Patel Rita R, Döllinger Michael, Semmler Marion
Department of Otolaryngology Head and Neck Surgery Indiana University Indianapolis Indiana USA.
Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head & Neck Surgery University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg Erlangen Germany.
Laryngoscope Investig Otolaryngol. 2024 Oct 23;9(5):e70024. doi: 10.1002/lio2.70024. eCollection 2024 Oct.
The objective of this study is to evaluate three-dimensional vertical motion of the superior surface of the vocal folds in vivo in (a) typically developing children as a function of vocal frequency variations and (b) a child with vocal nodules.
A custom developed laser endoscope coupled with high-speed videoendoscopy was used to obtain 3D parameters from 2 healthy children, one child with vocal nodules, and 23 vocally healthy adults (females = 11, males = 12). Parameters of amplitude (mm), maximum opening/closing velocity (mm/s), and mean opening/closing velocity (mm/s) were computed for the lateral and vertical vibratory motion along the anterior, middle, and posterior sections of the vocal folds were computed.
We provide for the first time, absolute measurements of vertical amplitude and maximum/ mean velocity during the opening and closing phases, in vivo in children. Overall, the vertical motion was larger in vocally normal children compared with the lateral motion, especially along the visible posterior section of the vocal folds and during low pitch phonation. The opening phase dynamics were consistently large along the posterior section in the child with vocal nodules.
The study findings establish the feasibility of capturing 3D motion in a clinical setting and provide proof of concept for the application of the proposed 3D laser in the pediatric population. Future large sample size studies are needed to establish the diagnostic potential of examining the closing phase vertical motion to evaluate vibratory development in children with normal voice and investigating the opening phase vertical motion in children with nodules.
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本研究的目的是在体内评估(a)正常发育儿童声带表面的三维垂直运动与声音频率变化的关系,以及(b)一名患有声带小结的儿童的声带表面三维垂直运动。
使用定制开发的激光内窥镜结合高速视频内窥镜,从2名健康儿童、1名患有声带小结的儿童和23名嗓音健康的成年人(女性=11名,男性=12名)中获取三维参数。计算沿声带前、中、后段的横向和垂直振动运动的幅度(mm)、最大开合速度(mm/s)和平均开合速度(mm/s)等参数。
我们首次在儿童体内提供了开合阶段垂直幅度和最大/平均速度的绝对测量值。总体而言,与横向运动相比,正常发声儿童的垂直运动更大,尤其是在声带可见的后段以及低音调发声时。患有声带小结的儿童后段的开放阶段动态始终较大。
研究结果证实了在临床环境中捕捉三维运动的可行性,并为所提出的三维激光在儿科人群中的应用提供了概念验证。未来需要进行大样本量研究,以确定检查闭合阶段垂直运动对评估正常嗓音儿童振动发育的诊断潜力,以及研究患有声带小结儿童的开放阶段垂直运动。
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