Quantitative methods for calibrated spatial measurements of laryngeal phonatory mechanisms

The ability to perform measurements is an important cornerstone and the prerequisite of any quantitative research. Measurements allow us to quantify inputs and outputs of a system, and then to express their relationships using concise mathematical expressions and models. Those models would then enable us to understand how a target system works and to predict its output for changes in the system parameters. Conversely, models would enable us to determine the proper parameters of a system for achieving a certain output. Putting these in the context of voice science research, variations in the parameters of the phonatory system could be attributed to individual differences. Thus, accurate models would enable us to account for individual differences during the diagnosis and to make reliable predictions about the likely outcome of different treatment options. Analysis of vibration of the vocal folds using high-speed videoendoscopy (HSV) could be an ideal candidate for constructing computational models. However, conventional images are not spatially calibrated and cannot be used for absolute spatial measurements. This dissertation is focused on developing the required methodologies for calibrated spatial measurements from in-vivo HSV recordings. Specifically, two different approaches for calibrated horizontal measurements of HSV images are presented. The first approach is called the indirect approach, and it is based on the registration of a specific attribute of a common object (e.g. size of a lesion) from a calibrated intraoperative still image to its corresponding non-calibrated in-vivo HSV recording. This approach does not require specialized instruments and can be implemented in many clinical settings. However, its validity depends on a couple of assumptions. Violation of those assumptions could lead to significant measurement errors. The second approach is called the direct approach, and it is based on a laser-projection flexible fiberoptic endoscope. This approach would enable us to make accurate calibrated spatial measurements. This dissertation evaluates the accuracy of the first approach indirectly, and by studying its underlying fundamental assumptions. However, the accuracy of the second approach is evaluated directly, and using benchtop experiments with different surfaces, different working distances, and different imaging angles. The main significances and contributions of this dissertation are the following: (1) a formal treatment of indirect horizontal calibration is presented, and the assumptions governing its validity and reliability are discussed. A battery of tests is presented that can indirectly assess the validity of those assumptions in laryngeal imaging applications; (2) recordings from pre- and post-surgery from patients with vocal fold mass lesions are used as a testbench for the developed indirect calibration approach. In that regard, a full solution is developed for measuring the calibrated velocity of the vocal folds. The developed solution is then used to investigate post-surgery changes in the closing velocity of the vocal folds from patients with vocal fold mass lesions; (3) the method for calibrated vertical measurement from a laser-projection fiberoptic flexible endoscope is developed. The developed method is evaluated at different working distances, different imaging angles, and on a 3D surface; (4) a detailed analysis and investigation of non-linear image distortion of a fiberoptic flexible endoscope is presented. The effect of imaging angle and spatial location of an object on the magnitude of that distortion is studied and quantified; (5) the method for calibrated horizontal measurement from a laser-projection fiberoptic flexible endoscope is developed. The developed method is evaluated at different working distances, different imaging angles, and on a 3D surface.