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Jiang W, Geng B, Zheng X, Xue Q. A computational study of the influence of thyroarytenoid and cricothyroid muscle interaction on vocal fold dynamics in an MRI-based human laryngeal model. Biomech Model Mechanobiol 2024:10.1007/s10237-024-01869-9. [PMID: 38981946 DOI: 10.1007/s10237-024-01869-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 06/21/2024] [Indexed: 07/11/2024]
Abstract
A human laryngeal model, incorporating all the cartilages and the intrinsic muscles, was reconstructed based on MRI data. The vocal fold was represented as a multilayer structure with detailed inner components. The activation levels of the thyroarytenoid (TA) and cricothyroid (CT) muscles were systematically varied from zero to full activation allowing for the analysis of their interaction and influence on vocal fold dynamics and glottal flow. The finite element method was employed to calculate the vocal fold dynamics, while the one-dimensional Bernoulli equation was utilized to calculate the glottal flow. The analysis was focused on the muscle influence on the fundamental frequency (fo). We found that while CT and TA activation increased the fo in most of the conditions, TA activation resulted in a frequency drop when it was moderately activated. We show that this frequency drop was associated with the sudden increase of the vertical motion when the vibration transited from involving the whole tissue to mainly in the cover layer. The transition of the vibration pattern was caused by the increased body-cover stiffness ratio that resulted from TA activation.
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Affiliation(s)
- Weili Jiang
- Department of Mechanical Engineering, Kate Gleason College of Engineering, Rochester Institute of Technology, Rochester, NY, USA
| | - Biao Geng
- Department of Mechanical Engineering, Kate Gleason College of Engineering, Rochester Institute of Technology, Rochester, NY, USA
| | - Xudong Zheng
- Department of Mechanical Engineering, Kate Gleason College of Engineering, Rochester Institute of Technology, Rochester, NY, USA
| | - Qian Xue
- Department of Mechanical Engineering, Kate Gleason College of Engineering, Rochester Institute of Technology, Rochester, NY, USA.
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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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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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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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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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Schenck A, Hilger AI, Levant S, Kim JH, Lester-Smith RA, Larson C. The Effect of Pitch and Loudness Auditory Feedback Perturbations on Vocal Quality During Sustained Phonation. J Voice 2023; 37:37-47. [PMID: 33191054 DOI: 10.1016/j.jvoice.2020.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/31/2020] [Accepted: 11/02/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Dysphonia is a reduction in vocal quality that impacts communication and is often an early sign of a voice disorder. There is little information regarding the effects of auditory feedback control of loudness and pitch on voice quality. In this study, we used both loudness-shift and pitch-shift paradigms to study the relationship between auditory feedback control and vocal quality as measured by smoothed cepstral peak prominence (CPPS), which reflects the harmonicity of the voice signal. STUDY DESIGN Experimental, mixed design. METHODS We applied 200 ms loudness-shifts (± 0, 3, or 6 dB) and pitch-shifts (± 0, 50, and 100 cents) to auditory feedback during sustained vowel production in 25 healthy adults. We then measured CPPS before and after the loudness-shift or pitch-shift to investigate the effect of changes in auditory feedback on vocal harmonicity. RESULTS & CONCLUSIONS Results showed that, on average, CPPS significantly decreased between the first half of the measured segment and the last half of the segment in the absence of auditory feedback shifts, suggesting that voice quality may be reduced across longer vowels over time. Upward and downward shifts in loudness auditory feedback caused a relative increase in CPPS, indicating an improvement in vocal harmonicity, even in cases when vocal intensity was reduced. Pitch alterations had inconsistent and minimal effects. We propose that there may be a control mechanism for voice quality that increases harmonicity of the voice signal to improve voice audibility (ie, ability to be heard) in the presence of unpredictable variability in voice intensity.
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Affiliation(s)
- Alexandra Schenck
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois
| | - Allison I Hilger
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois
| | - Samuel Levant
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois
| | - Jason H Kim
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois
| | - Rosemary A Lester-Smith
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Charles Larson
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois.
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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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Vojtech JM, Mitchell CL, Raiff L, Kline JC, De Luca G. Prediction of Voice Fundamental Frequency and Intensity from Surface Electromyographic Signals of the Face and Neck. VIBRATION 2022; 5:692-710. [PMID: 36299552 PMCID: PMC9592063 DOI: 10.3390/vibration5040041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Silent speech interfaces (SSIs) enable speech recognition and synthesis in the absence of an acoustic signal. Yet, the archetypal SSI fails to convey the expressive attributes of prosody such as pitch and loudness, leading to lexical ambiguities. The aim of this study was to determine the efficacy of using surface electromyography (sEMG) as an approach for predicting continuous acoustic estimates of prosody. Ten participants performed a series of vocal tasks including sustained vowels, phrases, and monologues while acoustic data was recorded simultaneously with sEMG activity from muscles of the face and neck. A battery of time-, frequency-, and cepstral-domain features extracted from the sEMG signals were used to train deep regression neural networks to predict fundamental frequency and intensity contours from the acoustic signals. We achieved an average accuracy of 0.01 ST and precision of 0.56 ST for the estimation of fundamental frequency, and an average accuracy of 0.21 dB SPL and precision of 3.25 dB SPL for the estimation of intensity. This work highlights the importance of using sEMG as an alternative means of detecting prosody and shows promise for improving SSIs in future development.
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Affiliation(s)
| | | | - Laura Raiff
- Delsys, Inc., Natick, MA 01760, USA
- Altec, Inc., Natick, MA 01760, USA
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
| | - Joshua C. Kline
- Delsys, Inc., Natick, MA 01760, USA
- Altec, Inc., Natick, MA 01760, USA
| | - Gianluca De Luca
- Delsys, Inc., Natick, MA 01760, USA
- Altec, Inc., Natick, MA 01760, USA
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Weerathunge HR, Alzamendi GA, Cler GJ, Guenther FH, Stepp CE, Zañartu M. LaDIVA: A neurocomputational model providing laryngeal motor control for speech acquisition and production. PLoS Comput Biol 2022; 18:e1010159. [PMID: 35737706 PMCID: PMC9258861 DOI: 10.1371/journal.pcbi.1010159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 07/06/2022] [Accepted: 05/02/2022] [Indexed: 11/18/2022] Open
Abstract
Many voice disorders are the result of intricate neural and/or biomechanical impairments that are poorly understood. The limited knowledge of their etiological and pathophysiological mechanisms hampers effective clinical management. Behavioral studies have been used concurrently with computational models to better understand typical and pathological laryngeal motor control. Thus far, however, a unified computational framework that quantitatively integrates physiologically relevant models of phonation with the neural control of speech has not been developed. Here, we introduce LaDIVA, a novel neurocomputational model with physiologically based laryngeal motor control. We combined the DIVA model (an established neural network model of speech motor control) with the extended body-cover model (a physics-based vocal fold model). The resulting integrated model, LaDIVA, was validated by comparing its model simulations with behavioral responses to perturbations of auditory vocal fundamental frequency (fo) feedback in adults with typical speech. LaDIVA demonstrated capability to simulate different modes of laryngeal motor control, ranging from short-term (i.e., reflexive) and long-term (i.e., adaptive) auditory feedback paradigms, to generating prosodic contours in speech. Simulations showed that LaDIVA’s laryngeal motor control displays properties of motor equivalence, i.e., LaDIVA could robustly generate compensatory responses to reflexive vocal fo perturbations with varying initial laryngeal muscle activation levels leading to the same output. The model can also generate prosodic contours for studying laryngeal motor control in running speech. LaDIVA can expand the understanding of the physiology of human phonation to enable, for the first time, the investigation of causal effects of neural motor control in the fine structure of the vocal signal.
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Affiliation(s)
- Hasini R. Weerathunge
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, United States of America
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, Massachusetts, United States of America
- * E-mail:
| | - Gabriel A. Alzamendi
- Department of Electronic Engineering, Universidad Técnica Federico Santa María, Valparaíso, Chile
- Institute for Research and Development on Bioengineering and Bioinformatics (IBB), CONICET-UNER, Oro Verde, Argentina
| | - Gabriel J. Cler
- Department of Speech & Hearing Sciences, University of Washington, Seattle, Washington, United States of America
| | - Frank H. Guenther
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, United States of America
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, Massachusetts, United States of America
| | - Cara E. Stepp
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, United States of America
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, Massachusetts, United States of America
- Department of Otolaryngology-Head and Neck Surgery, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Matías Zañartu
- Department of Electronic Engineering, Universidad Técnica Federico Santa María, Valparaíso, Chile
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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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11
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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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12
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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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13
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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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14
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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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15
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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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16
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Behroozmand R, Johari K, Bridwell K, Hayden C, Fahey D, den Ouden DB. Modulation of vocal pitch control through high-definition transcranial direct current stimulation of the left ventral motor cortex. Exp Brain Res 2020; 238:1525-1535. [PMID: 32447409 DOI: 10.1007/s00221-020-05832-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/09/2020] [Indexed: 12/21/2022]
Abstract
Neural interactions between sensorimotor integration mechanisms play critical roles in voice motor control. We investigated how high-definition transcranial direct current stimulation (HD-tDCS) of the left ventral motor cortex modulates neural mechanisms of sensorimotor integration during voice motor control. HD-tDCS was performed during speech vowel production in an altered auditory feedback (AAF) paradigm in response to upward and downward pitch-shift stimuli. In one experiment, two groups received either anodal or cathodal 2 milliamp (mA) HD-tDCS to the left ventral motor cortex while a third group received sham (placebo) stimulation. In a second experiment, two groups received either 1 mA or 2 mA cathodal HD-tDCS to the left ventral motor cortex. Results of the first experiment indicated that the magnitude of vocal compensation was significantly reduced following anodal and cathodal HD-tDCS only in responses to downward pitch-shift AAF stimuli, with stronger effects associated with cathodal HD-tDCS. However, no such effect was observed following sham stimulation. Results of the second experiment indicate that there is not a differential effect of modulation from 1 mA versus 2 mA. Further, these results replicate the directional finding of the first experiment for vocal compensation in response to downward pitch-shift only. These findings suggest that neurostimulation of the left ventral motor cortex modulates sensorimotor mechanisms underlying voice motor control. We speculate that this effect is associated with the increased contribution of feedforward motor mechanisms, leading to reduced compensatory speech responses to AAF.
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Affiliation(s)
- Roozbeh Behroozmand
- Speech Neuroscience Lab, Department of Communication Sciences and Disorders, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
| | - Karim Johari
- Speech Neuroscience Lab, Department of Communication Sciences and Disorders, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA.,Department of Psychology, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
| | - Keiko Bridwell
- Neurolinguistics Lab, Department of Communication Sciences and Disorders, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
| | - Caroline Hayden
- Speech Neuroscience Lab, Department of Communication Sciences and Disorders, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
| | - Danielle Fahey
- Neurolinguistics Lab, Department of Communication Sciences and Disorders, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
| | - Dirk-Bart den Ouden
- Neurolinguistics Lab, Department of Communication Sciences and Disorders, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA.
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17
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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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18
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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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19
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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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20
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Behroozmand R, Johari K, Kelley RM, Kapnoula EC, Narayanan NS, Greenlee JDW. Effect of deep brain stimulation on vocal motor control mechanisms in Parkinson's disease. Parkinsonism Relat Disord 2019; 63:46-53. [PMID: 30871801 DOI: 10.1016/j.parkreldis.2019.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 02/20/2019] [Accepted: 03/04/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for limb motor symptoms in Parkinson's disease (PD); however, its effect on vocal motor function has yielded conflicted and highly variable results. The present study investigated the effects of STN-DBS on the mechanisms of vocal production and motor control. METHODS A total of 10 PD subjects with bilateral STN-DBS implantation were tested with DBS ON and OFF while they performed steady vowel vocalizations and received randomized upward or downward pitch-shift stimuli (±100 cents) in their voice auditory feedback. RESULTS Data showed that the magnitude of vocal compensation responses to pitch-shift stimuli was significantly attenuated during DBS ON vs. OFF (p = 0.012). This effect was direction-specific and was only observed when subjects raised their voice fundamental frequency (F0) in the opposite direction to downward stimuli (p = 0.019). In addition, we found that voice F0 perturbation (i.e. jitter) was significantly reduced during DBS ON vs. OFF (p = 0.022), and this DBS-induced modulation was positively correlated with the attenuation of vocal compensation responses to downward pitch-shift stimuli (r = +0.57, p = 0.028). CONCLUSIONS These findings provide the first data supporting the role of STN in vocal F0 motor control in response to altered auditory feedback. The DBS-induced attenuation of vocal compensation responses may result from increased inhibitory effects of the subcortical hyperdirect (fronto-subthalamic) pathways on the vocal motor cortex, which can help stabilize voice F0 and ameliorate vocal motor symptoms by impeding PD subjects' abnormal (i.e. overshooting) vocal responses to alterations in the auditory feedback.
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Affiliation(s)
- Roozbeh Behroozmand
- Speech Neuroscience Lab, Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29028, USA.
| | - Karim Johari
- Speech Neuroscience Lab, Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29028, USA
| | - Ryan M Kelley
- Medical Scientist Training Program, University of Iowa, Iowa City, IA 52242, USA; Program in Neuroscience, University of Iowa, Iowa City, IA 52242, USA
| | | | | | - Jeremy D W Greenlee
- Human Brain Research Lab, Department of Neurosurgery, University of Iowa, Iowa City, IA 52242, USA
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21
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Palaparthi A, Smith S, Mau T, Titze IR. A computational study of depth of vibration into vocal fold tissues. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 145:881. [PMID: 30823802 PMCID: PMC6380906 DOI: 10.1121/1.5091099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 01/30/2019] [Accepted: 01/31/2019] [Indexed: 06/01/2023]
Abstract
The effective depth of vocal fold vibration is self-regulated and generally not known a priori in vocalization. In this study, the effective depth was quantified systematically under various phonatory conditions using a fiber-gel finite element vocal fold model. The horizontal and vertical excursions of each finite element nodal point trajectory were recorded to compute trajectory areas. The extent of vibration was then studied based on the variation of trajectory radii as a function of depth in several coronal sections along the anterior-posterior direction. The results suggested that the vocal fold nodal trajectory excursions decrease systematically as a function of depth but are affected by the layered structure of the vocal folds. The effective depth of vibration was found to range between 15 and 55% of the total anatomical depth across all phonatory conditions. The nodal trajectories from the current study were compared qualitatively with the results from excised human hemi-larynx experiments published in Döllinger and Berry [(2006). J. Voice. 20(3), 401-413]. An estimate of the effective mass of a one-mass vocal fold model was also computed based on the effective depth of vibration observed in this study under various phonatory conditions.
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Affiliation(s)
- Anil Palaparthi
- National Center for Voice and Speech, The University of Utah, 136 South Main Street, Suite 320, Salt Lake City, Utah 84101, USA
| | - Simeon Smith
- National Center for Voice and Speech, The University of Utah, 136 South Main Street, Suite 320, Salt Lake City, Utah 84101, USA
| | - Ted Mau
- National Center for Voice and Speech, The University of Utah, 136 South Main Street, Suite 320, Salt Lake City, Utah 84101, USA
| | - Ingo R Titze
- National Center for Voice and Speech, The University of Utah, 136 South Main Street, Suite 320, Salt Lake City, Utah 84101, USA
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22
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Perju-Dumbrava L, Lau K, Phyland D, Papanikolaou V, Finlay P, Beare R, Bardin P, Stuckey S, Kempster P, Thyagarajan D. Arytenoid cartilage movements are hypokinetic in Parkinson's disease: A quantitative dynamic computerised tomographic study. PLoS One 2017; 12:e0186611. [PMID: 29099841 PMCID: PMC5669420 DOI: 10.1371/journal.pone.0186611] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 10/04/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Voice change is one of the earliest features of Parkinson's disease. However, quantitative studies of vocal fold dynamics which are needed to provide insight into disease biology, aid diagnosis, or track progression, are few. METHODS We therefore quantified arytenoid cartilage movements and glottic area during repeated phonation in 15 patients with Parkinson's disease (symptom duration < 6 years) and 19 controls, with 320-slice computerised tomography (CT). We related these measures to perceptual voice evaluations and spirometry. We hypothesised that Parkinson's disease patients have a smaller inter-arytenoid distance, a preserved or larger glottic area because vocal cord bowing has previously been reported, less variability in loudness, more voice dysdiadochokinesis and breathiness and a shortened phonation time because of arytenoid hypokinesis relative to glottic area. RESULTS Inter-arytenoid distance in Parkinson's disease patients was moderately smaller (Mdn = 0.106, IQR = 0.091-0.116) than in controls (Mdn = 0.132, IQR = 0.116-0.166) (W = 212, P = 0.015, r = -0.42), normalised for anatomical and other inter-subject variance, analysed with two-tailed Wilcoxon's rank sum test. This finding was confirmed in a linear mixed model analysis-Parkinson's disease significantly predicted a reduction in the dependent variable, inter-arytenoid distance (b = -0.87, SEb = 0.39, 95% CI [-1.66, -0.08], t(31) = -2.24, P = 0.032). There was no difference in glottic area. On perceptual voice evaluation, patients had more breathiness and dysdiadochokinesis, a shorter maximum phonation time, and less variability in loudness than controls. There was no difference in spirometry after adjustment for smoking history. CONCLUSIONS As predicted, vocal fold adduction movements are reduced in Parkinson's disease on repeated phonation but glottic area is maintained. Some perceptual characteristics of Parkinsonian speech reflect these changes. We are the first to use 320-slice CT to study laryngeal motion. Our findings indicate how Parkinson's disease affects intrinsic laryngeal muscle position and excursion.
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Affiliation(s)
| | - Ken Lau
- Department of Medical Imaging, Monash Medical Center, Clayton, Victoria, Australia
| | - Debbie Phyland
- Department of Surgery, Monash Medical Center, Clayton, Victoria, Australia
| | - Vicki Papanikolaou
- Department of Respiratory Medicine, Monash Medical Center, Clayton, Victoria, Australia
| | - Paul Finlay
- Department of Respiratory Medicine, Monash Medical Center, Clayton, Victoria, Australia
| | - Richard Beare
- Department of Neuroscience, Monash Medical Center, Clayton, Victoria, Australia
| | - Philip Bardin
- Department of Respiratory Medicine, Monash Medical Center, Clayton, Victoria, Australia
| | - Stephen Stuckey
- Department of Medical Imaging, Monash Medical Center, Clayton, Victoria, Australia
| | - Peter Kempster
- Department of Neuroscience, Monash Medical Center, Clayton, Victoria, Australia
| | - Dominic Thyagarajan
- Department of Neuroscience, Monash Medical Center, Clayton, Victoria, Australia
- * E-mail:
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Birk V, Kniesburges S, Semmler M, Berry DA, Bohr C, Döllinger M, Schützenberger A. Influence of glottal closure on the phonatory process in ex vivo porcine larynges. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2017; 142:2197. [PMID: 29092569 PMCID: PMC6909995 DOI: 10.1121/1.5007952] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Many cases of disturbed voice signals can be attributed to incomplete glottal closure, vocal fold oscillation asymmetries, and aperiodicity. Often these phenomena occur simultaneously and interact with each other, making a systematic, isolated investigation challenging. Therefore, ex vivo porcine experiments were performed which enable direct control of glottal configurations. Different pre-phonatory glottal gap sizes, adduction levels, and flow rates were adjusted. The resulting glottal closure types were identified in a post-processing step. Finally, the acoustic quality, aerodynamic parameters, and the characteristics of vocal fold oscillation were analyzed in reference to the glottal closure types. Results show that complete glottal closure stabilizes the phonation process indicated through a reduced left-right phase asymmetry, increased amplitude and time periodicity, and an increase in the acoustic quality. Although asymmetry and periodicity parameter variation covers only a small range of absolute values, these small variations have a remarkable influence on the acoustic quality. Due to the fact that these parameters cannot be influenced directly, the authors suggest that the (surgical) reduction of the glottal gap seems to be a promising method to stabilize the phonatory process, which has to be confirmed in future studies.
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Affiliation(s)
- Veronika Birk
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Erlangen, Medical School at Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstr. 1, 91054 Erlangen, Germany
| | - Stefan Kniesburges
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Erlangen, Medical School at Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstr. 1, 91054 Erlangen, Germany
| | - Marion Semmler
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Erlangen, Medical School at Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstr. 1, 91054 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
| | - Christopher Bohr
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Erlangen, Medical School at Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstr. 1, 91054 Erlangen, Germany
| | - Michael Döllinger
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Erlangen, Medical School at Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstr. 1, 91054 Erlangen, Germany
| | - Anne Schützenberger
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Erlangen, Medical School at Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstr. 1, 91054 Erlangen, Germany
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Dong B. Characterizing resonant component in speech: A different view of tracking fundamental frequency. MECHANICAL SYSTEMS AND SIGNAL PROCESSING 2017; 88:318-333. [DOI: 10.1016/j.ymssp.2016.11.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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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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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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Chhetri DK, Park SJ. Interactions of subglottal pressure and neuromuscular activation on fundamental frequency and intensity. Laryngoscope 2016; 126:1123-30. [PMID: 26971707 DOI: 10.1002/lary.25550] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS Fundamental frequency (F0) and intensity sound pressure level (SPL) of voice are controlled by intrinsic laryngeal muscle (ILM) activation and subglottal pressure (Psub). Their interactions were investigated. METHODS In an in vivo canine model, the thyroarytenoid (TA), lateral cricoarytenoid/interarytenoid (LCA/IA), and cricothyroid (CT) muscles were independently activated from threshold to maximal contraction by neuromuscular stimulation in various combinations, whereas airflow was increased to phonation onset pressure and beyond. The resultant acoustic output was analyzed for effects of Psub on vibratory stability, F0, and SPL. Muscle activation plots and vocal range profiles by individual ILM activation states were analyzed. RESULTS Cricothyroid activation increased phonation onset F0, but vibration was less stable in high CT conditions and displayed vibratory mode change. In addition, a decrease in F0 with increased Psub was observed in high CT conditions. Intensity increased with Psub in all conditions, but the slope was greater at high CT, low TA/LCA/IA activations. Lateral cricoarytenoid/interarytenoid activation improved vocal efficiency. To maintain same F0 with increasing SPL (messa di voce), TA activation was decreased and LCA/IA activation was increased. The same F0 and SPL could be achieved with a variety of ILM activation combinations. CONCLUSION Cricothyroid is primarily required for increasing F0, whereas TA can increase or decrease F0 and SPL. Lateral cricoarytenoid/interarytenoid activation likely maintains vocal fold adduction during increased Psub and improves vocal efficiency. This study also demonstrates laryngeal motor equivalence, the ability of the larynx to achieve the same target F0 and SPL with multiple combinations of ILM activation. LEVEL OF EVIDENCE N/A. Laryngoscope, 126:1123-1130, 2016.
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Affiliation(s)
- Dinesh K Chhetri
- Laryngeal Physiology Laboratory, CHS 62-132, Department of Head and Neck Surgery, UCLA School of Medicine, Los Angeles, California, U.S.A
| | - Soo Jin Park
- Laryngeal Physiology Laboratory, CHS 62-132, Department of Head and Neck Surgery, UCLA School of Medicine, Los Angeles, California, U.S.A
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Chhetri DK, Neubauer J. Differential roles for the thyroarytenoid and lateral cricoarytenoid muscles in phonation. Laryngoscope 2015. [PMID: 26198167 DOI: 10.1002/lary.25480] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS Laryngeal adductor muscle dysfunction is a common cause of voice disorders. Reconstitution of adductor muscle function is often the target of therapy, but the effects of these muscles on voice production remain to be fully understood. This study investigated the differential roles of thyroarytenoid (TA) and lateral cricoarytenoid (LCA) muscles on voice production. STUDY DESIGN Basic science study using an in vivo canine model of phonation. METHODS The TA and LCA muscle nerve branches were stimulated to obtain seven graded levels of muscle activation, from threshold to maximal contraction. The effects of LCA muscle activation alone, TA muscle activation alone, and combined TA and LCA muscle activation on phonation onset parameters were investigated. Phonatory posture, phonation onset type, fundamental frequency (F0), phonation onset pressure, and airflow were evaluated. RESULTS LCA muscle activation closed the posterior glottis, but the midmembranous gap remained. TA muscle activation closed the membranous glottis, but the posterior gap remained. Complete glottal closure was obtained only with combined TA and LCA muscle activation. Phonation onset with the LCA muscle alone was characterized by multiple modes (soft, aperiodic, periodic), whereas with the TA muscle alone it was abrupt and periodic but had significant baseline noise. Combined muscle activation led to elimination of baseline noise with stable abrupt periodic onset of phonation. Combined muscle activation was also necessary for F0 variation. The LCA muscle assisted the TA muscle in increasing subglottal pressure while concurrently reducing phonation onset airflow. CONCLUSIONS The TA muscle is necessary for F0 variation, stable onset phonation, and increased subglottal pressure, but needs the LCA muscle for optimal effectiveness and to reduce airflow requirements with increased activation. LEVEL OF EVIDENCE NA.
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Affiliation(s)
- Dinesh K Chhetri
- Laryngeal Physiology Laboratory, Department of Head and Neck Surgery, UCLA School of Medicine, Los Angeles, California, U.S.A
| | - Juergen Neubauer
- Laryngeal Physiology Laboratory, Department of Head and Neck Surgery, UCLA School of Medicine, Los Angeles, California, U.S.A
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Superior laryngeal nerve injury: effects, clinical findings, prognosis, and management options. Curr Opin Otolaryngol Head Neck Surg 2015; 22:439-43. [PMID: 25136863 DOI: 10.1097/moo.0000000000000097] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The superior laryngeal nerve (SLN) provides motor innervation to the cricothyroid muscle. However, the functions of this muscle and the anatomic variations of the nerve that supplies it are not fully understood. SLN paresis and paralysis (SLNp) is difficult to diagnose because of a lack of consistent laryngeal findings, and its effects on the voice likely go beyond simple pitch elevation control. RECENT FINDINGS Although SLNp has traditionally been thought to lead to voice pitch limitation, recent research findings reveal multiple roles for this nerve in voice and speech. Cricothyroid muscles are the primary controls of fundamental frequency of voice. SLNp can lead to significant contraction of pitch range, vocal fold vibratory phase asymmetry, and acoustic aperiodicity, thus leading to an overall poor vocal quality. In addition, cricothyroid muscles may also play a role in pitch lowering and shifting from voiced to unvoiced sounds during speech. SUMMARY Subtle signs, symptoms, and diagnostic findings associated with SLNp make this disorder difficult to characterize clinically. Lack of treatment methodologies to restore the dynamic action of the cricothyroid muscles poses difficulties in treating patients with this condition. A more thorough understanding of the effects of SLNp will improve diagnosis and treatment.
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Luegmair G, Chhetri DK, Zhang Z. THE ROLE OF THE THYROARYTENOID MUSCLE IN REGULATING GLOTTAL AIRFLOW AND GLOTTAL CLOSURE IN AN IN VIVO CANINE LARYNX MODEL. PROCEEDINGS OF MEETINGS ON ACOUSTICS. ACOUSTICAL SOCIETY OF AMERICA 2014; 22:060007. [PMID: 34900082 PMCID: PMC8656240 DOI: 10.1121/2.0001504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study investigated the effectiveness of individual laryngeal muscles in regulating the mean glottal flow and glottal closure pattern during phonation in an in vivo canine larynx model. Phonation experiments were performed with parametric stimulation of the thyroarytenoid (TA), lateral cricoarytenoid (LCA), interarytenoid (IA), and the cricothyroid (CT) muscles. For each stimulation level, the subglottal pressure was gradually increased to produce phonation. The subglottal pressure, the volume flow, and the outside acoustic pressure were measured together with high-speed recording of vocal fold vibration from a superior view. The results show that the TA muscle played a dominant role in regulating both the membranous glottal width and the glottal closure pattern during phonation, indicating an important role of the TA muscle in regulating voice quality. The TA muscle activation was also the most effective in regulating the mean glottal flow, and thus an important laryngeal adjustment in airflow conservation, particularly at high subglottal pressures or loud voice production, although increasing TA activation decreased the vocal intensity. This study also presented a complete set of data on muscular control of the glottal width and voice production, which can be used in validation of computational models of vocal fold posturing and voice production.
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Chhetri DK, Rafizadeh S. Young's modulus of canine vocal fold cover layers. J Voice 2014; 28:406-10. [PMID: 24491497 DOI: 10.1016/j.jvoice.2013.12.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Accepted: 12/04/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The objective of this study was to measure the elastic modulus (Young's modulus) of canine vocal fold cover layers. STUDY DESIGN Basic science study. METHODS Cover layers from vocal folds of eight canine larynges were dissected. Cover layer samples from the mid-membranous, medial vocal fold surface area were used to measure material stiffness using a previously validated indentation method. Cover layers from two human larynges were also measured as control references. Superior and inferior medial cover layers were measured separately. A total of 15 superior medial surface and 17 inferior medial surface specimens from the canine and two and four specimens, respectively, from the human were tested. RESULTS In the canine larynges, the mean Young's modulus of the superior medial surface was 4.2 kPa (range, 3.0-5.4 kPa; standard deviation [SD], 0.6 kPa) and of the inferior medial surface was 6.8 kPa (range, 5.4-8.5 kPa; SD, 0.8 kPa). Measurements on human cover samples were 5.0 kPa (range, 4.7-5.4 kPa; SD, 0.5 kPa) and 7.0 kPa (range, 6.7-7.3 kPa; SD, 0.3 kPa) for the superior medial and inferior medial surface, respectively. Human measurements were similar to the previously validated measurements. There was no difference between the stiffness measurements in the human and canine cover layer samples (P>0.05). CONCLUSIONS The elastic stiffness (Young's modulus) of the canine and human vocal fold cover layers is similar. Findings support the use of canine larynx as an externally valid model to study voice production.
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Affiliation(s)
- Dinesh K Chhetri
- Laryngeal Physiology Laboratory, Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California.
| | - Sassan Rafizadeh
- Laryngeal Physiology Laboratory, Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California
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