Significance: The human vocal fold (VF) oscillates in multiple vectors and consists of distinct layers with varying viscoelastic properties that contribute to the mucosal wave. Office-based and operative laryngeal endoscopy are limited to diagnostic evaluation of the VF epithelial surface only and are restricted to axial-plane characterization of the horizontal mucosal wave. As such, understanding of the biomechanics of human VF motion remains limited.
Aim: Optical coherence tomography (OCT) is a micrometer-resolution, high-speed endoscopic imaging modality which acquires cross-sectional images of tissue. Our study aimed to leverage OCT technology and develop quantitative methods for analyzing the anatomy and kinematics of in vivo VF motion in the coronal plane.
Approach: A custom handheld laryngeal stage was used to capture OCT images with 800 A-lines at 250 Hz. Automated image postprocessing and analytical methods were developed.
Results: Novel kinematic analysis of in vivo, long-range OCT imaging of the vibrating VF in awake human subjects is reported. Cross-sectional, coronal-plane panoramic videos of the larynx during phonation are presented with three-dimensional videokymographic and space-time velocity analysis of VF motion.
Conclusions: Long-range OCT with automated computational methods allows for cross-sectional dynamic laryngeal imaging and has the potential to broaden our understanding of human VF biomechanics and sound production.
KEYWORDS: Optical coherence tomography, Imaging systems, Vertical cavity surface emitting lasers, Real time imaging, Range imaging, Medical imaging, Laser development, GRIN lenses, Image resolution, In vivo imaging
Fourier domain optical coherence tomography (FD-OCT) is a noninvasive imaging modality that has previously been used to image the human larynx. However, differences in anatomical geometry and short imaging range of conventional OCT limits its application in a clinical setting. In order to address this issue, we have developed a gradient-index (GRIN) lens rod-based hand-held probe in conjunction with a long imaging range 200 kHz Vertical-Cavity Surface Emitting Lasers (VCSEL) swept-source optical coherence tomography (SS-OCT) system for high speed real-time imaging of the human larynx in an office setting. This hand-held probe is designed to have a long and dynamically tunable working distance to accommodate the differences in anatomical geometry of human test subjects. A nominal working distance (~6 cm) of the probe is selected to have a lateral resolution <100 um within a depth of focus of 6.4 mm, which covers more than half of the 12 mm imaging range of the VCSEL laser. The maximum lateral scanning range of the probe at 6 cm working distance is approximately 8.4 mm, and imaging an area of 8.5 mm by 8.5 mm is accomplished within a second. Using the above system, we will demonstrate real-time cross-sectional OCT imaging of larynx during phonation in vivo in human and ex-vivo in pig vocal folds.
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