{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:43:20Z","timestamp":1760150600757,"version":"build-2065373602"},"reference-count":57,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T00:00:00Z","timestamp":1702339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders (NIDCD)","doi-asserted-by":"publisher","award":["5R01DC009616"],"award-info":[{"award-number":["5R01DC009616"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Applied Sciences"],"abstract":"<jats:p>Subglottic stenosis (SGS) is a rare yet potentially life-threatening condition that requires prompt identification and treatment. One of the primary symptoms of SGS is a respiratory sound that is tonal. To better understand the effect of SGS on expiratory sound, we used direct noise calculation to simulate sound production in a simplified axisymmetric configuration that included the trachea, the vocal folds, the supraglottal tract, and an open environmental space. This study focused on flow-sustained tones and explored the impact of various parameters, such as the SGS severity, the SGS distance, the flowrate, and the glottal opening size. It was found that the sound pressure level (SPL) of the expiratory sound increased with flowrate. SGS had little effect on the sound until its severity approached 75% and SPL increased rapidly as the severity approached 100%. The results also revealed that the tonal components of the sound predominantly came from hole tones and tract harmonics and their coupling. The spectra of the sound were greatly influenced by constricting the glottis, which suggests that respiratory tasks that involve maneuvers to change the glottal opening size could be useful in gathering more information on respiratory sound to aid in the diagnosis of subglottic stenosis.<\/jats:p>","DOI":"10.3390\/app132413197","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T11:30:14Z","timestamp":1702380614000},"page":"13197","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Subglottic Stenosis on Expiratory Sound Using Direct Noise Calculation"],"prefix":"10.3390","volume":"13","author":[{"given":"Biao","family":"Geng","sequence":"first","affiliation":[{"name":"Department of Mechanical Engineering, Rochester Institute of Technology, Rochester, NY 14623, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8462-1271","authenticated-orcid":false,"given":"Qian","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Rochester Institute of Technology, Rochester, NY 14623, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Thomson","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Civil Engineering, Brigham Young University-Idaho, Rexburg, ID 83460, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xudong","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Rochester Institute of Technology, Rochester, NY 14623, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1080\/23772484.2022.2050374","article-title":"Life-threatening idiopathic subglottic stenosis misdiagnosed as asthma","volume":"7","author":"Dreyer","year":"2022","journal-title":"Acta Oto-Laryngol. Case Rep."},{"key":"ref_2","unstructured":"Barker, N., and Elphick, H. (2018). Breath Sounds from Basic Science to Clinical Practice, Springer."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1177\/000348948008900502","article-title":"Etiology of Stridor in the Neonate, Infant and Child","volume":"89","author":"Holinger","year":"1980","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1177\/000348947608500505","article-title":"Subglottic Stenosis in Infants and Children","volume":"85","author":"Holinger","year":"1976","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1002\/ppul.1950200404","article-title":"Congenital stridor","volume":"20","author":"Lis","year":"1995","journal-title":"Pediatr. Pulmonol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1177\/000348940711600503","article-title":"Etiology of Stridor in Infants","volume":"116","author":"Zoumalan","year":"2007","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1002\/ppul.23930","article-title":"The highs and lows of wheezing: A review of the most popular adventitious lung sound","volume":"53","author":"Pasterkamp","year":"2018","journal-title":"Pediatr. Pulmonol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1002\/ppul.26228","article-title":"Circumferential subglottic hemangioma misdiagnosed twice in an infant with life-threatening dyspnea","volume":"58","author":"Cai","year":"2022","journal-title":"Pediatr. Pulmonol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1136\/bmj.321.7267.1000","article-title":"Lesson of the week: Tracheal stenosis after intubation","volume":"321","author":"Spittle","year":"2000","journal-title":"Br. Med. J."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Priftis, K.N., Hadjileontiadis, L.J., and Everard, M.L. (2018). Breath Sounds: From Basic Science to Clinical Practice, Springer International Publishing.","DOI":"10.1007\/978-3-319-71824-8"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1164\/ajrccm\/139.6.1407","article-title":"Stridor: Differentiation from Asthma or Upper Airway Noise","volume":"139","author":"Baughman","year":"1989","journal-title":"Am. Rev. Respir. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1001\/archotol.1991.01870220092016","article-title":"A Basic Model to Study Acoustic Evaluation of Airway Obstruction","volume":"117","author":"Coleman","year":"1991","journal-title":"Arch. Otolaryngol. Neck Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1615\/InterJFluidMechRes.v31.i5.40","article-title":"On Generation of Tonal Sound Vibrations by Airflow in Stenotic Airways","volume":"31","author":"Basovsky","year":"2004","journal-title":"Int. J. Fluid Mech. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1121\/1.1909476","article-title":"Some Experiments concerning the Hole and Ring Tone","volume":"37","author":"Chanaud","year":"1965","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Dar, J.A., Srivastava, K.K., and Mishra, A. (2023). Lung anomaly detection from respiratory sound database (sound signals). Comput. Biol. Med., 164.","DOI":"10.1016\/j.compbiomed.2023.107311"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Kim, H., Koh, D., Jung, Y., Han, H., Kim, J., and Joo, Y. (2023, November 30). Breathing Sounds Analysis System for Early Detection of Airway Problems in Patients with a Trache-Ostomy Tube. (Under Review at Scientific Reports). Available online: https:\/\/www.researchsquare.com.","DOI":"10.1038\/s41598-023-47904-0"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Bodaghi, D., Xue, Q., Zheng, X., and Thomson, S. (2021). Effect of Subglottic Stenosis on Vocal Fold Vibration and Voice Production Using Fluid\u2013Structure\u2013Acoustics Interaction Simulation. Appl. Sci., 11.","DOI":"10.3390\/app11031221"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Hilton, B.A., and Thomson, S.L. (J. Voice, 2022). Aerodynamic-induced Effects of Artificial Subglottic Stenosis on Vocal Fold Model Phonatory Response, J. Voice, in press.","DOI":"10.1016\/j.jvoice.2022.11.024"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.jfluidstructs.2012.11.010","article-title":"Influence of subglottic stenosis on the flow-induced vibration of a computational vocal fold model","volume":"38","author":"Smith","year":"2013","journal-title":"J. Fluids Struct."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1080\/10255842.2014.996877","article-title":"Acoustic simulation of a patient\u2019s obstructed airway","volume":"19","author":"Lynch","year":"2016","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/j.pcl.2018.12.013","article-title":"Stridor in the Newborn","volume":"66","author":"Bluher","year":"2019","journal-title":"Pediatr. Clin. N. Am."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1183\/09031936.06.00029605","article-title":"Laryngeal ultrasound: A useful method in predicting post-extubation stridor. A pilot study","volume":"27","author":"Ding","year":"2006","journal-title":"Eur. Respir. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1016\/j.ijporl.2010.05.027","article-title":"Serial intralesional steroid injection combined with balloon dilation as an alternative to open repair of subglottic stenosis","volume":"74","author":"Edmondson","year":"2010","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1038\/scientificamerican0170-40","article-title":"Aerodynamic whistles","volume":"222","author":"Chanaud","year":"1970","journal-title":"Sci. Am."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1121\/1.1907284","article-title":"A Jet-Tone Orifice Number for Orifices of Small Thickness-Diameter Ratio","volume":"26","author":"Anderson","year":"1954","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1121\/1.1907475","article-title":"Metastable Jet-Tone States of Jets from Sharp-Edged, Circular, Pipe-Like Orifices","volume":"27","author":"Anderson","year":"1955","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1017\/S0022112060000049","article-title":"The stability and transition of a two-dimensional jet","volume":"7","author":"Sato","year":"1960","journal-title":"J. Fluid Mech."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1017\/S0022112070001714","article-title":"Vortex growth in jets","volume":"44","author":"Beavers","year":"1970","journal-title":"J. Fluid Mech."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1017\/S0022112068000248","article-title":"Vortex evolution in a round jet","volume":"31","author":"Becker","year":"1968","journal-title":"J. Fluid Mech."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1063\/1.1694612","article-title":"Spatial waves in turbulent jets","volume":"17","author":"Chan","year":"1974","journal-title":"Phys. Fluids"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1115\/1.3448983","article-title":"Experimental Study of a Jet-Driven Helmholtz Oscillator","volume":"101","author":"Morel","year":"1978","journal-title":"J. Fluids Eng. Trans. ASME"},{"key":"ref_32","unstructured":"Karamcheti, K., Bauer, A.B., Shields, W.L., Stegen, G.R., and Woolley, J.P. (1969). Some Features of an Edge-Tone Flow Field, NASA Spec Publ 207 (Basic Aerodynamic Noise Research)."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1121\/1.1912641","article-title":"Experiments on the Fluid Mechanics of Whistling","volume":"50","author":"Wilson","year":"1971","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/0889-9746(91)90472-2","article-title":"On the active control of shear layer oscillations across a cavity in the presence of pipeline acoustic resonance","volume":"5","author":"Huang","year":"1991","journal-title":"J. Fluids Struct."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/S0022-460X(82)80007-2","article-title":"An experimental investigation of pure tone generation by vortex shedding in a duct","volume":"84","author":"Nomoto","year":"1982","journal-title":"J. Sound Vib."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1121\/1.1906894","article-title":"Acoustical Characteristics of Jet-Edge and Jet-Edge-Resonator Systems","volume":"24","author":"Nyborg","year":"1952","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1134\/S1063771018030016","article-title":"Effect of Nozzle Shape on Amplitude of Well Acoustic Emitter Generation","volume":"64","author":"Abdrashitov","year":"2018","journal-title":"Acoust. Phys."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"107101","DOI":"10.1063\/1.4821782","article-title":"The aeroacoustics of a steam kettle","volume":"25","author":"Henrywood","year":"2013","journal-title":"Phys. Fluids"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1121\/1.1906955","article-title":"Dependence of Pfeifenton (Pipe Tone) Frequency on Pipe Length, Orifice Diameter, and Gas Discharge Pressure","volume":"24","author":"Anderson","year":"1952","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1260\/1475-472X.9.1-2.123","article-title":"Progress in Direct Noise Computation","volume":"9","author":"Bailly","year":"2010","journal-title":"Int. J. Aeroacoustics"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"110548","DOI":"10.1016\/j.jcp.2021.110548","article-title":"Hydrodynamic\/acoustic splitting approach with flow-acoustic feedback for universal subsonic noise computation","volume":"444","author":"Ewert","year":"2021","journal-title":"J. Comput. Phys."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2147","DOI":"10.1121\/1.1506694","article-title":"Computational aeroacoustics of phonation, Part II: Effects of flow parameters and ventricular folds","volume":"112","author":"Zhang","year":"2002","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2134","DOI":"10.1121\/1.1506693","article-title":"Computational aeroacoustics of phonation, Part I: Computational methods and sound generation mechanisms","volume":"112","author":"Zhao","year":"2002","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_44","unstructured":"Wootton, D.M., Guez, A., Vaidyanathan, P., Avinash, D., Stablum, J.R., McDonough, J.M., Udupa, J.K., and Arens, R. (2003, January 22\u201323). Model of Upper Airway Flow Restriction in Children with Obstructive Sleep APNEA. Proceedings of the 2003 IEEE 29th Annual Proceedings of Bioengineering Conference, Newark, NJ, USA."},{"key":"ref_45","first-page":"784","article-title":"Increase in tracheal size with age. Implications for maximal expiratory flow","volume":"132","author":"Gibellino","year":"1985","journal-title":"Am. Rev. Respir. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1002\/ca.20815","article-title":"In vivo and in vitro morphometry of the human trachea","volume":"22","author":"Kamel","year":"2009","journal-title":"Clin. Anat."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1121\/1.427148","article-title":"Morphology and development of the human vocal tract: A study using magnetic resonance imaging","volume":"106","author":"Fitch","year":"1999","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1121\/1.1333420","article-title":"Intraglottal pressure profiles for a symmetric and oblique glottis with a divergence angle of 10 degrees","volume":"109","author":"Scherer","year":"2001","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2072","DOI":"10.1121\/1.419657","article-title":"The perfectly matched layer for acoustic waves in absorptive media","volume":"102","author":"Liu","year":"1997","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/j.medengphy.2015.05.014","article-title":"Realistic glottal motion and airflow rate during human breathing","volume":"37","author":"Scheinherr","year":"2015","journal-title":"Med. Eng. Phys."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1016\/j.csl.2012.10.005","article-title":"Phrase-level speech simulation with an airway modulation model of speech production","volume":"27","author":"Story","year":"2013","journal-title":"Comput. Speech Lang."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.jvoice.2009.01.001","article-title":"Whispering\u2014A Single-Subject Study of Glottal Configuration and Aerodynamics","volume":"24","author":"Sundberg","year":"2010","journal-title":"J. Voice"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1136\/thx.37.11.840","article-title":"Respiration during sleep in normal man","volume":"37","author":"Douglas","year":"1982","journal-title":"Thorax"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1109\/TBME.2002.807327","article-title":"Modeling and measurement of flow effects on tracheal sounds","volume":"50","author":"Harper","year":"2003","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1260\/1475-472X.7.3.321","article-title":"Mechanism of Pipe-Tone Excitation by Flow through an Orifice in a Duct","volume":"7","author":"Karthik","year":"2008","journal-title":"Int. J. Aeroacoust."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Volk, O., Ratnovsky, A., Naftali, S., and Singer, G. (2023). Classification of tracheal stenosis with asymmetric misclassification errors from EMG signals using an adaptive cost-sensitive learning method. Biomed. Signal Process. Control, 85.","DOI":"10.1016\/j.bspc.2023.104962"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1007\/s00348-006-0106-0","article-title":"An investigation of bimodal jet trajectory in flow through scaled models of the human vocal tract","volume":"40","author":"Erath","year":"2006","journal-title":"Exp. Fluids"}],"container-title":["Applied Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3417\/13\/24\/13197\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:37:30Z","timestamp":1760132250000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3417\/13\/24\/13197"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,12]]},"references-count":57,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["app132413197"],"URL":"https:\/\/doi.org\/10.3390\/app132413197","relation":{},"ISSN":["2076-3417"],"issn-type":[{"type":"electronic","value":"2076-3417"}],"subject":[],"published":{"date-parts":[[2023,12,12]]}}}