Contribution of paranasal sinuses to the acoustic properties of the nasal tract

Three-dimensional reconstruction of King Henri IV's paranasal sinuses and mastoid cells

PURPOSE

The preserved head of King Henri IV of France (life 1553-1610, reign 1589-1610) has survived to the present day thanks to high-quality embalming and favorable conservation conditions. The aim of this study was to examine Henry IV's upper resonant cavities and mastoids using an original and innovative forensic three-dimensional segmentation method.

METHODS

The paranasal sinuses and mastoid cells of King Henri IV of France were studied by cross-referencing available biographical information with clinical and flexible endoscopic examination and computed tomography (CT-scan) imaging. The paranasal sinuses and mastoid cells were delineated and their volumes were assessed using ITK-SNAP 4.0 software (open-source). Graphical representations were created using Fusion 360® (Autodesk Inc., San Rafael, CA, USA) and MeshMixer® (Autodesk Inc., San Rafael, CA, USA).

RESULTS

Paranasal sinus tomodensitometry revealed abnormalities in shape and number. Henri IV of France suffered from sinus aplasia. Neither the left sphenoid nor left frontal sinus contrasted sharply, and a remarkable pneumatization of the right clinoid processes extended throughout the height of the right pterygoid process. The total volumes of Henri IV's mastoid air-cells were estimated at 27 and 26 mL, respectively, for the right and left sides, exceeding the normal mean and the maximum of modern subjects by a wide margin. No sign of chronic ear or sinus condition was found.

CONCLUSIONS

An innovative method has been developed in forensic medicine to establish hypotheses about the growth and respiratory conditions of the face.

Temporal and Permanent Changes Induced by Maxillary Sinus Lifting with Bone Grafts and Maxillary Functional Endoscopic Sinus Surgery in the Voice Characteristics-Systematic Review

Sinus surgery procedures such as sinus lifting with bone grafting or maxillary functional endoscopy surgery (FESS) can present different complications. The aims of this systematic review are to compile the post-operatory complications of sinus elevation with bone grafting and FESS including voice changes, and to elucidate if those changes are either permanent or temporary. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used, and the literature was exhaustively searched without time restrictions for randomized and non-randomized clinical studies, cohort studies (prospective and retrospective), and clinical case reports with ≥4 cases focused on sinus lift procedures with bone grafts and functional endoscopic maxillary sinus surgery. A total of 435 manuscripts were identified. After reading the abstracts, 101 articles were selected to be read in full. Twenty articles that fulfilled the inclusion criteria were included for analysis. Within the limitations of this systematic review, complications are frequent after sinus lifting with bone grafts and after FEES. Voice parameters are scarcely evaluated after sinus lifting with bone grafts and no voice changes are reported. The voice changes that occur after FESS include a decreased fundamental frequency, increased nasality, and nasalance, all of which are transitory.

Investigation of resonance strategies of high pitch singing sopranos using dynamic three-dimensional magnetic resonance imaging

Resonance-strategies with respect to vocal registers, i.e., frequency-ranges of uniform, demarcated voice quality, for the highest part of the female voice are still not completely understood. The first and second vocal tract resonances usually determine vowels. If the fundamental frequency exceeds the vowel-shaping resonance frequencies of speech, vocal tract resonances are tuned to voice source partials. It has not yet been clarified if such tuning is applicable for the entire voice-range, particularly for the top pitches. We investigated professional sopranos who regularly sing pitches above C6 (1047 Hz). Dynamic three-dimensional (3D) magnetic resonance imaging was used to calculate resonances for pitches from C5 (523 Hz) to C7 (2093 Hz) with different vowel configurations ([a:], [i:], [u:]), and different contexts (scales or octave jumps). A spectral analysis and an acoustic analysis of 3D-printed vocal tract models were conducted. The results suggest that there is no exclusive register-defining resonance-strategy. The intersection of fundamental frequency and first vocal tract resonance was not found to necessarily indicate a register shift. The articulators and the vocal tract resonances were either kept without significant adjustments, or the f_R1:f_o-tuning, wherein the first vocal tract resonance enhances the fundamental frequency, was applied until F6 (1396 Hz). An f_R2:f_o-tuning was not observed.