DOMINGOS HIROSHI TSUJI
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Otorrinolaringologia e Oftalmologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
9 resultados
Resultados de Busca
Agora exibindo 1 - 9 de 9
- Impact of Cricothyroid Muscle Contraction on Vocal Fold Vibration: Experimental Study with High-Speed Videoendoscopy(2017) ISHIKAWA, Camila Cristina; PINHEIRO, Thais Goncalves; HACHIYA, Adriana; MONTAGNOLI, Arlindo Neto; TSUJI, Domingos HiroshiObjectives. The aim of this study was to evaluate the effects of cricothyroid muscle contraction on vocal fold vibration, as evaluated with high-speed videoendoscopy, and to identify one or more aspects of vocal fold vibration that could be used as an irrefutable indicator of unilateral cricothyroid muscle paralysis. Study Design. This was an experimental study employing excised human larynges. Methods. Twenty freshly excised human larynges were evaluated during artificially produced vibration. Each larynx was assessed in three situations: bilateral cricothyroid muscle contraction, unilateral cricothyroid muscle contraction, and no contraction of either cricothyroid muscle. The following parameters were evaluated by high-speed videoendoscopy: fundamental frequency, periodicity, amplitude of vocal fold vibration, and phase symmetry between the vocal folds. Results. Although neither unilateral nor bilateral cricothyroid muscle contraction altered the periodicity of vibration or the occurrence of phase asymmetry, there was a significant decrease in fundamental frequency in parallel with decreasing longitudinal tension. We also found an increase in vibration amplitude of right and left vocal folds, which were similar in terms of their behavior for this parameter in the various situations studied. Conclusion. Our results suggest that differences in vibration amplitude and phase symmetry between vocal folds are not reliable indicators of unilateral cricothyroid muscle paralysis.
- Comparative Analysis of Vocal Fold Vibration Using High-Speed Videoendoscopy and Digital Kymography(2014) BARAVIEIRA, Paula Belini; BRASOLOTTO, Alcione Ghedini; HACHIYA, Adriana; TAKAHASHI-RAMOS, Marystella Tomoe; TSUJI, Domingos Hiroshi; MONTAGNOLI, Arlindo NetoObjectives. To compare high-speed videoendoscopy (HSV) and digital kymography (DKG) in the vocal fold vibration analysis of normophonic women with no vocal fold abnormalities. Study Design. Prospective study comparing quantitative parameters extracted by HSV and DKG. Methods. Eighteen normophonic women whose age ranged from 18 to 45 years participated in the study. The procedures comprised HSV and DKG of the medial line of the vocal folds. The parameters evaluated were fundamental frequency (F-0), open quotient (OQ), and duration of vibration cycle phases (open phase, closed phase, opening phase, and closing phase). Results. The F-0 results of HSV and DKG were similar. However, significant differences were found in both duration of vibration cycle phases and OQ, indicating a longer open phase in the vocal fold vibration when this phase was measured by HSV. Conclusions. The results emphasize the need to set up different normative threshold values for both HSV and DKG.
- High-speed Videolaryngoscopy: Quantitative Parameters of Glottal Area Waveforms and High-speed Kymography in Healthy Individuals(2017) TSUTSUMI, Monike; ISOTANI, Seiji; PIMENTA, Regina Aparecida; DAJER, Maria Eugenia; HACHIYA, Adriana; TSUJI, Domingos Hiroshi; TAYAMA, Niro; YOKONISHI, Hisayuki; IMAGAWA, Hiroshi; YAMAUCHI, Akihito; TAKANO, Shingo; SAKAKIBARA, Ken-Ichi; MONTAGNOLI, Arlindo NetoObjectives. We conducted a study to obtain quantitative parameters of the vocal dynamic using highspeed videolaryngoscopy and to characterize the vocal fold vibration pattern of healthy individuals by analyzing glottal area waveforms and high-speed kymography. Methods. Laryngeal images of 45 healthy individuals were captured using high-speed videolaryngoscopy. The open and speed quotients of the glottal area waveforms and high-speed kymography were obtained and statistically analyzed according to the gender of each individual. Results. Glottal area waveforms revealed average values of 0.85 and 1.16 for open and speed quotients, respectively, for women, and 0.70 and 1.19 for men. Using high-speed kymography, quantitative parameters of open and speed quotients for women were 0.62 and 1.02, respectively, and for men were 0.57 and 1.12. By gender, a significant statistical difference emerged for open quotients obtained from both glottal area waveforms ( P = 0.004) and high-speed kymography ( P = 0.013). Conclusion. Obtained by using computational tools specifically for analyzing laryngeal images from high-speed videolaryngoscopy, quantitative parameters of glottal area waveforms and high-speed kymography in healthy individuals provide reference data and normality for future studies.
- Excised human larynx in N-vinyl-2-pyrrolidone-embalmed cadavers can produce voiced sound by pliable vocal fold vibration(2022) MIYAMOTO, Makoto; NAGASE, Miki; WATANABE, Itaru; NAKAGAWA, Hideki; KARITA, Kanae; TSUJI, Domingos Hiroshi; MONTAGNOLI, Arlindo Neto; MATSUMURA, George; SAITO, KoichiroTissue-hardening effect and health-hazard issue of formaldehyde (FA) have long been a great disadvantage of this conventional fixative in anatomical research. We recently developed a FA-free embalming method for cadavers which utilizes N-vinyl-2-pyrrolidone (NVP) and enables assessment of motion kinetics by maintaining the softness of embalmed tissue. By assessing the feasibility of NVP-embalmed tissue to mimic vocalization, this study aimed to prove the potential of embalmed cadavers, which have previously been used only for the understanding of anatomical morphology, for the assessment of precise motion physiology in the human body. Ten cadavers embalmed in NVP (n = 6) and FA (n = 4) were incorporated in this study. Excised larynges underwent experimental phonation to mimic vocalization with fast and pliable vibration of vocal folds. High-speed digital imaging was utilized for the assessment of vocal fold vibration. Furthermore, acoustic analysis of the voiced sound, and reproducibility examination were also performed. Regular vocal fold vibrations successfully produced voiced sounds during experimental phonation using NVP-embalmed larynges. The vibratory frequency, vibration amplitude, and stretch rate of the vocal folds were comparable to those of living humans. Six months after the first experiment, the vocal parameters were reproduced, to suggest the long-term preservation potential of our NVP-embalming technique. On the other hand, neither voiced sound nor vocal fold vibration were observed in FA-embalmed larynges. This novel embalming technique could pioneer the next era to utilize embalmed cadavers for the examination of motion physiology in the human body.
- Comparative Analysis of the Closed Quotient for Lip and Tongue Trills in Relation to the Sustained Vowel /epsilon/(2012) CORDEIRO, Gislaine Ferro; MONTAGNOLI, Arlindo Neto; NEMR, Nair Katia; MENEZES, Marcia Helena Moreira; TSUJI, Domingos HiroshiVarious types of trill exercises have been used for a long time as a tool in the treatment and preparation of the voice. Although they are reported to produce vocal benefits in most subjects, their physiology has not yet been studied in depth. The aim of this study was to compare the mean and standard deviation of the closed quotient in exercises of lip and tongue trills with the sustained vowel /epsilon/ in opera singers. Ten professional classical (operatic) singers, reportedly in perfect laryngeal health, served as subjects for this study and underwent electroglottography. During the examination, the subjects were instructed to deliver the sustained vowel /epsilon/ and lip and tongue trills in a same preestablished frequency and intensity. The mean values and standard deviation of the closed quotient were obtained using the software developed for this purpose. The comparison of the results was intrasubjects; maximum intensities were compared only among them and so were minimum intensities. The means of closed quotient were statistically significant only in the strong intensities, and the lip trill was different from the tongue trill and the sustained vowel /epsilon/. The standard deviation of the closed quotient distinguished the sustained vowel /epsilon/ from the lip and tongue trills in the two intensities. We concluded that there is oscillation of the closed quotient during the exercises of tongue and lip trills, and the closed quotient is higher during the performance of exercises of the lip trill, when compared with the two other utterances, only in the strong intensities.
- Improvement of Vocal Pathologies Diagnosis Using High-Speed Videolaryngoscopy(2014) TSUJI, Domingos Hiroshi; HACHIYA, Adriana; DAJER, Maria Eugenia; ISHIKAWA, Camila Cristina; TAKAHASHI, Marystella Tomoe; MONTAGNOLI, Arlindo NetoIntroduction The study of the dynamic properties of vocal fold vibration is important for understanding the vocal production mechanism and the impact of organic and functional changes. The advent of high-speed videolaryngoscopy (HSV) has provided the possibility of seeing the real cycle of vocal fold vibration in detail through high sampling rate of successive frames and adequate spatial resolution. Objective To describe the technique, advantages, and limitations of using HSV and digital videokymography in the diagnosis of vocal pathologies. Methods We used HSV and digital videokymography to evaluate one normophonic individual and four patients with vocal fold pathologies (nodules, unilateral paralysis of the left vocal fold, intracordal cyst, and adductor spasmodic dysphonia). The vocal fold vibration parameters (glottic closure, vibrational symmetry, periodicity, mucosal wave, amplitude, and glottal cycle phases) were assessed. Results Differences in the vocal vibration parameters were observed and correlated with the pathophysiology. Conclusion HSV is the latest diagnostic tool in visual examination of vocal behavior and has considerable potential to refine our knowledge regarding the vocal fold vibration and voice production, as well as regarding the impact of pathologic conditions have on the mechanism of phonation.
- Fundamental Frequency in Excised Human Larynges after Anterior Glottic Web Formation of Various Extents(2019) PINHEIRO, Thais Goncalves; ISHIKAWA, Camila Cristina; IMAMURA, Rui; FRIZZARINI, Ronaldo; MONTAGNOLI, Arlindo Neto; TSUJI, Domingos HiroshiObjective To determine the effect of vocal fold anterior web formation on fundamental frequency with a cadaveric excised larynx model. Study Design Experimental study with excised human larynges. Setting Academic tertiary care hospital. Subjects and Methods Sixteen freshly excised human larynges were evaluated with high-speed videoendoscopy and digital kymography during artificially produced vibration. Each larynx was assessed in 4 conditions: preoperative controls and after 25%, 33%, and 50% decreases in the vibratory portion of the vocal folds. The following parameters were evaluated: fundamental frequency, periodicity, vocal fold vibration amplitude, phase symmetry, and glottic closure. Results The mean fundamental frequencies were 208.87, 250.20, 292.37, and 342.67 Hz for preoperative controls and 25%, 33%, and 50% reductions in vibratory length of the vocal folds, respectively. Fundamental frequency increased with each increase in anterior glottic web extent, and the difference among the groups was statistically significant in absolute values in hertz and in semitone elevation. The mathematical models for estimating postoperative fundamental frequency had a statistically significant coefficient. The vibration of the vocal folds remained periodic in all larynges before and after the procedures. Conclusion There was a significant and progressive increase in the fundamental frequency with each enlargement of anterior glottic web. Based on the control frequency, mathematical models could estimate the value of the fundamental frequency after the procedure.
- High-speed kymography identifies the immediate effects of voiced vibration in healthy vocal folds(2013) PIMENTA, Regina Aparecida; DÁJER, María Eugenia; HACHIYA, Adriana; CORDEIRO, Gislaine Ferro; TSUJI, Domingos Hiroshi; MONTAGNOLI, Arlindo NetoINTRODUCTION: The effects of voiced vibration technique can be assessed by laryngeal imaging. Kymographic images derived from high-speed videoendoscopy allow actual visualization of vocal folds vibration. PURPOSE: The aim of this study is to identify the immediate effects of the voiced vibration technique in healthy vocal folds using high-speed digital laryngeal imaging. METHODS: Samples were obtained from 15 healthy subjects with no history of voice disorders (6 men and 9 women aged 21 to 43 years). High-speed videoendoscopy recordings were performed before and after the voiced vibration technique. Kymographic images were obtained using high-speed videoendoscopy. The vocal folds were examined in their open and closed positions and the characteristics of the opening and closing phases were determined. A customize computational routine was used quantify these parameters. The closing, opening, and speed quotients were also calculated. RESULTS: In this study, women displayed statistically significant differences in opened phase (P= 0.05*), closed phase (P= 0.046*), and closing phase (P= 0.026*) phase characteristics. Men displayed the highest difference rate in opening time characteristics (P= 0.06). The closing and opening quotients for the female group showed significant differences (P= 0.029* and P= 0.049*, respectively). The speed quotient exhibited statistically significant differences in the male group (P= 0.048*). CONCLUSION: The kymographic images indicated that the immediate effect of the voiced vibration technique was smooth contact in healthy vocal fold vibration.
- Parameters Acoustic and High-speed kymography identified effects of voiced vibration and vocal fry exercises(2013) PIMENTA, Regina Aparecida; DAJER, Maria Eugenia; HACHIYA, Adriana; TSUJI, Domingos Hiroshi; MONTAGNOLI, Arlindo NetoPurpose: To identify the immediate effects of voiced vibration and vocal fry exercises on healthy subjects by means of acoustic parameters and high-speed kymography. Methods: Thirty healthy subjects (18 women and 12 men, aged from 19 to 45 years old) participated in this study. The voices were recorded at the range of 44.100 samples/second, before and after of the vocal exercises. We developed a computational routine to extract jitter and shimmer. High-speed kymography was generated from laryngeal images for the analysis of the phase times: closed (CPh), open (OPh), of closing (cPh) and of opening (oPh) and used the paired t-Student test and the Mann-Whitney test, with a significance level of 0.05. Results: After voiced vibrations, acoustic parameters showed reduced jitter for both genders (p=0.018 for men and p<0.01 for women) and reduced shimmer for female voices (p<0.01). There was a decrease in CPh (p=0.046) and cPh (p=0.026) and an increase in OPh (p=0.05) in female vocal folds. After vocal fry, we identified decreased jitter (p<0.01) in female voices and cPh (p=0.026) in male vocal folds. Conclusion: We observed more positive immediate effects of the voiced vibrations, mainly in voice quality and vocal folds among females. Nevertheless, studies with larger male sample and investigation of the appropriate time of vocal fry are necessary to confirm the results of this search.