Imaging and influence of glottic and subglottic anatomy in healthy and stenotic patients

SUMMARY
Upper airway stenosis is a condition that significantly impairs breathing and voice. Stenosis-related voice
disorders can adversely impact communication, job performance, psychosocial function, and quality of life.
Clinical and scientific studies have elucidated important relationships between voice function and stenosis
severity and management, but many aspects of these relationships are not fully understood. The objectives of
the proposed research are to develop larynx-specific MRI coils and protocols for upper airway stenosis imaging
and to determine the impact of glottic and subglottic morphology on voice function in upper airway stenosis
patients. Custom imaging coils and protocols will be developed and refined based on physical principles and
preliminary tests. MR images in stenosis patients will be acquired pre- and post-operatively. Images will be used
to create 3D geometric models for morphometric analysis and posting on an online laryngeal data repository for
further research. Retrospective and prospective pre- and post-operative aerodynamic and acoustic studies of
patients with upper airway stenosis will be conducted to explore relationships between preoperative voice
complaints and pre/post-operative voice changes. Excised larynx and synthetic vocal fold laboratory experiments
using 3D-printed airways with adjustable stenoses, in conjunction with complementary computational simulations
of phonatory flow-structure-acoustic interactions, will be used to explore fundamental physical relationships
between stenosis geometry and changes in flow patterns, vocal fold vibration, and acoustics. Anticipated
outcomes include larynx imaging coil prototypes and protocols suitable for the needs of clinical laryngeal imaging
evaluations and scientific research, detailed geometric three-dimensional models of the upper airway in healthy
and stenosis populations, and deeper insight into the sources of dysphonia in stenosis patients and into the
aerodynamic and acoustical changes associated with upper airway stenosis. The ultimate aim is to develop tools
and understanding that will lead to improved voice outcomes for patients with upper airway stenosis.

Grant Number: 7R01DC009616-11
NIH Institute/Center: NIH
Principal Investigator: Julie Barkmeier-Kraemer