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Analysis of vocal fold vibration by X-ray stroboscopy with multi-markers
OtolaryngologyHead and NeckSurgery August 1999
P1112 Research F o r u m - - M o n d a y
more fully delineated with this method. A series of coronalplane images comprising a vocal cycle are presented and analyzed. Conclusion: This imaging modality produces a completely novel view of the vibrating larynx. Such imaging will provide insight into the 3-dimensional impact of a Silastic implant on laryngeal vibration, with the potential to improve medialization techniques. Clinical Significance: This project represents progress in the pursuit of 3-dimensional imaging of human mucosal wave motion. In the future, the ability to perform noninvasive coronal plane imaging of the larynx may enhance the understanding of a variety of disorders, including laryngeal paralysis, and could improve patient diagnosis and treatment options. (Supported by a VA Merit Review Grant.) Poster 68
Vertical Velocity of Vocal Fold Vibration Correlates to Mucosal Traveling Wave Velocity EIJI YUMOTO MD PHD (presenter); JOJI KOBAYASHI MD; Kumamoto Japan; Onsengun Ehime Japan
Problem Addressed: Vocal fold vibration is essentially propagation of a mucosal traveling wave. The mucosal traveling wave involves a 3-dimensional pattern. If the vocal fold is regarded as a 3-dimensionally uniform structure in terms of elasticity, vertical velocity of the vocal fold vibration (Vvt) should vary in proportion to velocity of the mucosal traveling wave (TWV). This study determines whether Vvt correlates with TWV. Methods/Measures: We measured TWV and Vvt simultaneously during vibration in each of 3 excised canine larynges. Vvt was measured using laser Doppler vibrometer (LDV). TWV was determined by measuring the duration of time the traveling wave moved between 2 markers on the vocal fold with a known distance. Different airflows and different degrees of elongation of the vocal fold were applied to obtain different TWV values. Results: TWV always increased as airflow rate was raised. TWV also became greater when the vocal fold was elongated. TWV showed a highly significant correlation with Vvt. Correlation coefficients in the 3 larynges were greater than 0.9. Conclusions: The results suggested that the vocal fold can be considered to be 3-dimensionallyuniform in terms of elasticity when it vibrates. In addition, Vvt may be used as an alternative to TWV to assess vocal fold vibration. Clinical Significance: Quantification of TWV in a human subject during phonation is quite difficult. Vvt could be measured with the aid of LDV without damage to the laryngeal tissue. Thus, Vvt should be useful in the assessment of vocal fold vibration in normal subjects and patients.
Poster 69
Analysis of Vocal Fold Vibration by X-Ray Stroboscopy with Multi-Markers TOSHIYUKI KUSUYAMA MD (presenter); HIROYUKI FUKUDA MD; AKIHIRO SHIOTANI MD; HIDEKI NAKAGAWA MD; JIN KANZAKI MD; Tokyo Japan; Tokyo Japan; Ise Mie Japan; Baltimore MD; Tokyo Japan
Problem: Most previous observations of the vibratory pattern of the vocal fold have been made from a superior view using laryngostroboscopy or an ultra-high-speed camera. However, observations should be made in the frontal plane because the fundamental principle of vibration is that a traveling wave proceeds upward from the lower surface of the vocal fold (Hirano), and thus vocal fold vibration is transmitted within the frontal plane. The creation of x-ray stroboscopy has made visualization of vocal fold vibration in the frontal and sagittal planes possible (Saitoh). In this study, for the purpose of deriving a more precise description of vocal fold vibratory motion with emphasis on the starting point of the traveling wave, multi-x-ray-positive markers were inserted just under the epithelial membrane in the frontal plane, and their vibratory movement was observed in the frontal plane using x-ray stroboscopy. Methods: The canine larynges were used. X-ray-positive markers were inserted every 1 mm from 6 mm below the free edge just under the epithelial membrane at the midportion of the membranous vocal fold. The arytenoid cartilages were sutured to obtain glottal closure and enable phonation. The images obtained under x-ray stroboscopy were analyzed frame by frame using NIH image analysis software on a personal computer. The vibratory pattern of the vocal fold was studied with change of pitch and intensity. A histological study was also carried out to investigate the location of the markers. Results: The starting point of the mucosal wave was recognized at a point located 4 mm below the free edge. Histologically, that point was the place where the lamina propria became thinner and the muscular layer neared the epithelial layer. It was recognized that the starting point of the mucosal wave was displaced upwards with high pitch and downwards with high intensity. Conclusion: The results support the concept that the difference of flexibility between the lamina propria and the muscular layer plays an important role in starting of the mucosal wave. Poster 70
Voice Outcome Following Lateral Laryngotomy to Remove Teflon Granuloma CHERYL R BILLANTE PHD (presenter); KIMBERLY BURKARD MS; JANYE R MOORE MS; JAMES L NEI-rERVILLEMD; Nashville TN
Problem: Intracordal injection of polytef has reportedly caused chronic inflammatory changes in vocal fold histology.
P1112 Research F o r u m - - M o n d a y
more fully delineated with this method. A series of coronalplane images comprising a vocal cycle are presented and analyzed. Conclusion: This imaging modality produces a completely novel view of the vibrating larynx. Such imaging will provide insight into the 3-dimensional impact of a Silastic implant on laryngeal vibration, with the potential to improve medialization techniques. Clinical Significance: This project represents progress in the pursuit of 3-dimensional imaging of human mucosal wave motion. In the future, the ability to perform noninvasive coronal plane imaging of the larynx may enhance the understanding of a variety of disorders, including laryngeal paralysis, and could improve patient diagnosis and treatment options. (Supported by a VA Merit Review Grant.) Poster 68
Vertical Velocity of Vocal Fold Vibration Correlates to Mucosal Traveling Wave Velocity EIJI YUMOTO MD PHD (presenter); JOJI KOBAYASHI MD; Kumamoto Japan; Onsengun Ehime Japan
Problem Addressed: Vocal fold vibration is essentially propagation of a mucosal traveling wave. The mucosal traveling wave involves a 3-dimensional pattern. If the vocal fold is regarded as a 3-dimensionally uniform structure in terms of elasticity, vertical velocity of the vocal fold vibration (Vvt) should vary in proportion to velocity of the mucosal traveling wave (TWV). This study determines whether Vvt correlates with TWV. Methods/Measures: We measured TWV and Vvt simultaneously during vibration in each of 3 excised canine larynges. Vvt was measured using laser Doppler vibrometer (LDV). TWV was determined by measuring the duration of time the traveling wave moved between 2 markers on the vocal fold with a known distance. Different airflows and different degrees of elongation of the vocal fold were applied to obtain different TWV values. Results: TWV always increased as airflow rate was raised. TWV also became greater when the vocal fold was elongated. TWV showed a highly significant correlation with Vvt. Correlation coefficients in the 3 larynges were greater than 0.9. Conclusions: The results suggested that the vocal fold can be considered to be 3-dimensionallyuniform in terms of elasticity when it vibrates. In addition, Vvt may be used as an alternative to TWV to assess vocal fold vibration. Clinical Significance: Quantification of TWV in a human subject during phonation is quite difficult. Vvt could be measured with the aid of LDV without damage to the laryngeal tissue. Thus, Vvt should be useful in the assessment of vocal fold vibration in normal subjects and patients.
Poster 69
Analysis of Vocal Fold Vibration by X-Ray Stroboscopy with Multi-Markers TOSHIYUKI KUSUYAMA MD (presenter); HIROYUKI FUKUDA MD; AKIHIRO SHIOTANI MD; HIDEKI NAKAGAWA MD; JIN KANZAKI MD; Tokyo Japan; Tokyo Japan; Ise Mie Japan; Baltimore MD; Tokyo Japan
Problem: Most previous observations of the vibratory pattern of the vocal fold have been made from a superior view using laryngostroboscopy or an ultra-high-speed camera. However, observations should be made in the frontal plane because the fundamental principle of vibration is that a traveling wave proceeds upward from the lower surface of the vocal fold (Hirano), and thus vocal fold vibration is transmitted within the frontal plane. The creation of x-ray stroboscopy has made visualization of vocal fold vibration in the frontal and sagittal planes possible (Saitoh). In this study, for the purpose of deriving a more precise description of vocal fold vibratory motion with emphasis on the starting point of the traveling wave, multi-x-ray-positive markers were inserted just under the epithelial membrane in the frontal plane, and their vibratory movement was observed in the frontal plane using x-ray stroboscopy. Methods: The canine larynges were used. X-ray-positive markers were inserted every 1 mm from 6 mm below the free edge just under the epithelial membrane at the midportion of the membranous vocal fold. The arytenoid cartilages were sutured to obtain glottal closure and enable phonation. The images obtained under x-ray stroboscopy were analyzed frame by frame using NIH image analysis software on a personal computer. The vibratory pattern of the vocal fold was studied with change of pitch and intensity. A histological study was also carried out to investigate the location of the markers. Results: The starting point of the mucosal wave was recognized at a point located 4 mm below the free edge. Histologically, that point was the place where the lamina propria became thinner and the muscular layer neared the epithelial layer. It was recognized that the starting point of the mucosal wave was displaced upwards with high pitch and downwards with high intensity. Conclusion: The results support the concept that the difference of flexibility between the lamina propria and the muscular layer plays an important role in starting of the mucosal wave. Poster 70
Voice Outcome Following Lateral Laryngotomy to Remove Teflon Granuloma CHERYL R BILLANTE PHD (presenter); KIMBERLY BURKARD MS; JANYE R MOORE MS; JAMES L NEI-rERVILLEMD; Nashville TN
Problem: Intracordal injection of polytef has reportedly caused chronic inflammatory changes in vocal fold histology.