Differentiation of voice disorders using objective parameters from harmonic waveform modeling in high-speed digital imaging

High-speed digital imaging (HSDI) has recently become clinically available for the direct observation of vocal fold movement in the last 20 years. However, before it can become routinely used in the clinical setting, a universal means of objectively analyzing and interpreting the HSDI data must be established. In this study, preliminary data was gathered for five parameters used to objectively analyze vocal fold vibratory patterns observed with HSDI. The parameters investigated were established by Ikuma, Kunduk, and McWhorter (2012a) and were previously studied with a small sample (N=8) comparing pre and post-phonosurgical removal of benign lesions. The five parameters included fundamental frequency standard deviation (F0SD), harmonics-to-noise ratio (HNR) mean, open quotient (OQ) mean, speed index (SI) mean, and relative glottal gap (RGG) mean. The current study aimed to statistically and visually analyze measurements of the five objective parameters for differences between pathology groups with different etiologies. High-speed videos (N=50) were divided into five groups based on one of the following medical diagnoses: normal voice, vocal fold nodules, polyps, true vocal fold motion impairment (TVFMI), and adductor spasmodic dysphonia (ADSD). Statistical analysis showed that HNR mean differentiated normal voices from ADSD voices and that F0 mean differentiated ADSD voices from all groups except vocal fold nodules (p \u3c 0.005). Visual analysis revealed a strong trend for RGG mean to differentiate vocal fold nodules from all other groups. Less prominent visual trends for OQ mean and SI mean were also noted

Fitting a biomechanical model of the folds to high-speed video data through bayesian estimation

High-speed video recording of the vocal folds during sustained phonation has become a widespread diagnostic tool, and the development of imaging techniques able to perform automated tracking and analysis of relevant glottal cues, such as folds edge position or glottal area, is an active research field. In this paper, a vocal folds vibration analysis method based on the processing of visual data through a biomechanical model of the layngeal dynamics is proposed. The procedure relies on a Bayesian non-stationary estimation of the biomechanical model parameters and state, to fit the folds edge position extracted from the high-speed video endoscopic data. This finely tuned dynamical model is then used as a state transition model in a Bayesian setting, and it allows to obtain a physiologically motivated estimation of upper and lower vocal folds edge position. Based on model prediction, an hypothesis on the lower fold position can be made even in complete fold occlusion conditions occurring during the end of the closed phase and the beginning of the open phase of the glottal cycle. To demonstrate the suitability of the procedure, the method is assessed on a set of audiovisual recordings featuring high-speed video endoscopic data from healthy subjects producing sustained voiced phonation with different laryngeal settings

Biomechanics

Biomechanics is a vast discipline within the field of Biomedical Engineering. It explores the underlying mechanics of how biological and physiological systems move. It encompasses important clinical applications to address questions related to medicine using engineering mechanics principles. Biomechanics includes interdisciplinary concepts from engineers, physicians, therapists, biologists, physicists, and mathematicians. Through their collaborative efforts, biomechanics research is ever changing and expanding, explaining new mechanisms and principles for dynamic human systems. Biomechanics is used to describe how the human body moves, walks, and breathes, in addition to how it responds to injury and rehabilitation. Advanced biomechanical modeling methods, such as inverse dynamics, finite element analysis, and musculoskeletal modeling are used to simulate and investigate human situations in regard to movement and injury. Biomechanical technologies are progressing to answer contemporary medical questions. The future of biomechanics is dependent on interdisciplinary research efforts and the education of tomorrow’s scientists

Direct measurement and modeling of intraglottal, subglottal, and vocal fold collision pressures during phonation in an individual with a hemilaryngectomy

The purpose of this paper is to report on the first in vivo application of a recently developed transoral, dual-sensor pressure probe that directly measures intraglottal, subglottal, and vocal fold collision pressures during phonation. Synchronous measurement of intraglottal and subglottal pressures was accomplished using two miniature pressure sensors mounted on the end of the probe and inserted transorally in a 78-year-old male who had previously undergone surgical removal of his right vocal fold for treatment of laryngeal cancer. The endoscopist used one hand to position the custom probe against the surgically medialized scar band that replaced the right vocal fold and used the other hand to position a transoral endoscope to record laryngeal high-speed videoendoscopy of the vibrating left vocal fold contacting the pressure probe. Visualization of the larynx during sustained phonation allowed the endoscopist to place the dual-sensor pressure probe such that the proximal sensor was positioned intraglottally and the distal sensor subglottally. The proximal pressure sensor was verified to be in the strike zone of vocal fold collision during phonation when the intraglottal pressure signal exhibited three characteristics: an impulsive peak at the start of the closed phase, a rounded peak during the open phase, and a minimum value around zero immediately preceding the impulsive peak of the subsequent phonatory cycle. Numerical voice production modeling was applied to validate model-based predictions of vocal fold collision pressure using kinematic vocal fold measures. The results successfully demonstrated feasibility of in vivo measurement of vocal fold collision pressure in an individual with a hemilaryngectomy, motivating ongoing data collection that is designed to aid in the development of vocal dose measures that incorporate vocal fold impact collision and stresses.Fil: Mehta, Daryush D.. Massachusetts General Hospital; Estados UnidosFil: Kobler, James B.. Massachusetts General Hospital; Estados UnidosFil: Zeitels, Steven M.. Harvard Medical School. Department of Medicine. Massachusetts General Hospital; Estados UnidosFil: Zañartu, Matías. Universidad Técnica Federico Santa María; ChileFil: Ibarra, Emiro J.. Universidad Técnica Federico Santa María; ChileFil: Alzamendi, Gabriel Alejandro. Universidad Nacional de Entre Ríos. Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática; ArgentinaFil: Manriquez, Rodrigo. Universidad Técnica Federico Santa María; ChileFil: Erath, Byron D.. Clarkson University; Estados UnidosFil: Peterson, Sean D.. University of Waterloo; CanadáFil: Petrillo, Robert H.. Center For Laryngeal Surgery and Voice Rehabilitation; Estados UnidosFil: Hillman, Robert E.. Center For Laryngeal Surgery and Voice Rehabilitation; Estados Unidos. Harvard Medical School. Department of Medicine. Massachusetts General Hospital; Estados Unido

Aerospace Medicine and Biology

This bibliography lists 184 reports, articles and other documents introduced into the NASA Scientific and Technical Information System during October 1989. Subject coverage includes: aerospace medicine and psychology, life support systems and controlled environments, safety equipment, exobiology and extraterrestrial life, and flight crew behavior and performance

Accurate glottal model parametrization by integrating audio and high-speed endoscopic video data

The aim of this paper is to evaluate the effectiveness of using video data for voice source parametrization in the representation of voice production through physical modeling. Laryngeal imaging techniques can be effectively used to obtain vocal fold video sequences and to derive time patterns of relevant glottal cues, such as folds edge position or glottal area. In many physically based numerical models of the vocal folds, these parameters are estimated from the inverse filtered glottal flow waveform, obtained from audio recordings of the sound pressure at lips. However, this model inversion process is often problematic and affected by accuracy and robustness issues. It is here discussed how video analysis of the fold vibration might be effectively coupled to the parametric estimation algorithms based on voice recordings, to improve accuracy and robustness of model inversio

Models and Analysis of Vocal Emissions for Biomedical Applications

The Models and Analysis of Vocal Emissions with Biomedical Applications (MAVEBA) workshop came into being in 1999 from the particularly felt need of sharing know-how, objectives and results between areas that until then seemed quite distinct such as bioengineering, medicine and singing. MAVEBA deals with all aspects concerning the study of the human voice with applications ranging from the neonate to the adult and elderly. Over the years the initial issues have grown and spread also in other aspects of research such as occupational voice disorders, neurology, rehabilitation, image and video analysis. MAVEBA takes place every two years always in Firenze, Italy

Consensus Paper: Neurophysiological Assessments of Ataxias in Daily Practice

The purpose of this consensus paper is to review electrophysiological abnormalities and to provide a guideline of neurophysiological assessments in cerebellar ataxias. All authors agree that standard electrophysiological methods should be systematically applied in all cases of ataxia to reveal accompanying peripheral neuropathy, the involvement of the dorsal columns, pyramidal tracts and the brainstem. Electroencephalography should also be considered, although findings are frequently non-specific. Electrophysiology helps define the neuronal systems affected by the disease in an individual patient and to understand the phenotypes of the different types of ataxia on a more general level. As yet, there is no established electrophysiological measure which is sensitive and specific of cerebellar dysfunction in ataxias. The authors agree that cerebellar brain inhibition (CBI), which is based on a paired-pulse transcranial magnetic stimulation (TMS) paradigm assessing cerebellar-cortical connectivity, is likely a useful measure of cerebellar function. Although its role in the investigation and diagnoses of different types of ataxias is unclear, it will be of interest to study its utility in this type of conditions. The authors agree that detailed clinical examination reveals core features of ataxia (i.e., dysarthria, truncal, gait and limb ataxia, oculomotor dysfunction) and is sufficient for formulating a differential diagnosis. Clinical assessment of oculomotor function, especially saccades and the vestibulo-ocular reflex (VOR) which are most easily examined both at the bedside and with quantitative testing techniques, is of particular help for differential diagnosis in many cases. Pure clinical measures, however, are not sensitive enough to reveal minute fluctuations or early treatment response as most relevant for pre-clinical stages of disease which might be amenable to study in future intervention trials. The authors agree that quantitative measures of ataxia are desirable as biomarkers. Methods are discussed that allow quantification of ataxia in laboratory as well as in clinical and real-life settings, for instance at the patients' home. Future studies are needed to demonstrate their usefulness as biomarkers in pharmaceutical or rehabilitation trials

Models and Analysis of Vocal Emissions for Biomedical Applications

The MAVEBA Workshop proceedings, held on a biannual basis, collect the scientific papers presented both as oral and poster contributions, during the conference. The main subjects are: development of theoretical and mechanical models as an aid to the study of main phonatory dysfunctions, as well as the biomedical engineering methods for the analysis of voice signals and images, as a support to clinical diagnosis and classification of vocal pathologies