Abstract
Objective
Subglottic stenosis (SGS) is characterized by a narrowing of the trachea near the
cricotracheal junction and impairs breathing. SGS may also adversely affect voice
quality, but for reasons that are not fully understood. The purpose of this study
is to provide experiment-based data concerning the effects on phonation of airway
obstruction due to SGS.
Study Design
Basic science
Methods
A device simulating a SGS of adjustable severity ranging from 36% to 99.8% obstruction
was created. Self-oscillating synthetic VF models were mounted downstream of the device
and data were acquired to evaluate the effects of the obstruction on phonatory response.
Results
Onset pressures were relatively insensitive to obstructions of up to approximately
80% to 90% reductions in subglottic airway area and sharply increased thereafter.
Flow rate (under conditions of constant pressure), flow resistance, and fundamental
frequency all exhibited similar degrees of sensitivity to SGS obstruction as onset
pressure. High-frequency noise became significant by 80% obstruction. Glottal area
appeared to be less sensitive, not being affected until approximately 90% obstruction.
Conclusions
Consistent with previous computational studies, this study found that aerodynamic,
acoustic, and vibratory responses of self-oscillating VF models were largely unaffected
by SGS until approximately 80% to 90% obstruction, and significantly affected at higher
obstructions. This suggests that Grades I and II stenoses are unlikely to introduce
subglottic airway aerodynamic disturbances that are sufficient in and of themselves
to significantly alter phonatory output. The SGS model introduces a framework for
future benchtop studies involving subglottic and supraglottic airway constrictions.
Key Words
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Article info
Publication history
Published online: December 08, 2022
Accepted:
November 17,
2022
Publication stage
In Press Corrected ProofFootnotes
Early materials relating to portions of this manuscript were presented at the 11th International Conference on Voice Physiology and Biomechanics (ICVPB) meeting and at the 71st Annual Meeting of the American Physical Society Division of Fluid Dynamics meeting in 2018.
Identification
Copyright
© 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
