Imaging of the Calf Vocal Fold With High-Frequency Ultrasound

Authors

  • Conor J. Walsh MSME,

    1. Department of Mechanical Engineering, Massachusetts Institute of Technology, and Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, U.S.A.
    Search for more papers by this author
  • James T. Heaton PhD,

    Corresponding author
    1. Department of Surgery, Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.
    • James T. Heaton, PhD, Department of Surgery Havard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, One Bowdoin Square, 11th Floor, Boston, MA 02114.
    Search for more papers by this author
  • James B. Kobler PhD,

    1. Department of Surgery, Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.
    Search for more papers by this author
  • Thomas L. Szabo PhD,

    1. Department of Biomedical Engineering, Boston University, Boston, Massachusetts, U.S.A.
    Search for more papers by this author
  • Steven M. Zeitels MD, FACS

    1. Department of Surgery, Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.
    Search for more papers by this author

  • Supported by the Eugene B. Casey Foundation and the Institute of Laryngology and Voice Restoration.

Abstract

Objectives/Hypothesis: High-frequency ultrasound imaging offers the potential for assisting in the diagnosis and treatment of vocal fold pathology if it allows aspects of vocal fold microstructure to be visualized noninvasively. The objective of this study was to assess the ability of high-frequency ultrasound to image vocal fold anatomy and injected biomaterials.

Study Design: The vocal folds of two excised calf larynges were imaged ex vivo and compared with corresponding histological sections.

Methods: High-frequency ultrasound imaging was performed under saline submersion using 40 and 50 MHz transducers, and corresponding cryostat cross-sections were stained with H&E, Trichome, and Verhoeff's Van Gieson stains.

Results: The epithelial surface, lamina propria, and underlying muscle were easily identified with the high-frequency ultrasound as verified with histological sections representing each imaged region. The arytenoid cartilage vocal process can also be clearly distinguished from the surrounding tissue, as can the full extent of injected biomaterials within the superficial lamina propria. Useful ultrasound resolution was obtained to depths of at least 10 mm within the tissue with the 40 MHz transducer.

Conclusions: This preliminary study demonstrates the capability of high-frequency ultrasound to image the layered anatomy of the calf vocal fold and to discern materials injected into the superficial lamina propria, indicating that this technology holds a strong potential for use in phonosurgery.

Ancillary