Hüttner Björn, Luegmair Georg, Patel Rita R, Ziethe Anke, Eysholdt Ulrich, Bohr Christopher, Sebova Irina, Semmler Marion, Döllinger Michael
Department of Phoniatrics and Pediatric Audiology, Medical School, University Hospital Erlangen, Bohlenplatz 21, 91054 , Erlangen, Germany,
Biomech Model Mechanobiol. 2015 Jan;14(1):169-84. doi: 10.1007/s10237-014-0597-1. Epub 2014 May 27.
Laryngeal cancer due to, e.g., extensive smoking and/or alcohol consumption can necessitate the excision of the entire larynx. After such a total laryngectomy, the voice generating structures are lost and with that the quality of life of the concerning patients is drastically reduced. However, the vibrations of the remaining tissue in the so called pharyngoesophageal (PE) segment can be applied as alternative sound generator. Tissue, scar, and geometric aspects of the PE-segment determine the postoperative substitute voice characteristic, being highly important for the future live of the patient. So far, PE-dynamics are simulated by a biomechanical model which is restricted to stationary vibrations, i.e., variations in pitch and amplitude cannot be handled. In order to investigate the dynamical range of PE-vibrations, knowledge about the temporal processes during substitute voice production is of crucial interest. Thus, time-dependent model parameters are suggested in order to quantify non-stationary PE-vibrations and drawing conclusions on the temporal characteristics of tissue stiffness, oscillating mass, pressure, and geometric distributions within the PE-segment. To adapt the numerical model to the PE-vibrations, an automatic, block-based optimization procedure is applied, comprising a combined global and local optimization approach. The suggested optimization procedure is validated with 75 synthetic data sets, simulating non-stationary oscillations of differently shaped PE-segments. The application to four high-speed recordings is shown and discussed. The correlation between model and PE-dynamics is ≥ 97%.
例如，由于大量吸烟和/或酗酒导致的喉癌可能需要切除整个喉部。在进行这种全喉切除术后，发声结构丧失，相关患者的生活质量大幅下降。然而，所谓的咽食管（PE）段中剩余组织的振动可以用作替代发声器。PE段的组织、瘢痕和几何形状决定了术后替代声音的特征，这对患者的未来生活非常重要。到目前为止，PE动力学是通过一个生物力学模型来模拟的，该模型仅限于稳态振动，即音高和振幅的变化无法处理。为了研究PE振动的动态范围，了解替代声音产生过程中的时间过程至关重要。因此，建议使用随时间变化的模型参数来量化非稳态PE振动，并得出关于PE段内组织刚度、振荡质量、压力和几何分布的时间特征的结论。为了使数值模型适应PE振动，应用了一种基于块的自动优化程序，该程序包括全局和局部优化相结合的方法。所建议的优化程序用75个合成数据集进行了验证，模拟了不同形状PE段的非稳态振荡。展示并讨论了该程序在四个高速记录上的应用。模型与PE动力学之间的相关性≥97%。
