheme to the voice production model, changes in the dynamics of the system can be observed, ranging from fluctuations in the fundamental frequency to unstable behavior near bifurcation regions. The resulting coefficient of variation of the model parameters is not uniform with muscle activation. The stochastic components of muscle activation influence both the fine structure variability and the ability to achieve a target value for pitch control. These components can have a significant impact on the vocal fold parameters, as well as the outputs of the voice production model. Good agreement was found when contrasting the proposed scheme with prior experimental studies accounting for variability in vocal fold posturing and spectral characteristics of the muscle activation signal. The proposed scheme constitutes a novel and physiologically-based approach for controlling lumped-element models for normal voice production and can be extended to explore neuropathological conditions.
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Affiliation(s)
- Rodrigo Manríquez
- Department of Electronic Engineering, Universidad Técnica Federico Santa María, Valparaíso, Chile
| | - Sean D. Peterson
- Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Pavel Prado
- Department of Electronic Engineering, Universidad Técnica Federico Santa María, Valparaíso, Chile
| | - Patricio Orio
- Instituto de Neurociencia and Centro Interdisciplinario de Neurociencia de Valparaíso, Universidad de Valparaíso, Valparaíso, Chile
| | - Gabriel E. Galindo
- Department of Electronic Engineering, Universidad Técnica Federico Santa María, Valparaíso, Chile
| | - Matías Zañartu
- Department of Electronic Engineering, Universidad Técnica Federico Santa María, Valparaíso, Chile
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Pham N, Xue Q, Zheng X. Coupling between a fiber-reinforced model and a Hill-based contractile model for passive and active tissue properties of laryngeal muscles: A finite element study. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2018; 144:EL248. [PMID: 30424644 DOI: 10.1121/1.5055564] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 07/31/2018] [Indexed: 06/09/2023]
Abstract
In this work, a three-dimensional fiber-reinforced model was used to simulate passive stress response of vocal fold muscle tissue undergoing a series of isometric force measurement and a dynamic stretching. It was found that, with proper material constants, the fiber-reinforced model is able to reproduce literature data with acceptable deviation. A Hill-based contractile model was then coupled with the fiber-reinforced model to enable simulations of stretching-induced and activation-induced stress at the same time. For dynamic, concurrent tissue stimulation and stretching, the coupled model demonstrated a good agreement with past experimental data.
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Affiliation(s)
- 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 , ,
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Samlan RA, Kunduk M, Ikuma T, Black M, Lane C. Vocal Fold Vibration in Older Adults With and Without Age-Related Dysphonia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 27:1039-1050. [PMID: 29931255 DOI: 10.1044/2018_ajslp-17-0061] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 03/25/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE The purpose of this study was to identify the extent to which 7 measures of glottal area timing and regularity differ between older adults with and without age-related dysphonia (ARD). METHOD Laryngeal high-speed videoendoscopy was completed at 4,000 frames per second for 42 adults aged 70 years and older (ARD: 9 female, 5 male; control group: 15 female, 13 male). Relative glottal gap, open quotient, speed index, maximum area declination rate, harmonics-to-noise ratio, harmonic richness factor, and standard deviation of fundamental frequency were measured from a 0.5-s segment of the glottal area waveform. Eta squared (η2) was computed to estimate group effect. RESULTS Small effect sizes (η2 = .18-.35) were present for relative glottal gap, open quotient, maximum area declination rate, harmonic richness factor, and standard deviation of fundamental frequency. Speed index and glottal harmonics-to-noise ratio did not explain group membership (η2 = .001 and .05, respectively). CONCLUSION These findings provide evidence that vocal fold vibration in ARD is different than in normal aging, whereas the overlap in values for every measure is consistent with the concept that normal aging and ARD exist as a continuum of health and disease.
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Affiliation(s)
- Robin A Samlan
- Department of Speech, Language, & Hearing Sciences, University of Arizona, Tucson
- Department of Otolaryngology Head & Neck Surgery, University of Arizona College of Medicine, Tucson
| | - Melda Kunduk
- Department of Communication Sciences & Disorders, Louisiana State University, Baton Rouge
| | - Takeshi Ikuma
- Department of Otolaryngology-Head & Neck Surgery, Louisiana State University Health Sciences Center, New Orleans
| | - Mindy Black
- Department of Otolaryngology Head & Neck Surgery, University of Arizona College of Medicine, Tucson
| | - Christianne Lane
- Division of Biostatistics, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
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Ma Y, Wang R, Zhang Y, Le J, Zhuang P, Pulvermacher AC. Evaluation of Surgical Strategies for Bilateral Vocal Fold Paralysis Using Excised Canine Larynges. J Voice 2018; 33:33-39. [PMID: 29478709 DOI: 10.1016/j.jvoice.2017.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 10/11/2017] [Accepted: 10/16/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The objective of this study was to provide a theoretical basis for the selection of optimal surgical procedures in ex vivo simulated bilateral vocal fold paralysis (BVFP). STUDY DESIGN Four surgical stages were sequentially performed on 10 excised canine larynges with simulated BVFP: (1) transverse cordotomy, (2) medial arytenoidectomy, (3) subtotal arytenoidectomy, and (4) total arytenoidectomy. MATERIALS AND METHODS The sound pressure level, the signal-to-noise ratio, the glottal resistance, the glottal airflow (GF), the maximal glottal area (MGA), and spectrograms were measured after each stage. For comparative analysis of variance, a randomized block design and the Student-Newman-Keuls test were performed. RESULTS Under stable phonation, the sound pressure level showed no significant differences among the four stages. The signal-to-noise ratio was significantly different between the preoperative period and stage 1, as well as between stages 2 and 3. Glottal resistance was significantly different between the preoperative period and stage 1 and between stages 1 and 2. GF and MGA were significantly different among all stages, compared with those between stages 3 and 4 for GF and the preoperative period and stage 1 for MGA. The spectrograms indicated that the degree of disorder in the acoustic signals gradually increased. CONCLUSIONS Based on a comprehensive analysis of GF and voice quality in excised canine larynges, which simulated BVFP, our results suggest that the optimal surgical choice for BVFP is either medial or subtotal arytenoidectomy.
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Affiliation(s)
- YanLi Ma
- ENT Department, Xiamen University Zhongshan Hospital, Xiamen, Fujian, China
| | - RuiQing Wang
- ENT Department, Xiamen University Zhongshan Hospital, Xiamen, Fujian, China
| | - Yu Zhang
- Key Laboratory of Underwater Acoustic Communication and Marine Information Technology of the Ministry of Education, Xiamen University, Xiamen, Fujian, China
| | - Jiazhen Le
- ENT Department, Xiamen University Zhongshan Hospital, Xiamen, Fujian, China
| | - PeiYun Zhuang
- ENT Department, Xiamen University Zhongshan Hospital, Xiamen, Fujian, China.
| | - Allyson C Pulvermacher
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Lee SH, Koh KS, Song WC. Oblique thyroarytenoid muscle in humans: An independent muscle or an accessory belly? Laryngoscope 2018; 128:1634-1638. [PMID: 29332305 DOI: 10.1002/lary.27090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 11/27/2017] [Accepted: 12/18/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS This study aimed to determine the prevalence and morphological variations of the oblique thyroarytenoid (TA) muscle in humans. STUDY DESIGN Cadaveric anatomic dissections. METHODS One hundred hemilarynges from 50 formalin-embalmed cadavers were dissected to investigate the morphology of muscle fibers of the TA muscle. RESULTS Thirty-six (36%) hemilarynges were found to have a distinct oblique belly superficial to the TA muscle. In 28 cases, the belly had a relatively constant origin and an insertion that extended straight onto the TA muscle from the anterosuperior area of the internal surface of the thyroid lamina to the base of the muscular process of the arytenoid cartilage. Eight cases were located in a similar area but with some differences in the origin or insertion features. CONCLUSIONS We proposed that the oblique TA muscle has a high prevalence and probably acts to close and relax the vocal cords. It remains to be determined whether the oblique TA muscle is an independent muscle or an accessory belly of the main TA muscle. LEVEL OF EVIDENCE NA. Laryngoscope, 128:1634-1638, 2018.
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Affiliation(s)
- Shin-Hyo Lee
- Department of Anatomy, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Ki-Seok Koh
- Department of Anatomy, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Wu-Chul Song
- Department of Anatomy, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
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Liu K, Ge P, Sheng X, Jiang J, Qin H. Survival in Vivo Canine Phonation Model Without Stimulation. Ann Otol Rhinol Laryngol 2018; 127:178-184. [PMID: 29298508 DOI: 10.1177/0003489417751473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES We describe a survival nonstimulated in vivo canine phonation model using distending laryngoscope, cramp frame, and constant humidified glottal airflow to elicit phonation. METHODS Five beagle dogs were involved in this study. One cuffed endotracheal tube was placed below the glottis through the tracheotomy and delivered humidified airflow to the glottis. Arytenoids approximation was maintained using a clamp under the distending laryngoscope. Acoustic and aerodynamic parameters were measured using synchronous signal collection system and analysis software. Vocal oscillation also was examined using stroboscope laryngeal imaging. RESULTS For the nonstimulated in vivo phonation animal, the sound intensity and fundamental frequency were 78.3 ± 6.8 dB and 127.6 ± 29.2 Hz in the first experiment and 82.9 ± 6.6 dB and 175.2 ± 4.4 Hz 4 weeks later. The aerodynamic analysis revealed the mean subglottal phonation threshold pressure (PTP) and phonation threshold flow (PTF) were 8.5 ± 4.0 cmH20 and 683.0 ± 356.4 mL/s in the first experiment and 16.1 ± 8.6 cmH20 and 384.8.0 ± 230.6 mL/s in the second experiment 4 weeks later. Stroboscope image revealed sustained vocal vibration during great airflow delivery to glottis in the phonation animal model. CONCLUSIONS We developed a survival nonstimulated in vivo phonation canine model that allows the study of long-term animal phonation study as its own control.
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Affiliation(s)
- Kena Liu
- 1 Department of Laryngopharynx Head & Neck Maxillofacial Surgery, Guangdong General Hospital and Guangdong Academy of Medical Sciences, School of Medicine, South China University Technology, Guangzhou City, PR China
| | - Pingjiang Ge
- 1 Department of Laryngopharynx Head & Neck Maxillofacial Surgery, Guangdong General Hospital and Guangdong Academy of Medical Sciences, School of Medicine, South China University Technology, Guangzhou City, PR China.,2 Southern Medical University, Guangzhou City, PR China
| | - Xiaoli Sheng
- 1 Department of Laryngopharynx Head & Neck Maxillofacial Surgery, Guangdong General Hospital and Guangdong Academy of Medical Sciences, School of Medicine, South China University Technology, Guangzhou City, PR China
| | - Jie Jiang
- 1 Department of Laryngopharynx Head & Neck Maxillofacial Surgery, Guangdong General Hospital and Guangdong Academy of Medical Sciences, School of Medicine, South China University Technology, Guangzhou City, PR China
| | - Huabiao Qin
- 3 School of Electronic and Information Engineering, South China University Technology, Guangzhou City, PR China
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HERBST CHRISTIANT, DUNN JACOBC. Non-invasive documentation of primate voice production using electroglottography. ANTHROPOL SCI 2018. [DOI: 10.1537/ase.180201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
| | - JACOB C. DUNN
- Department of Animal and Environmental Biology, Faculty of Science & Technology, Anglia Ruskin University, Cambridge
- Division of Biological Anthropology, University of Cambridge, Cambridge
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Kryshtopava M, Van Lierde K, Defrancq C, De Moor M, Thijs Z, D'Haeseleer E, Meerschman I, Vandemaele P, Vingerhoets G, Claeys S. Brain activity during phonation in healthy female singers with supraglottic compression: an fMRI pilot study. LOGOP PHONIATR VOCO 2017; 44:95-104. [PMID: 29219633 DOI: 10.1080/14015439.2017.1408853] [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] [Indexed: 10/18/2022]
Abstract
This pilot study evaluated the usability of functional magnetic resonance imaging (fMRI) to detect brain activation during phonation in healthy female singers with supraglottic compression. Four healthy female classical singers (mean age: 26 years) participated in the study. All subjects had normal vocal folds and vocal characteristics and showed supraglottic compression. The fMRI experiment was carried out using a block design paradigm. Brain activation during phonation and exhalation was analyzed using Brain Voyager software (Brain Innovation B.V., Maastricht, The Netherlands). An fMRI data analysis showed a significant effect of phonation control in the bilateral pre/postcentral gyrus, and in the frontal, cingulate, superior and middle temporal gyrus, as well as in the parietal lobe, insula, lingual gyrus, cerebellum, thalamus and brainstem. These activation areas are consistent with previous reports using other fMRI protocols. In addition, a significant effect of phonation compared to exhalation control was found in the bilateral superior temporal gyrus, and the pre/postcentral gyrus. This fMRI pilot study allowed to detect a normal pattern of brain activity during phonation in healthy female singers with supraglottic compression using the proposed protocol. However, the pilot study detected problems with the experimental material/procedures that would necessitate refining the fMRI protocol. The phonation tasks were not capable to show brain activation difference between high-pitched and comfortable phonation. Further fMRI studies manipulating vocal parameters during phonation of the vowels /a/ and /i/ may elicit more distinctive hemodynamic response (HDR) activity patterns relative to voice modulation.
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Affiliation(s)
- Maryna Kryshtopava
- a Department of Otorhinolaryngology , University Hospital Ghent , Ghent , Belgium
| | - Kristiane Van Lierde
- b Department of Speech , Language and Hearing Sciences, University Ghent , Ghent , Belgium
| | - Charlotte Defrancq
- a Department of Otorhinolaryngology , University Hospital Ghent , Ghent , Belgium
| | - Michiel De Moor
- a Department of Otorhinolaryngology , University Hospital Ghent , Ghent , Belgium
| | - Zoë Thijs
- a Department of Otorhinolaryngology , University Hospital Ghent , Ghent , Belgium
| | - Evelien D'Haeseleer
- b Department of Speech , Language and Hearing Sciences, University Ghent , Ghent , Belgium
| | - Iris Meerschman
- b Department of Speech , Language and Hearing Sciences, University Ghent , Ghent , Belgium
| | - Pieter Vandemaele
- c Department of Radiology and Nuclear Medicine , University Hospital Ghent , Ghent , Belgium
| | - Guy Vingerhoets
- d Department of Experimental Psychology , Faculty of Psychology and Educational Sciences, Ghent University , Ghent , Belgium.,e Ghent Institute for functional and Metabolic Imaging (GIfMI) , University Hospital Ghent , Ghent , Belgium
| | - Sofie Claeys
- a Department of Otorhinolaryngology , University Hospital Ghent , Ghent , Belgium
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Galindo GE, Peterson SD, Erath BD, Castro C, Hillman RE, Zañartu M. Modeling the Pathophysiology of Phonotraumatic Vocal Hyperfunction With a Triangular Glottal Model of the Vocal Folds. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:2452-2471. [PMID: 28837719 PMCID: PMC5831616 DOI: 10.1044/2017_jslhr-s-16-0412] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 04/19/2017] [Indexed: 05/08/2023]
Abstract
PURPOSE Our goal was to test prevailing assumptions about the underlying biomechanical and aeroacoustic mechanisms associated with phonotraumatic lesions of the vocal folds using a numerical lumped-element model of voice production. METHOD A numerical model with a triangular glottis, posterior glottal opening, and arytenoid posturing is proposed. Normal voice is altered by introducing various prephonatory configurations. Potential compensatory mechanisms (increased subglottal pressure, muscle activation, and supraglottal constriction) are adjusted to restore an acoustic target output through a control loop that mimics a simplified version of auditory feedback. RESULTS The degree of incomplete glottal closure in both the membranous and posterior portions of the folds consistently leads to a reduction in sound pressure level, fundamental frequency, harmonic richness, and harmonics-to-noise ratio. The compensatory mechanisms lead to significantly increased vocal-fold collision forces, maximum flow-declination rate, and amplitude of unsteady flow, without significantly altering the acoustic output. CONCLUSION Modeling provided potentially important insights into the pathophysiology of phonotraumatic vocal hyperfunction by demonstrating that compensatory mechanisms can counteract deterioration in the voice acoustic signal due to incomplete glottal closure, but this also leads to high vocal-fold collision forces (reflected in aerodynamic measures), which significantly increases the risk of developing phonotrauma.
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Affiliation(s)
- Gabriel E. Galindo
- Department of Electronic Engineering, Universidad Técnica Federico Santa María, Valparaíso, Chile
| | - Sean D. Peterson
- Mechanical and Mechatronics Engineering, University of Waterloo, Ontario, Canada
| | - Byron D. Erath
- Department of Mechanical & Aeronautical Engineering, Clarkson University, Potsdam, NY
| | - Christian Castro
- Department of Electronic Engineering, Universidad Técnica Federico Santa María, Valparaíso, Chile
- School of Speech and Hearing Sciences, Universidad de Valparaíso, Chile
| | - Robert E. Hillman
- Center for Laryngeal Surgery & Voice Rehabilitation, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA
- MGH Institute of Health Professions, Boston, MA
| | - Matías Zañartu
- Department of Electronic Engineering, Universidad Técnica Federico Santa María, Valparaíso, Chile
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Lee SH, Fang TJ, Yu JF, Lee GS. Responses of Middle-Frequency Modulations in Vocal Fundamental Frequency to Different Vocal Intensities and Auditory Feedback. J Voice 2017; 31:536-544. [PMID: 28268129 DOI: 10.1016/j.jvoice.2017.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 01/27/2017] [Accepted: 01/30/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVES AND BACKGROUND Auditory feedback can make reflexive responses on sustained vocalizations. Among them, the middle-frequency power of F0 (MFP) may provide a sensitive index to access the subtle changes in different auditory feedback conditions. MATERIALS AND METHODS Phonatory airflow temperature was obtained from 20 healthy adults at two vocal intensity ranges under four auditory feedback conditions: (1) natural auditory feedback (NO); (2) binaural speech noise masking (SN); (3) bone-conducted feedback of self-generated voice (BAF); and (4) SN and BAF simultaneously. The modulations of F0 in low-frequency (0.2 Hz-3 Hz), middle-frequency (3 Hz-8 Hz), and high-frequency (8 Hz-25 Hz) bands were acquired using power spectral analysis of F0. Acoustic and aerodynamic analyses were used to acquire vocal intensity, maximum phonation time (MPT), phonatory airflow, and MFP-based vocal efficiency (MBVE). RESULTS SN and high vocal intensity decreased MFP and raised MBVE and MPT significantly. BAF showed no effect on MFP but significantly lowered MBVE. Moreover, BAF significantly increased the perception of voice feedback and the sensation of vocal effort. CONCLUSIONS Altered auditory feedback significantly changed the middle-frequency modulations of F0. MFP and MBVE could well detect these subtle responses of audio-vocal feedback.
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Affiliation(s)
- Shao-Hsuan Lee
- Ph.D. Program in Biomedical Engineering, College of Engineering, Chang-Gung University, Taoyuan City, Taiwan
| | - Tuan-Jen Fang
- Department of Otorhinolaryngology, Chang-Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Jen-Fang Yu
- Institute of Medical Mechatronics, College of Engineering, Chang-Gung University, Taoyuan City, Taiwan
| | - Guo-She Lee
- Department of Otorhinolaryngology, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Otolaryngology, Taipei City Hospital Renai Branch, Taipei, Taiwan.
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Birk V, Döllinger M, Sutor A, Berry DA, Gedeon D, Traxdorf M, Wendler O, Bohr C, Kniesburges S. Automated setup for ex vivo larynx experiments. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2017; 141:1349. [PMID: 28372097 PMCID: PMC6909984 DOI: 10.1121/1.4976085] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Ex vivo larynx experiments are limited in time due to degeneration of the laryngeal tissues. In order to acquire a significant and comparable amount of data, automatization of current manual experimental procedures is desirable. A computer controlled, electro-mechanical setup was developed for time-dependent variation of specific physiological parameters, including adduction and elongation level of the vocal folds and glottal flow. The setup offers a standardized method to induce defined forces on the laryngeal cartilages. Furthermore, phonation onset is detected automatically and the subsequent measurement procedure is automated and standardized to improve the efficiency of the experimental process. The setup was validated using four ex vivo porcine larynges, whereas each validation measurement series was executed with one separate larynx. Altogether 31 single measurements were undertaken, which can be summed up to a total experimental time of about 4 min. Vocal fold elongation and adduction lead both to an increase in fundamental frequency and subglottal pressure. Measurement procedures like applying defined subglottal pressure steps and onset-offset detection were reliably executed. The setup allows for a computer-based parameter control, which enables fast experimental execution over a wide range of laryngeal configurations. This maximizes the number of measurements and reduces personal effort compared with manual procedures.
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Affiliation(s)
- Veronika Birk
- Medical School, Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Erlangen, Raumerstrasse 1a, 91054 Erlangen, Germany
| | - Michael Döllinger
- Medical School, Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Erlangen, Raumerstrasse 1a, 91054 Erlangen, Germany
| | - Alexander Sutor
- Chair of Sensor Technology, Friedrich-Alexander-University Erlangen-Nürnberg, Paul-Gordan-Strasse 3/5, 91052 Erlangen, Germany
| | - David A Berry
- Laryngeal Dynamics Laboratory, Division of Head and Neck Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, California 90095-1624, USA
| | - Dominik Gedeon
- Chair of Sensor Technology, Friedrich-Alexander-University Erlangen-Nürnberg, Paul-Gordan-Strasse 3/5, 91052 Erlangen, Germany
| | - Maximilian Traxdorf
- Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Erlangen, Waldstrasse 1, 91054 Erlangen, Germany
| | - Olaf Wendler
- Laboratory for Molecular Biology at the Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Erlangen, Waldstrasse 1, 91054 Erlangen, Germany
| | - Christopher Bohr
- Medical School, Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Erlangen, Raumerstrasse 1a, 91054 Erlangen, Germany
| | - Stefan Kniesburges
- Medical School, Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Erlangen, Raumerstrasse 1a, 91054 Erlangen, Germany
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Dewan K, Vahabzadeh-Hagh A, Soofer D, Chhetri DK. Neuromuscular compensation mechanisms in vocal fold paralysis and paresis. Laryngoscope 2017; 127:1633-1638. [PMID: 28059441 DOI: 10.1002/lary.26409] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 10/01/2016] [Accepted: 10/10/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Vocal fold paresis and paralysis are common conditions. Treatment options include augmentation laryngoplasty and voice therapy. The optimal management for this condition is unclear. The objective of this study was to assess possible neuromuscular compensation mechanisms that could potentially be used in the treatment of vocal fold paresis and paralysis. STUDY DESIGN In vivo canine model. METHODS In an in vivo canine model, we examined three conditions: 1) unilateral right recurrent laryngeal nerve (RLN) paresis and paralysis, 2) unilateral superior laryngeal nerve (SLN) paralysis, and 3) unilateral vagal nerve paresis and paralysis. Phonatory acoustics and aerodynamics were measured in each of these conditions. Effective compensation was defined as improved acoustic and aerodynamic profile. RESULTS The most effective compensation for all conditions was increasing RLN activation and decreasing glottal gap. Increasing RLN activation increased the percentage of possible phonatory conditions that achieved phonation onset. SLN activation generally led to decreased number of total phonation onset conditions within each category. Differential effects of SLN (cricothyroid [CT] muscle) activation were seen. Ipsilateral SLN activation could compensate for RLN paralysis; normal CT compensated well in unilateral SLN paralysis; and in vagal paresis/paralysis, contralateral SLN and RLN displayed antagonistic relationships. CONCLUSIONS Methods to improve glottal closure should be the primary treatment for large glottal gaps. Neuromuscular compensation is possible for paresis. This study provides insights into possible compensatory mechanisms in vocal fold paresis and paralysis. LEVEL OF EVIDENCE NA Laryngoscope, 127:1633-1638, 2017.
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Affiliation(s)
- Karuna Dewan
- Department of Head and Neck Surgery, David Geffen School of Medicine, Los Angeles, California, U.S.A
| | - Andrew Vahabzadeh-Hagh
- Department of Head and Neck Surgery, David Geffen School of Medicine, Los Angeles, California, U.S.A
| | - Donna Soofer
- Department of Head and Neck Surgery, David Geffen School of Medicine, Los Angeles, California, U.S.A
| | - Dinesh K Chhetri
- Department of Head and Neck Surgery, David Geffen School of Medicine, Los Angeles, California, U.S.A
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Zhang Z. Mechanics of human voice production and control. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2016; 140:2614. [PMID: 27794319 PMCID: PMC5412481 DOI: 10.1121/1.4964509] [Citation(s) in RCA: 156] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
As the primary means of communication, voice plays an important role in daily life. Voice also conveys personal information such as social status, personal traits, and the emotional state of the speaker. Mechanically, voice production involves complex fluid-structure interaction within the glottis and its control by laryngeal muscle activation. An important goal of voice research is to establish a causal theory linking voice physiology and biomechanics to how speakers use and control voice to communicate meaning and personal information. Establishing such a causal theory has important implications for clinical voice management, voice training, and many speech technology applications. This paper provides a review of voice physiology and biomechanics, the physics of vocal fold vibration and sound production, and laryngeal muscular control of the fundamental frequency of voice, vocal intensity, and voice quality. Current efforts to develop mechanical and computational models of voice production are also critically reviewed. Finally, issues and future challenges in developing a causal theory of voice production and perception are discussed.
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Affiliation(s)
- Zhaoyan Zhang
- Department of Head and Neck Surgery, University of California, Los Angeles, 31-24 Rehabilitation Center, 1000 Veteran Avenue, Los Angeles, California 90095-1794, USA
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Yin J, Zhang Z. Laryngeal muscular control of vocal fold posturing: Numerical modeling and experimental validation. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2016; 140:EL280. [PMID: 27914396 PMCID: PMC5384605 DOI: 10.1121/1.4962375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
A three-dimensional continuum model of vocal fold posturing was developed to investigate laryngeal muscular control of vocal fold geometry, stiffness, and tension, which are difficult to measure in live humans or in vivo models. This model was able to qualitatively reproduce in vivo experimental observations of laryngeal control of vocal fold posturing, despite the many simplifications which are necessary due to the lack of accurate data of laryngeal geometry and material properties. The results present a first comprehensive study of the co-variations between glottal width, vocal fold length, stiffness, tension at different conditions of individual, and combined laryngeal muscle activation.
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Affiliation(s)
- Jun Yin
- The State Key Lab of Fluid Power Transmission and Control Systems, School of Mechanical Engineering, Zhejiang University, Hangzhou 310028, China
| | - Zhaoyan Zhang
- UCLA School of Medicine, 31-24 Rehab Center, 1000 Veteran Avenue, Los Angeles, California 90095-1794, USA
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Patel RR. Vibratory onset and offset times in children: A laryngeal imaging study. Int J Pediatr Otorhinolaryngol 2016; 87:11-7. [PMID: 27368436 PMCID: PMC4930831 DOI: 10.1016/j.ijporl.2016.05.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 05/10/2016] [Accepted: 05/12/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The aim of the study was to evaluate the differences in vibratory onset and offset times across age (adult males, adult females, and children) and waveform types (total glottal area waveform, left glottal area waveform, and right glottal area waveform) using high-speed videoendoscopy. METHODS In this prospective study, vibratory onset and offset times were evaluated in a total of 86 participants. Forty-three children (23 girls, 18 boys) between 5 and 11 years and 43 gender matched vocally normal young adults (23 females and 18 males) in the age range (21-45 years) were recruited. Vibratory onset and offset times were calculated in milliseconds from the total, left, and right Glottal Area Waveform (GAW). A two-factor analysis of variance was used to compare the means among the subject groups (children, adult male, and adult female) and waveform type (total GAW, left GAW, right GAW) for onset and offset variables. Post hoc analyses were performed using the Fishers Least Significant Different test with Bonferroni correction for multiple comparisons. RESULTS Children exhibited significantly shorter vibratory onset and offset times compared to adult males and females. Differences in vibratory onset and offset times were not statistically significant between adult males and females. Across all waveform types (i.e. total GAW, left GAW, and right GAW), no statistical significance was observed among the subject groups. CONCLUSION This is the first study reporting vibratory onset and offset times in the pediatric population. The study findings lay the foundation for the development of a large age- and gender-based database of the pediatric population to aid the study of the effects of maturation of vocal fold vibration in adulthood. The findings from this study may also provide the basis for evaluating the impact of numerous lesions on tissue pliability, and thereby has potential utility for the clinical differentiation of various lesions.
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Affiliation(s)
- Rita R. Patel
- Department of Speech and Hearing Sciences, Indiana University
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50
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Titze IR. Human Speech: A Restricted Use of the Mammalian Larynx. J Voice 2016; 31:135-141. [PMID: 27397113 DOI: 10.1016/j.jvoice.2016.06.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 06/08/2016] [Accepted: 06/13/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Speech has been hailed as unique to human evolution. Although the inventory of distinct sounds producible with vocal tract articulators is a great advantage in human oral communication, it is argued here that the larynx as a sound source in speech is limited in its range and capability because a low fundamental frequency is ideal for phonemic intelligibility and source-filter independence. METHOD Four existing data sets were combined to make an argument regarding exclusive use of the larynx for speech: (1) range of fundamental frequency, (2) laryngeal muscle activation, (3) vocal fold length in relation to sarcomere length of the major laryngeal muscles, and (4) vocal fold morphological development. RESULTS Limited data support the notion that speech tends to produce a contracture of the larynx. The morphological design of the human vocal folds, like that of primates and other mammals, appears to be optimized for vocal communication over distances for which higher fundamental frequency, higher intensity, and fewer unvoiced segments are used. CONCLUSION The positive message is that raising one's voice to call, shout, or sing, or executing pitch glides to stretch the vocal folds, can counteract this trend toward a contracted state.
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Affiliation(s)
- Ingo R Titze
- National Center for Voice and Speech, The University of Utah, Lead Institution, Salt Lake City, Utah; Department of Communication Sciences and Disorders, The University of Iowa, Iowa City, Iowa.
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