Impact of the Paraglottic Space on Voice Production in an MRI-Based Vocal Fold Model

ObjectiveWhile the vocal fold is in direct contact anteriorly with the thyroid cartilage, posteriorly the vocal fold connects to the thyroid cartilage through a soft tissue layer in the paraglottic space. Currently the paraglottic space is often neglected in computational models of phonation, in which a fixed boundary condition is often imposed on the lateral surface of the vocal fold. The goal of this study was to investigate the effect of the paraglottic space on voice production in an MRI-based vocal fold model, and how this effect may be counteracted by vocal fold stiffening due to laryngeal muscle activation.MethodsParametric simulation study using an MRI-based computational vocal fold model.ResultsThe results showed that the presence of the paraglottic space increased the mean and amplitude of the glottal area waveform, decreased the phonation frequency and closed quotient. For the particular vocal fold geometry used in this study, the presence of the paraglottic space also reduced the occurrence of irregular vocal fold vibration. These effects of the paraglottic space became smaller with increasing paraglottic space stiffness and to a lesser degree with vocal fold stiffening.ConclusionsThe results suggest that the paraglottic space may be neglected in qualitative evaluations of normal phonation, but needs to be included in simulations of pathological phonation or vocal fold posturing