Volumetric Analysis of the Vocal Folds Using Computed Tomography: Effects of Age, Height, and Gender

Alexander, Nicole L.; Wang, Kevin Y.; Jiang, Kevin; Ongkasuwan, Julina; Lincoln, Christie M.

doi:10.1002/lary.28750

Cited by 4 publications

(7 citation statements)

References 25 publications

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“…This smaller cross-sectional area has been shown in computed tomography studies to have a difference in the size of glottal folds. Nevertheless, computed tomography studies have shown gender differences in the size of glottal folds [ 23 ], reporting that glottal folds movement was correlated with fundamental frequency in healthy subjects [ 24 ]. These results propose that the height of the voice and aerosol production in the glottis are involved in the dynamics of small aerosols.…”

Section: Discussionmentioning

confidence: 99%

Expansion of droplets during speaking and singing in Japanese

Kato

Okamoto²,

Miyoshi³

et al. 2022

PLoS ONE

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During the COVID-19 pandemic, a number of infection clusters associated with choral singing have been reported. Singing generates droplets and carries the risk of spreading infection. However, no reports have explored droplet flight and aerosol production rates by singing and speaking in Japanese. First, we conducted an observation experiment evaluating the maximum flight distance and number of droplets generated by singing in Japanese, using a high-speed camera and particle counter. Twenty amateur choir members, 10 male and 10 female (five members for each of the four voices), participated in the experiment. Subsequently, although the maximum distance that droplets traveled by singing in Japanese was 61 cm for men (median of 46.5, interquartile range, 36–57) and 56 cm for women (median of 27.5, interquartile range, 20–50), droplets were observed anteriorly and laterally to be up to 66.8 cm. At the singer’s mouth, ≥ 5 μm droplets were observed, whereas not observed at 1 meter toward the front of the singers in women and men, respectively. In German singing, droplets were observed up to 111 cm toward the front of the singer, possibly reflecting differences in pronunciation. In Japanese reading aloud, droplets were also observed up to 47 cm toward the front, whereas no droplet dispersion was observed by speaking the Japanese /a/ vowel or singing with wearing surgical mask toward the front. The aerosols produced when reading singing the /u/ vowels were significantly higher than those in other vowels. When singing in a choral group, keeping a sufficient distance at the front and side is recommended in minimizing infectious spread. If distance is not possible, practicing with /a/ vowels and avoiding consonants may be an alternative method. Our observations lasted only 50 seconds per song, and further observational studies are needed to determine the dynamics of aerosols that stay for long periods.

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Section: Discussionmentioning

confidence: 99%

Expansion of droplets during speaking and singing in Japanese

Kato

Okamoto²,

Miyoshi³

et al. 2022

PLoS ONE

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“…The relationship between vocal fold atrophy and age has been probed in many studies, 3,15,16 including a recent study that performed volumetric analysis of vocal folds using computed tomography (CT), which found that age was not linearly associated with vocal fold volume. 15 Vocal fold histologic and physiologic changes that are associated with ageing include calcification of the hyaline cartilages, decreased mucosal mucoserous function, decreased neuromuscular control, mucosal atrophy and changes in the composition of the vocal folds themselves. 2,3,17,18 However, these findings are not necessarily assessed during laryngoscopy and there remains a lack of correlation between patient age and video-laryngoscopy examination findings.…”

Section: Findings In the Context Of Other Studiesmentioning

confidence: 99%

Laryngoscopic findings of age‐related vocal fold atrophy are reliable but not specific

Song

Campbell

Lin

et al. 2022

Clinical Otolaryngology

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Objectives We aimed to evaluate the reliability of laryngoscopic features of vocal fold atrophy as assessed by novice otolaryngology trainees and expert laryngologists. Design Two expert fellowship‐trained laryngologists and three non‐expert otolaryngology resident trainees were recruited to view 50 anonymised laryngo‐stroboscopic examinations of patients presenting with dysphonia and non‐voice, laryngeal complaints. Reviewers were asked to stratify the patient's age, provide an opinion about the presence of age‐related vocal fold atrophy and specify which laryngoscopy features were present to make the diagnosis. Setting Tertiary care laryngology practice. Participants Two fellowship‐trained laryngologists and three trainee otolaryngologists. Main outcome measures Accuracy of age categorisation was determined and Kappa analysis was performed to assess inter‐rater agreement. Results The mean age of patients was 54.9 years old with near equal male to female distribution. The overall accuracy of age category determination by raters was only 30.8%. Kappa analysis demonstrated fair agreement regarding the presence of vocal fold atrophy in non‐expert reviewers, and moderate agreement amongst expert reviewers. Features of glottic gap, muscular atrophy of vocal folds and prominent vocal processes were all identified with high agreement (>80.0%). Conclusion Our study illustrates that while raters can agree on the presence of age‐related vocal fold atrophy, the findings may be non‐specific and do not necessarily correlate with age.

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“…Measured and predicted parameter values and the associated stress-strain curves are discussed in Section 5. The conclusion is formulated in Section 6. iv Table 1: Overall properties for M5, MRI and EPI replicas and values reported for a male adult [13,14,4,15] and using soft tissue density 1.03 g/cm 3 [3,16]: right-left length L x , posterior-anterior length L y , inferior-superior length L z , volume V V F and mass m V F . Mu) of a human VF depicted in Fig.…”

Section: Introductionmentioning

confidence: 99%

“…1(a) are summarised in Table 1 indicating right-left length L x , posterior-anterior length L y , inferior-superior length L z , total mass m V F and volume V V F . As a reference, typical values reported for the VF of a male adult are given as well [13,14,4,15,3,16].…”

Section: Introductionmentioning

confidence: 99%