Triangular body-cover model of the vocal folds with coordinated activation of the five intrinsic laryngeal muscles

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.Fil: 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: Peterson, Sean D.. University of Waterloo; CanadáFil: Erath, Byron D.. Clarkson University; Estados UnidosFil: Hillman, Robert E.. Massachusetts General Hospital; Estados UnidosFil: Zañartu, Matías. Universidad Tecnica Federico Santa Maria.; Chil

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

Experimental and theoretical assessment of flow asymmetries in normal and pathological speech

Speech is initiated when a critical pressure is achieved in the lungs, forcing the vocal folds apart. As the air is pushed up the trachea and through the larynx, the resulting aerodynamic forces, coupled with the vocal fold tissue properties, excite self-sustained oscillations of the vocal folds, which form the basis for vocalized speech. Voiced speech is a complex process which involves the inter-dependency of fluid flow, tissue properties, and acoustics. The speech process becomes even more complicated by the introduction of neurogenic and structural pathologies which may disrupt vocal fold motion and alter fluid behavior and/or the acoustical response. Recurrent laryngeal nerve paralysis is the most common neurogenic pathology resulting from damage to the vagus nerve which innervates all of the muscles of the larynx except the cricothyroid. Recurrent laryngeal nerve paralysis usually results in the complete immobility of the damaged vocal fold. Unilateral polyps, characterized by large growths on the medial surface of the vocal folds, are a common structural pathology that most often results from misuse and abuse of the voice. Flow through 7.5 times scaled-up driven vocal fold models in a pressure-driven flow facility was investigated for both normal and pathological speech conditions over a range of physiologically relevant flow rates. The glottal jet trajectory was resolved during the divergent portions of the phonatory cycle. The glottal jet assumed a bi-modal trajectory for normal speech. Vocal fold paresis and paralysis were modeled by limiting the motion of one vocal fold wall, which resulted in a stable, stationary attachment of the flow to the impaired vocal fold wall. The presence of a unilateral polyp introduced (1) large spatial variations in the flow in both the anterior-posterior and the inferior-superior directions and (2) fluctuations in the flow separation points that were atypical compared to those found during normal vocal fold motion. A theoretical solution for flow over an infinite flat plate that is translating and rotating at constant velocity in a direction normal to the freestream velocity was developed for application to intraglottal flows. The solution addresses the role of boundary conditions on flow stability. It is shown that downstream of the point of rotation, the influence of a rotating boundary acts as a favorable pressure gradient, stabilizing the flow field. A theoretical self-similarity solution was derived in the rotating reference frame for flow over the rotating and translating flat plate, allowing direct application of the solution to flow within the glottis. Reasonable agreement (∼ 5%) between the theory and the experimental results was found. A new procedure for applying the theoretical solution to multi-mass models of speech is proposed, with comparison to the often-employed, but inappropriate, Bernoulli flow assumption

Bayesian Inference of Vocal Fold Material Properties from Glottal Area Waveforms Using a 2D Finite Element Model

Bayesian estimation has been previously demonstrated as a viable method for developing subject-specific vocal fold models from observations of the glottal area waveform. These prior efforts, however, have been restricted to lumped-element fitting models and synthetic observation data. The indirect relationship between the lumped-element parameters and physical tissue properties renders extracting the latter from the former difficult. Herein we propose a finite element fitting model, which treats the vocal folds as a viscoelastic deformable body comprised of three layers. Using the glottal area waveforms generated by self-oscillating silicone vocal folds we directly estimate the elastic moduli, density, and other material properties of the silicone folds using a Bayesian importance sampling approach. Estimated material properties agree with the “ground truth” experimental values to within 3 % for most parameters. By considering cases with varying subglottal pressure and medial compression we demonstrate that the finite element model coupled with Bayesian estimation is sufficiently sensitive to distinguish between experimental configurations. Additional information not available experimentally, namely, contact pressures, are extracted from the developed finite element models. The contact pressures are found to increase with medial compression and subglottal pressure, in agreement with expectation

Estimating vocal fold contact pressure from raw laryngeal high-speed videoendoscopy using a Hertz contact model

The development of trauma-induced lesions of the vocal folds (VFs) has been linked to a high collision pressure on the VF surface. However, there are no direct methods for the clinical assessment of VF collision, thus limiting the objective assessment of these disorders. In this study, we develop a video processing technique to directly quantify the mechanical impact of the VFs using solely laryngeal kinematic data. The technique is based on an edge tracking framework that estimates the kinematic sequence of each VF edge with a Kalman filter approach and a Hertzian impact model to predict the contact force during the collision. The proposed formulation overcomes several limitations of prior efforts since it uses a more relevant VF contact geometry, it does not require calibrated physical dimensions, it is normalized by the tissue properties, and it applies a correction factor for using a superior view only. The proposed approach is validated against numerical models, silicone vocal fold models, and prior studies. A case study with high-speed videoendoscopy recordings provides initial insights between the sound pressure level and contact pressure. Thus, the proposed method has a high potential in clinical practice and could also be adapted to operate with laryngeal stroboscopic systems