Advanced Imaging


Advanced Imaging Magazine

Updated: January 12th, 2011 10:01 AM CDT

Voicing Concern

High-speed imaging links vibration of vocal folds to voice disorders for improved clinical diagnosis
Dr. Dimitar Deliyski
©l; Dr. Dimitar Deliyski
Dr. Dimitar Deliyski in his Arnold School of Public Health lab at the University of South Carolina.
HSV image
©l; Dr. Dimitar Deliyski
In this HSV image and wave playback, brightness relates to the speed of motion of the mucosal edges, and the color shows the phase of motion (the green half of the diamond shape shows opening, the red half, closed).
A high-speed image of a male vocal fold while producing a vowel sound.
©l; Dr. Dimitar Deliyski
A high-speed image of a male vocal fold while producing a vowel sound.

By Barry Hochfelder

Although it requires a significant amount of memory, long sample duration is necessary to register multiple phonations in a continuous recording, including comfortable, high and low pitches, glides, loudness levels, repetitive phonations, and forced inhalation. High dynamic range, like that of the Phantom V7.3's 14-bit grayscale/42-bit RGB CMOS sensor, allows for improved viewing quality and increased accuracy of automated image analyses.

While much work and discovery remains, Deliyski and his team are hopeful for the future of HSV and that it will ultimately supplant stroboscopy as the "gold standard" clinical technique for laryngeal imaging. Not only does HSV possess all the useful features of videostroboscopy, it overcomes the method's shortcomings and provides new, features for more accurate objective and quantification measurements.

This new technology featuring the Phantom camera has been already implemented at two clinical sites. At the Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital (Boston, Mass.), the HSV system became an important component in assessing voice function for patients treated with a revolutionary new laser technique for treating laryngeal cancer. And, at the Voice and Swallowing Center, Charlotte Eye Ear Nose and Throat Associates (Charlotte, N.C.), HSV is being tested as part of the day-to-day clinical voice evaluation practice.

The need to optimize HSV for clinical and research use is actually more pressing than ever because of the recent acceleration of efforts to develop surgical methods and bio-implants for repairing damaged vocal fold superficial lamina propria, a major factor in most voice disorders.

These efforts to restore the delicate biomechanical properties of the superficial lamina propria (a thin layer of connective tissue which lies beneath the epithelium and together with the epithelium constitutes the mucosa) need the type of increased accuracy that HSV can potentially provide to assist with more precisely defining/mapping specific damaged areas to target for repair and/or reconstitution of the superficial lamina propria pliability, and for accurately assessing the impact of such interventions on the fine temporal details of vocal fold vibration.

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