Morrison Robert A, Fetzer David T, Patterson-Lachowicz Amber, McDowell Sarah, Smeltzer Julianna C, Mau Ted, Shembel Adrianna C
School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas, U.S.A.
Department of Radiology, CACTUS Lab, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.
Laryngoscope. 2024 Apr;134(4):1792-1801. doi: 10.1002/lary.31063. Epub 2023 Sep 29.
The paralaryngeal muscles are thought to be hyperfunctional with phonation in patients with primary muscle tension dysphonia (pMTD). However, objective, quantitative tools to assess paralaryngeal movement patterns lack. The objectives of this study were to (1) validate the use of optical flow to characterize paralaryngeal movement patterns with phonation, (2) characterize phonatory optical flow velocities and variability of the paralaryngeal muscles before and after a vocal load challenge, and (3) compare phonatory optical flow measures to standard laryngoscopic, acoustic, and self-perceptual assessments.
Phonatory movement velocities and variability of the paralaryngeal muscles at vocal onsets and offsets were quantified from ultrasound videos and optical flow methods across 42 subjects with and without a diagnosis of pMTD, before and after a vocal load challenge. Severity of laryngoscopic mediolateral supraglottic compression, acoustic perturbation, and ratings of vocal effort and discomfort were also obtained at both time points.
There were no significant differences in optical flow measures of the paralaryngeal muscles with phonation between patients with pMTD and controls. Patients with pMTD had significantly more supraglottic compression, higher acoustic perturbations, and higher vocal effort and vocal tract discomfort ratings. Vocal load had a significant effect on vocal effort and discomfort but not on supraglottic compression, acoustics, or optical flow measures of the paralaryngeal muscles.
Optical flow methods can be used to study paralaryngeal muscle movement velocity and variability patterns during vocal productions, although the role of the paralaryngeal in pMTD diagnostics (e.g., vocal hyperfunction) remains suspect.
2 Laryngoscope, 134:1792-1801, 2024.
原发性肌肉紧张性发声障碍（pMTD）患者发声时，喉旁肌被认为存在功能亢进。然而，缺乏评估喉旁肌运动模式的客观定量工具。本研究的目的是：（1）验证使用光流来表征发声时喉旁肌的运动模式；（2）表征发声负荷挑战前后喉旁肌的发声光流速度和变异性；（3）将发声光流测量结果与标准喉镜检查、声学和自我感知评估进行比较。
在42名诊断为或未诊断为pMTD的受试者中，在发声负荷挑战前后，通过超声视频和光流方法对发声起始和结束时喉旁肌的发声运动速度和变异性进行量化。在两个时间点还获得了喉镜检查中声门上外侧压缩的严重程度、声学扰动以及发声努力和不适的评分。
pMTD患者与对照组在发声时喉旁肌的光流测量上无显著差异。pMTD患者的声门上压缩更明显，声学扰动更高，发声努力和声道不适评分更高。发声负荷对发声努力和不适有显著影响，但对声门上压缩、声学或喉旁肌的光流测量没有影响。
光流方法可用于研究发声过程中喉旁肌的运动速度和变异性模式，尽管喉旁肌在pMTD诊断（如发声功能亢进）中的作用仍值得怀疑。
2《喉镜》，2024年，第134卷，第1792 - 1801页
