Functional definitions of vocal fold geometry for laryngeal biomechanical modeling

Quantification of Porcine Vocal Fold Geometry

OBJECTIVE

The aim of this study was to quantify porcine vocal fold medial surface geometry and three-dimensional geometric distortion induced by freezing the larynx, especially in the region of the vocal folds.

STUDY DESIGN

The medial surface geometries of five excised porcine larynges were quantified and reported.

METHODS

Five porcine larynges were imaged in a micro-CT scanner, frozen, and rescanned. Segmentations and three-dimensional reconstructions were used to quantify and characterize geometric features. Comparisons were made with geometry data previously obtained using canine and human vocal folds as well as geometries of selected synthetic vocal fold models.

RESULTS

Freezing induced an overall expansion of approximately 5% in the transverse plane and comparable levels of nonuniform distortion in sagittal and coronal planes. The medial surface of the porcine vocal folds was found to compare reasonably well with other geometries, although the compared geometries exhibited a notable discrepancy with one set of published human female vocal fold geometry.

CONCLUSIONS

Porcine vocal folds are qualitatively geometrically similar to data available for canine and human vocal folds, as well as commonly used models. Freezing of tissue in the larynx causes distortion of around 5%. The data can provide direction in estimating uncertainty due to bulk distortion of tissue caused by freezing, as well as quantitative geometric data that can be directly used in developing vocal fold models.

Adapted to roar: functional morphology of tiger and lion vocal folds

Vocal production requires active control of the respiratory system, larynx and vocal tract. Vocal sounds in mammals are produced by flow-induced vocal fold oscillation, which requires vocal fold tissue that can sustain the mechanical stress during phonation. Our understanding of the relationship between morphology and vocal function of vocal folds is very limited. Here we tested the hypothesis that vocal fold morphology and viscoelastic properties allow a prediction of fundamental frequency range of sounds that can be produced, and minimal lung pressure necessary to initiate phonation. We tested the hypothesis in lions and tigers who are well-known for producing low frequency and very loud roaring sounds that expose vocal folds to large stresses. In histological sections, we found that the Panthera vocal fold lamina propria consists of a lateral region with adipocytes embedded in a network of collagen and elastin fibers and hyaluronan. There is also a medial region that contains only fibrous proteins and hyaluronan but no fat cells. Young's moduli range between 10 and 2000 kPa for strains up to 60%. Shear moduli ranged between 0.1 and 2 kPa and differed between layers. Biomechanical and morphological data were used to make predictions of fundamental frequency and subglottal pressure ranges. Such predictions agreed well with measurements from natural phonation and phonation of excised larynges, respectively. We assume that fat shapes Panthera vocal folds into an advantageous geometry for phonation and it protects vocal folds. Its primary function is probably not to increase vocal fold mass as suggested previously. The large square-shaped Panthera vocal fold eases phonation onset and thereby extends the dynamic range of the voice.

Identification of geometric parameters influencing the flow-induced vibration of a two-layer self-oscillating computational vocal fold model

Simplified models have been used to simulate and study the flow-induced vibrations of the human vocal folds. While it is clear that the models' responses are sensitive to geometry, it is not clear how and to what extent specific geometric features influence model motion. In this study geometric features that played significant roles in governing the motion of a two-layer (body-cover), two-dimensional, finite element vocal fold model were identified. The model was defined using a flow solver based on the viscous, unsteady, Navier-Stokes equations and a solid solver that allowed for large strain and deformation. A screening-type design-of-experiments approach was used to identify the relative importance of 13 geometric parameters. Five output measures were analyzed to assess the magnitude of each geometric parameter's effect on the model's motion. The measures related to frequency, glottal width, flow rate, intraglottal angle, and intraglottal phase delay. The most significant geometric parameters were those associated with the cover--primarily the pre-phonatory intraglottal angle--as well as the body inferior angle. Some models exhibited evidence of improved model motion, including mucosal wave-like motion and alternating convergent-divergent glottal profiles, although further improvements are still needed to more closely mimic human vocal fold motion.

Treatment of acute vocal fold scar with local injection of basic fibroblast growth factor: a canine study

CONCLUSIONS

Results of the current study revealed improved phonation threshold pressure (PTP), normalized mucosal wave amplitude (NMWA), and less contraction of the lamina propria in injured larynges treated with basic fibroblast growth factor (bFGF).

OBJECTIVES

We investigated the effects of local injection of bFGF for treatment of acute vocal fold injury in a canine model.

METHODS

Vocal folds of eight beagles were unilaterally injured by removal of the mucosa under direct laryngoscopy. Four beagles received local injections of bFGF delivered to the scarred vocal fold at 1 month after injury. The remaining four beagles received local injections of saline and served as a sham-treatment group. Larynges were harvested 5 months after treatment and excised larynx experiments were performed to measure PTP, NMWA, and normalized glottal gap (NGG). Histologic staining was performed to evaluate structural changes of the extracellular matrix.

RESULTS

Excised larynx measurements revealed significantly lower PTP and increased NMWA in bFGF-treated vocal fold. Elastica Van Gieson staining revealed less contraction of the bFGF-treated vocal fold. Histologic measurements revealed that the thickness of the lamina propria was significantly greater in the bFGF-treated vocal fold. Alcian blue staining revealed improved restoration of hyaluronic acid in the bFGF-treated vocal fold.

Geometry of human vocal folds and glottal channel for mathematical and biomechanical modeling of voice production

Current models of the vocal folds derive their shape from approximate information rather than from exactly measured data. The objective of this study was to obtain detailed measurements on the geometry of human vocal folds and the glottal channel in phonatory position. A non-destructive casting methodology was developed to capture the vocal fold shape from excised human larynges on both medial and superior surfaces. Two female larynges, each in two different phonatory configurations corresponding to low and high fundamental frequency of the vocal fold vibrations, were measured. A coordinate measuring machine was used to digitize the casts yielding 3D computer models of the vocal fold shape. The coronal sections were located in the models, extracted and fitted by piecewise-defined cubic functions allowing a mathematical expression of the 2D shape of the glottal channel. Left-right differences between the cross-sectional shapes of the vocal folds were found in both the larynges.

A new approach to geometrical measurements in an animal model of vocal fold scar

A standard method for quantifying the geometric properties of vocal folds has not been widely adopted. An ideal method of geometrical measurement should effectively quantify the dimensions of the medial vibratory portion of the vocal fold, should be easily performed, should yield consistent results, and should be readily available at little to no cost. We have developed a new approach for geometrical measurements to meet these goals. The objective of this study is to describe this new approach and to assess its effectiveness in a canine model of vocal fold scar. One hundred thirty-five mid-membranous coronal sections of vocal folds from 10 canines (five with unilateral surgical scarring) were examined by light microscopy; digital images were captured. ImageJ was used to measure a variety of described parameters. Comparison between scarred vocal folds and control vocal folds was made. At least 20% of the slides for each vocal fold were randomly selected (n=42) for repeat measurements of interrater and intrarater reliability. A statistically significant difference between scarred and control vocal folds was obtained for horizontal distance (P<0.001), vertical distance (P=0.005), area (P<0.001), mean optical density (OD) (P<0.001), and OD at defined points along the length of the vocal fold (P< or =0.009). Reliability calculations for intrarater and interrater measurements ranged from r=0.845 to r=0.994 and from r=0.734 to r=0.976, respectively. The proposed approach for geometrical measurements meets the intended objectives in a canine model of vocal fold scar. Future work is needed to apply this approach to other model systems.

Active and passive properties of canine abduction/adduction laryngeal muscles

Active and passive characteristics of the canine adductor- abductor muscles were investigated through a series of experiments conducted in vitro. Samples of canine posterior cricoarytenoid muscle (PCA), lateral cricoarytenoid muscle (LCA), and interarytenoid muscle (IA) were dissected from dog larynges excised a few minutes before death and kept in Krebs-Ringer solution at a temperature of 37 degrees C +/- 1 degree C and a pH of 7.4 +/- 0.05. Active twitch and tetanic force was obtained in an isometric condition by applying field stimulation to the muscle samples through a pair of parallel-plate platinum electrodes. Force and elongation of the samples were obtained electronically with a dual-servo system (ergometer). The results indicate that the twitch contraction times of the three muscles are very similar, with the average of 32 +/- 1.9 ms for PCA, 29 +/- 1.6 ms for LCA, and 32 +/- 2.4 ms for IA across all elongations. Thus, PCA, LCA, and IA muscles are all faster than the cricothyroid (CT) muscles but slower than the thyroarytenoid (TA) muscles. The tetanic force response times of these muscles are also similar, with a maximum rate of force increase of 0.14 N/ms.

Vocal fold tissue failure: preliminary data and constitutive modeling

In human voice production (phonation), linear small-amplitude vocal fold oscillation occurs only under restricted conditions. Physiologically, phonation more often involves large-amplitude oscillation associated with tissue stresses and strains beyond their linear viscoelastic limits, particularly in the lamina propria extracellular matrix (ECM). This study reports some preliminary measurements of tissue deformation and failure response of the vocal fold ECM under large-strain shear The primary goal was to formulate and test a novel constitutive model for vocal fold tissue failure, based on a standard-linear cohesive-zone (SL-CZ) approach. Tissue specimens of the sheep vocal fold mucosa were subjected to torsional deformation in vitro, at constant strain rates corresponding to twist rates of 0.01, 0.1, and 1.0 rad/s. The vocal fold ECM demonstrated nonlinear stress-strain and rate-dependent failure response with a failure strain as low as 0.40 rad. A finite-element implementation of the SL-CZ model was capable of capturing the rate dependence in these preliminary data, demonstrating the model's potential for describing tissue failure. Further studies with additional tissue specimens and model improvements are needed to better understand vocal fold tissue failure.

A three-dimensional model of vocal fold abduction/adduction

A three-dimensional biomechanical model of tissue deformation was developed to simulate dynamic vocal fold abduction and adduction. The model was made of 1721 nearly incompressible finite elements. The cricoarytenoid joint was modeled as a rocking-sliding motion, similar to two concentric cylinders. The vocal ligament and the thyroarytenoid muscle's fiber characteristics were implemented as a fiber-gel composite made of an isotropic ground substance imbedded with fibers. These fibers had contractile and/or passive nonlinear stress-strain characteristics. The verification of the model was made by comparing the range and speed of motion to published vocal fold kinematic data. The model simulated abduction to a maximum glottal angle of about 31 degrees. Using the posterior-cricoarytenoid muscle, the model produced an angular abduction speed of 405 degrees per second. The system mechanics seemed to favor abduction over adduction in both peak speed and response time, even when all intrinsic muscle properties were kept identical. The model also verified the notion that the vocalis and muscularis portions of the thyroarytenoid muscle play significantly different roles in posturing, with the muscularis portion having the larger effect on arytenoid movement. Other insights into the mechanisms of abduction/adduction were given.

Geometrical deformation of vocal fold tissues induced by formalin fixation

OBJECTIVES/HYPOTHESIS

Many existing studies of vocal fold geometry are based on anatomical measurements made on histologically fixed laryngeal tissues using formalin. However, the validity of these geometric data is questionable because of the potentially significant tissue deformation associated with formalin fixation, particularly tissue shrinkage. Previous experiments have shown that valid geometric data may be obtained on vocal fold tissue samples quickly frozen with liquid nitrogen. Based on this finding, the present study attempted to quantify the geometric deformation of formalin-fixed vocal fold tissues with respect to quick-frozen tissues.

METHODS

Six freshly harvested canine larynges were quickly frozen with liquid nitrogen and sectioned at the mid-membranous coronal plane. Each larynx was thawed and divided into halves along the midsagittal plane, one of which was not fixed; the other was fixed with formalin, from which histological tissue sections were also prepared. Measurements of vocal fold geometry were made on digital images of mid-membranous coronal sections of the tissue samples, based on linear dimensions of vocal fold depth and thickness defined functionally for biomechanical applications.

RESULTS

Significant shrinkage of the vocal fold (particularly the vocal fold body) and considerable distortion of the vocal fold contour (particularly at the free edge) were observed for the formalin-fixed samples and the histological sections in comparison with the unfixed samples.

CONCLUSIONS

Results of the present study suggested that significant geometric artifacts are induced by conventional histological fixation of laryngeal tissues using formalin. These artifacts should be carefully considered for interpreting any vocal fold geometric data obtained through formalin fixation.

Laryngeal biomechanics and vocal communication in the squirrel monkey (Saimiri boliviensis)

The larynges of eight squirrel monkeys were harvested, dissected, mounted on a pseudotracheal tube, and phonated using compressed air. Patterns of vocal fold oscillation were compared with sound spectrograms of calls recorded from monkeys in our colony. Four different regimes of vocal fold activation were identified. Regime 1 resembled typical human vowel production, with regular vocal-fold vibration, a prominent fundamental frequency, and an accompanying series of harmonic overtones. This regime is likely to give rise to squirrel monkey "cackles," as well as a variety of other harmonically structured calls. In regime 2, the pattern of vibrations exhibited the presence of two or more unrelated frequencies (biphonation). This regime of glottal activity resembled the biphonation observed in many exemplars of "twitter" and "kecker" calls. The vocal folds oscillated continuously in regime 3, but produced glottal pulses whose amplitudes waxed and waned rhythmically. This phenomenon resulted in the percept of a series of discrete pulses, and may give rise to "errs," "churrs," and other calls composed of a rapid sequence of acoustic elements. In regime 4, the period of each oscillation was quasi-irregular. Shrieks and other broadband calls or call elements that lack an apparent fundamental frequency may be produced in this manner.

An investigation of cricoarytenoid joint mechanics using simulated muscle forces

Rotational and translational stiffnesses were calculated for arytenoid motion about the cricoarytenoid joint. These calculations were obtained from measurements on five excised human larynxes. For each larynx, known forces were applied to the arytenoid cartilage, and three markers were tracked as a function of applied forces. Assuming rigid body motion, arytenoid translations and rotations were computed for each applied force. Translational stiffnesses were obtained by plotting force versus displacement, and rotational stiffnesses were calculated by plotting torque versus angular rotation. A major finding was that the translational stiffness along the anterior-posterior direction was three times as great as the translational stiffnesses in the other two directions. This nonisotropic nature of the stiffnesses may be an important consideration for phonosurgeons who wish to avoid subluxation of the cricoarytenoid joint in patients. The computed rotational and translational stiffnesses currently are being implemented in 2D and 3D models. These stiffness parameters play a vital role in prephonatory glottal shaping, which in turn exerts a majorinfluence on all aspects of vocal fold vibration, including fundamental frequency, voice quality, voice register, and phonation threshold pressure.