Effect of Fibular Malrotation on Tibiotalar Joint Contact Mechanics in a Weber B Ankle Fracture Model.

BACKGROUND: In minimally displaced Weber B ankle fractures, the distal fibular fracture fragment can be externally rotated. This malrotation is difficult to detect on radiographs and, when left malreduced through nonoperative treatment, may contribute to altered joint mechanics, predisposing to posttraumatic osteoarthritis. This study evaluates the effects of fibular malrotation on tibiotalar joint contact mechanics. METHODS: Six cadaveric ankles were tested using a materials testing system (MTS) machine. A tibiotalar joint sensor recorded contact area and pressure. Samples were tested in the intact, neutrally rotated, and malrotated state. Each trial applied a 686N axial load and a 147N Achilles tendon load in neutral position, 15° dorsiflexion, and 15° plantarflexion. RESULTS: In the comparison of malrotated to intact ankles, peak contact pressure was found to be significantly greater at neutral flexion (intact 5.56 MPa ± 1.39, malrotated 7.21 MPa ± 1.07, P = .03), not significantly different in dorsiflexion, and significantly decreased in plantarflexion (intact 11.2 MPa ± 3.04, malrotated 9.01 MPa ± 1.84, P = .01). Significant differences in contact area were not found between conditions. CONCLUSION: The findings suggest that fibular malrotation contributes to significant alterations in tibiotalar joint contact pressures, which may contribute to the development of posttraumatic osteoarthritis. When malrotation of the fibula is suspected on plain radiographs, a computer tomography (CT) scan should be obtained to evaluate its extent and further consideration should be given to surgical treatment. LEVELS OF EVIDENCE: Level V: Bench testing.

Effect of Vocal Fold Implant Placement on Depth of Vibration and Vocal Output.

OBJECTIVE: Most type 1 thyroplasty implants and some common injectable materials are mechanically stiff. Placing them close to the supple vocal fold mucosa can potentially dampen vibration and adversely impact phonation, yet this effect has not been systematically investigated. This study aims to examine the effect of implant depth on vocal fold vibration and vocal output. STUDY DESIGN: Computational simulation. METHODS: Voice production was simulated with a fiber-gel finite element computational model that incorporates a three-layer vocal fold composition (superficial lamina propria, vocal ligament, thyroarytenoid muscle). Implants of various depths were simulated, with a "deeper" or more medial implant positioned closer to the vocal fold mucosa and replacing more muscle elements. Trajectories of surface and within-tissue nodal points during vibration were produced. Outcome measures were the trajectory radii, fundamental frequency (F0 ), sound pressure level (SPL), and smoothed cepstral peak prominence (CPPS) as a function of implant depth. RESULTS: Amplitude of vibration at the vocal fold medial surface was reduced by an implant depth of as little as 14% of the total transverse vocal fold depth. Increase in F0 and decrease in CPPS were noted beyond 30% to 40% implant depth, and SPL decreased beyond 40% to 60% implant depth. CONCLUSIONS: Commonly used implants can dampen vibration "from a distance," ie, even without being immediately adjacent to vocal fold mucosa. Since implants are typically placed at depths examined in this study, stiff implants likely have a negative vocal impact in a subset of patients. Softer materials may be preferable, especially in bilateral medialization procedures. LEVEL OF EVIDENCE: N/A Laryngoscope, 130:2192-2198, 2020.

Sensitivity analysis of muscle mechanics-based voice simulator to determine gender-specific speech characteristics.

The purpose of this study was to investigate the gender differences in voice simulation using a sensitivity analysis approach. A global, Monte Carlo-based approach was employed, and the relationships between biomechanical inputs (lung pressure and muscle activation levels) and acoustic outputs (fundamental frequency, f0, and sound pressure level, SPL) were investigated for male and female versions of a voice simulator model. The gender distinction in the model was based on an anatomical scaling of the laryngeal structures. Results showed strong relationships for f0 and SPL as functions of lung pressure, as well as for f0 as a function of cricothyroid and thyroarytenoid muscle activity, in agreement with previous literature. Also expected was a systematic shift in f0 range between the genders. It was found that the female model exhibited greater pitch strength (saliency) than the male model, which might equate to a perceptually more periodic or higher-quality voice for females. In addition, the female model required slightly higher lung pressures than the male model to achieve the same SPL, suggesting a possibly greater phonatory effort and predisposition for fatigue in the female voice. The methods and results of this study lay the groundwork for a complete mapping of simulator sound signal characteristics as a function of simulator input parameters and a better understanding of gender-specific voice production and vocal health.

Vocal fold contact patterns based on normal modes of vibration.

The fluid-structure interaction and energy transfer from respiratory airflow to self-sustained vocal fold oscillation continues to be a topic of interest in vocal fold research. Vocal fold vibration is driven by pressures on the vocal fold surface, which are determined by the shape of the glottis and the contact between vocal folds. Characterization of three-dimensional glottal shapes and contact patterns can lead to increased understanding of normal and abnormal physiology of the voice, as well as to development of improved vocal fold models, but a large inventory of shapes has not been directly studied previously. This study aimed to take an initial step toward characterizing vocal fold contact patterns systematically. Vocal fold motion and contact was modeled based on normal mode vibration, as it has been shown that vocal fold vibration can be almost entirely described by only the few lowest order vibrational modes. Symmetric and asymmetric combinations of the four lowest normal modes of vibration were superimposed on left and right vocal fold medial surfaces, for each of three prephonatory glottal configurations, according to a surface wave approach. Contact patterns were generated from the interaction of modal shapes at 16 normalized phases during the vibratory cycle. Eight major contact patterns were identified and characterized by the shape of the flow channel, with the following descriptors assigned: convergent, divergent, convergent-divergent, uniform, split, merged, island, and multichannel. Each of the contact patterns and its variation are described, and future work and applications are discussed.

Characterization of Flow-resistant Tubes Used for Semi-occluded Vocal Tract Voice Training and Therapy.

OBJECTIVES: This study aimed to characterize the pressure-flow relationship of tubes used for semi-occluded vocal tract voice training/therapy, as well as to answer these major questions: (1) What is the relative importance of tube length to tube diameter? (2) What is the range of oral pressures achieved with tubes at phonation flow rates? (3) Does mouth configuration behind the tubes matter? METHODS: Plastic tubes of various diameters and lengths were mounted in line with an upstream pipe, and the pressure drop across each tube was measured at stepwise increments in flow rate. Basic flow theory and modified flow theory equations were used to describe the pressure-flow relationship of the tubes based on diameter and length. Additionally, the upstream pipe diameter was varied to explore how mouth shape affects tube resistance. RESULTS: The modified equation provided an excellent prediction of the pressure-flow relationship across all tube sizes (6% error compared with the experimental data). Variation in upstream pipe diameter yielded up to 10% deviation in pressure for tube sizes typically used in voice training/therapy. CONCLUSIONS: Using the presented equations, we can characterize resistance for any tube based on diameter, length, and flow rate. With regard to the original questions, we found that (1) For commonly used tubes, diameter is the critical variable for governing flow resistance; (2) For phonation flow rates, a range of tube dimensions produced pressures between 0 and 7.0 kPa; and (3) The mouth pressure behind the lips will vary slightly with different mouth shapes, but this effect can be considered relatively insignificant.

On measuring the bending strength of septate grass stems.

UNLABELLED: • PREMISE OF THE STUDY: Reliable testing methodologies are a fundamental tenet of scientific research. However, very little information is found in the literature explaining how to accurately measure the structural bending strength of plant stems. It was hypothesized that the most commonly employed loading configuration used in bending experiments (placement of loading anvil at an internodal region of the stem or stalk) may significantly alter test results and introduce errors in bending strength measurements of plant stems.• METHODS: Four types of mechanical tests were performed on bamboo (Phyllostachys aurea), giant reed (Arundo donax), and maize (Zea mays) to investigate how different loading configurations employed during three-point bending experiments affect test results of septate grass stems and to develop a testing protocol that provides reliable measures of stalk bending strength.• RESULTS: RESULTS confirmed the hypothesis that internodal-loaded three-point bending test can produce erroneous bending strength measurements. This testing methodology causes plant stems to break prematurely and produces failure types and patterns incongruent with stalks that broke in their natural (in situ) environment. In contrast, a modified test configuration produces natural failure patterns and more accurate measurements of bending strength.• CONCLUSION: Reliable measurements of stalk bending strength can be obtained by maximizing the span length of bending tests and placing the loading anvil at stronger and denser nodal tissues. These results are relevant to ecological and evolutionary plant biomechanics studies as well as agronomic breeding studies focused on measuring plant phenotypes such as stalk lodging strength, or on improving bending strength of septate plant stems.

Benchmarks for time-domain simulation of sound propagation in soft-walled airways: steady configurations.

Time-domain computer simulation of sound production in airways is a widely used tool, both for research and synthetic speech production technology. Speed of computation is generally the rationale for one-dimensional approaches to sound propagation and radiation. Transmission line and wave-reflection (scattering) algorithms are used to produce formant frequencies and bandwidths for arbitrarily shaped airways. Some benchmark graphs and tables are provided for formant frequencies and bandwidth calculations based on specific mathematical terms in the one-dimensional Navier-Stokes equation. Some rules are provided here for temporal and spatial discretization in terms of desired accuracy and stability of the solution. Kinetic losses, which have been difficult to quantify in frequency-domain simulations, are quantified here on the basis of the measurements of Scherer, Torkaman, Kucinschi, and Afjeh [(2010). J. Acoust. Soc. Am. 128(2), 828-838].

A viscoelastic laryngeal muscle model with active components.

Accurate definitions of both passive and active tissue characteristics are important to laryngeal muscle modeling. This report tested the efficacy of a muscle model which added active stress components to an accurate definition of passive properties. Using the previously developed three-network Ogden model to simulate passive stress, a Hill-based contractile element stress equation was utilized for active stress calculations. Model input parameters were selected based on literature data for the canine cricothyroid muscle, and simulations were performed in order to compare the model behavior to published results for the same muscle. The model results showed good agreement with muscle behavior, including appropriate tetanus response and contraction time for isometric conditions, as well as accurate stress predictions in response to dynamic strain with activation.

Influence of subglottic stenosis on the flow-induced vibration of a computational vocal fold model.

The effect of subglottic stenosis on vocal fold vibration is investigated. An idealized stenosis is defined, parameterized, and incorporated into a two-dimensional, fully-coupled finite element model of the vocal folds and laryngeal airway. Flow-induced responses of the vocal fold model to varying severities of stenosis are compared. The model vibration was not appreciably affected by stenosis severities of up to 60% occlusion. Model vibration was altered by stenosis severities of 90% or greater, evidenced by decreased superior model displacement, glottal width amplitude, and flow rate amplitude. Predictions of vibration frequency and maximum flow declination rate were also altered by high stenosis severities. The observed changes became more pronounced with increasing stenosis severity and inlet pressure, and the trends correlated well with flow resistance calculations. Flow visualization was used to characterize subglottal flow patterns in the space between the stenosis and the vocal folds. Underlying mechanisms for the observed changes, possible implications for human voice production, and suggestions for future work are discussed.

Effect of inferior surface angle on the self-oscillation of a computational vocal fold model.

Geometry of the human vocal folds strongly influences their oscillatory motion. While the effect of intraglottal geometry on phonation has been widely investigated, the study of the geometry of the inferior surface of the vocal folds has been limited. In this study the way in which the inferior vocal fold surface angle affects vocal fold vibration was explored using a two-dimensional, self-oscillating finite element vocal fold model. The geometry was parameterized to create models with five different inferior surface angles. Four of the five models exhibited self-sustained oscillations. Comparisons of model motion showed increased vertical displacement and decreased glottal width amplitude with decreasing inferior surface angle. In addition, glottal width and air flow rate waveforms changed as the inferior surface angle was varied. Structural, rather than aerodynamic, effects are shown to be the cause of the changes in model response as the inferior surface angle was varied. Supporting data including glottal pressure distribution, average intraglottal pressure, energy transfer, and flow separation point locations are discussed, and suggestions for future research are given.