Aerodynamic Study For Laryngeal Function Assessment Using Airflow Interruption Me

使用气流中断 Me 进行喉功能评估的空气动力学研究

• 批准号: 9134120
• 负责人: Jack J Jiang
• 金额: $ 30.9万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9134120
• 关键词: Acoustics; Affect; Aftercare; American; Biological Neural Networks; Botox; Cheek structure; Clinical; Computer Simulation; Data; Devices; Diagnostic; Disease; Dysphonia; Economics; Evaluation; Evidence based practice; Evidence based treatment; Family; Friends; Goals; Image; Individual; Injection of therapeutic agent; Interruption; Investigation; Laboratories; Larynx; Lead; Length; Lesion; Life; Location; Masks; Measurement; Measures; Mechanics; Methods; Modality; Modification; Monitor; Nature; Nodule; Operative Surgical Procedures; Outcome; Paralysed; Pathology; Pathway Analysis; Patient Monitoring; Patients; Phase; Phonation; Polyps; Production; Quality of life; Recruitment Activity; Reflex action; Research; Resistance; Role; Social Impacts; Societies; Spastic Dysphonias; Speed; System; Techniques; Time; Transducers; Treatment Efficacy; Treatment Protocols; Video Recording; Visual; Voice; Voice Disorders; Voice Quality; Work; auditory feedback; clinical application; common treatment; economic impact; effective therapy; glottis; improved; novel; pressure; profiles in patients; restraint; social; sound; success; trend; vibration; visual feedback; vocal cord; voice therapy

DESCRIPTION (provided by applicant): Voice disorders affect millions of Americans and have been targeted as a national priority for investigation. The impact of voice disorders on quality of life is significant; the ability to work, relate to friends and family, participate in social activties, and simply engage in everyday life becomes effortful, if not impossible, when one's voice is impaired. The multi-factorial nature of voice disorders necessitates that clinicians understand how the larynx functions in order to make appropriate treatment decisions. During phonation, the larynx serves as an energy transducer, transferring aerodynamic energy in the form of subglottal pressure (Ps) and airflow into acoustic energy in the form of sound. Noninvasive aerodynamic assessment is an objective and quantitative method of evaluating the inputs to voice production. The proposed research has two interrelated parts. In part I, research will focus on improving three methods of aerodynamic measurement developed in our laboratory: airflow interruption; incomplete airflow interruption; and airflow redirection. These methods have all been demonstrated to be accurate. Modifications will be made to the devices to allow for measurement of phonation threshold flow and phonation threshold power, two new parameters proposed by our laboratory that have been experimentally shown to be valuable. Enhancing these devices with additions such as auditory feedback, visual feedback, cheek restraints, and modified analysis techniques will also be investigated, potentially reducing intrasubject variability. We will also determine the optimal interruption length for measurement of Ps and determine how interruption affects vocal fold vibration by combining our aerodynamic assessment devices with high-speed video imaging. Elicitation of a reflex has hindered the widespread clinical application of airflow interruption. Visualizing the vocal folds during airflow interruption will allow us to determine if this reflex occurs at the larynx and if so, its precise latency. Data from part I will allow for selection of an improved method of aerodynamic assessment. In part II, the optimal system developed in part I will be used to evaluate and compare treatments for common voice disorders. The effect of polyp and nodule size on aerodynamic parameters will be evaluated; how aerodynamic parameters change as lesion size decreases will also be investigated. Pre- and post-treatment aerodynamic assessment will be performed to determine the effect of Botox injections on spasmodic dysphonia. We will also compare several common treatments for vocal fold paralysis. Though numerous treatments are available, an optimal treatment has yet to be developed. Real-time intraoperative measurements of vocal efficiency will be investigated as a means to optimize medialization laryngoplasty and arytenoid adduction. We will also determine the diagnostic power of each aerodynamic parameter individually and all parameters collectively. Preliminary observations suggest that aerodynamic measurements can improve assessment of voice disorders. Thus, the potential to improve understanding of normal and disordered voice production is great.

描述（由申请人提供）：语音障碍会影响数百万美国人，并被作为调查的国家优先事项。语音障碍对质量的影响 生活很重要；当一个人的声音受到损害时，工作能力，与朋友和家人相关，参与社交活动并简单地从事日常生活的能力变得艰苦，甚至不是不可能。语音疾病的多因素性质必须使临床医生了解喉部的功能以做出适当的治疗决策。在发声过程中，喉是能量传感器，以亚光滑压力（PS）的形式转移空气动力，并以声音形式转移到声能。非侵入性空气动力学评估是评估语音生产投入的客观和定量方法。拟议的研究有两个相互关联的部分。在第一部分中，研究将着重于改善我们实验室中开发的空气动力学测量方法：气流中断；气流中断不完整；和气流重定向。这些方法都被证明是准确的。将对设备进行修改，以允许测量发声阈值流量和发音阈值功率，这是我们实验室提出的两个新参数，这些参数已被实验证明是有价值的。还将研究通过听觉反馈，视觉反馈，脸颊约束和改进的分析技术来增强这些设备，也将进行研究，从而有可能降低主体内的可变性。我们还将确定测量PS的最佳中断长度，并通过将我们的空气动力学评估设备与高速视频成像相结合，确定中断如何影响声带振动。反射的启发阻碍了气流中断的广泛临床应用。在气流期间可视化声带 中断将使我们能够确定这种反射是否发生在喉部，如果是这样，则是其精确的延迟。第一部分的数据将允许选择改进的空气动力学评估方法。 在第二部分中，第一部分中开发的最佳系统将用于评估和比较常见语音疾病的治疗方法。将评估息肉和结节大小对空气动力学参数的影响；还将研究随着病变大小的降低而变化的空气动力学参数也将被研究。将进行治疗前后的空气动力学评估，以确定肉毒杆菌毒素对痉挛性吞咽困难的影响。我们还将比较多种声带瘫痪的常见治疗方法。尽管有许多治疗方法，但尚未开发出最佳的治疗方法。将研究人声效率的实时术中测量值，以作为优化内侧喉成形术和芳香肌的一种手段。我们还将共同确定每个空气动力学参数的诊断能力和所有参数。初步观察表明，空气动力学测量可以改善语音疾病的评估。因此，提高对正常和混乱语音产生的理解的潜力是很大的。

项目成果

Aerodynamic measures of glottal function: what extra can they tell us and how do they guide management?

• DOI: 10.1097/moo.0000000000000107
• 发表时间: 2014-12
• 期刊: Current opinion in otolaryngology & head and neck surgery
• 影响因子: 1.6
• 作者: Jiang JJ;Maytag AL
• 通讯作者: Maytag AL

Retest Reliability for Complete Airway Interruption Systems of Aerodynamic Measurement.

• DOI: 10.1016/j.jvoice.2020.02.024
• 发表时间: 2022-01
• 期刊: Journal of voice : official journal of the Voice Foundation
• 作者: Lamb JR;Schultz SA;Scholp AJ;Wendel ER;Jiang JJ
• 通讯作者: Jiang JJ

Phonation threshold flow measurements in normal and pathological phonation.

• DOI: 10.1002/lary.20165
• 发表时间: 2009-04
• 期刊: LARYNGOSCOPE
• 影响因子: 2.6
• 作者: Zhuang, Peiyun;Sprecher, Alicia J.;Hoffman, Matthew R.;Zhang, Yi;Fourakis, Marios;Jiang, Jack J.;Wei, Chun Sheng
• 通讯作者: Wei, Chun Sheng

Phonation threshold pressure estimation using electroglottography in an airflow redirection system.

• DOI: 10.1002/lary.20611
• 发表时间: 2009-12
• 期刊: LARYNGOSCOPE
• 影响因子: 2.6
• 作者: Rieves, Adam L.;Regner, Michael F.;Jiang, Jack J.
• 通讯作者: Jiang, Jack J.

New insights into mechanism of Eustachian tube ventilation based on cine computed tomography images.

• DOI: 10.1007/s00405-011-1829-y
• 发表时间: 2012-08
• 期刊: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
• 作者: McDonald MH;Hoffman MR;Gentry LR;Jiang JJ
• 通讯作者: Jiang JJ