A Methodology to Quantify the Effective Vertical Thickness of Prephonatory Vocal Fold Medial Surface

Objective: The shape of the vocal fold medial surface, particularly its vertical thickness, has been shown in computational and physical modeling studies to be highly influential in regulating glottal closure during phonation. However, because of the difficulty to quantify the vertical thickness in real vocal folds, this influence has often been overlooked in clinical contexts. Therefore, the goal of this study is to present a method to calculate an effective vertical thickness of the medial surface that is predictive of the glottal closure pattern during phonation.

Methods: An effective vertical thickness of the medial surface is calculated as a weighted integral of the medial surface contour along the vertical dimension. The weight is one for the part of the medial surface within a fixed threshold distance from the most medial point, and decays exponentially otherwise. The influence of the threshold distance value on the effective thickness value is investigated. Additionally, the sensitivity of the calculated effective thickness to slight misidentification of the vertical glottal midline is also studied. The methodology is validated on the vocal fold medial surface data from a canine hemilarynx at different levels of thyroarytenoid muscle activation.

Results: For most threshold distances, the thickness follows an expected sigmoid-like trend with respect to the thyroarytenoid muscle activation level. A threshold distance of 0.05 mm appears optimal as it produced thickness changes in a range comparable to previous computational and experimental studies. The methodology is relatively robust to slight misidentification of the vertical glottal midline.

Conclusions: A methodology to estimate the effective vocal fold vertical thickness from medial surface contours is proposed. The methodology can be applied in future studies to correlate medial surface shape to relevant parameters characterizing vocal fold vibration as well as clinical evaluation of treatment effectiveness.