Method, program, and device for quantitatively evaluating laryngeal motion in monitoring of non-invasive swallowing motion

Abstract

In order to evaluate laryngeal motion during swallowing in a non-invasive and simple manner, the present invention provides a method for quantitatively evaluating laryngeal motion, the method making it possible to create a laryngeal motion curve and, on the basis of the laryngeal motion curve, evaluate the laryngeal elevation speed, the laryngeal elevation distance, and the laryngeal elevation duration. The cervical median shape of a subject is acquired, shape feature points are detected from the acquired shape, a laryngeal motion curve is created from the temporal change in the positions of the shape feature points accompanying a prescribed action, and the laryngeal motion in the prescribed action is quantitatively evaluated. When the prescribed action is performed, the temporal change in the position of a cervical median convexity corresponding to the laryngeal prominence is measured. If the position of the cervical median convexity cannot be detected, then the laryngeal motion curve is created by using the temporal change in the positions of shape feature points other than the cervical median convexity, including cervical median concavities located above and below the cervical median convexity. The prescribed action is an action in which the larynx is moved, said action including a swallowing action and a vocalization action.

Description

Method, program and device for quantitative evaluation of laryngeal movement in non-invasive swallowing movement monitoring

[0001] The present invention relates mainly to the evaluation of laryngeal movement during swallowing, and in particular to a method for creating a laryngeal movement curve (a curve showing changes in laryngeal movement over time), a method for calculating laryngeal elevation velocity, laryngeal elevation distance, and laryngeal elevation duration based on the laryngeal movement curve, and an apparatus for realizing these methods.

[0002] As the population ages, the prevalence of swallowing disorders, such as aspiration pneumonia, is increasing. Swallowing involves the process of recognizing food, forming a bolus in the oral cavity, and then transporting the bolus from the oral cavity through the pharynx and esophagus to the stomach. The pharyngeal process, in particular, involves a series of instantaneous movements, including laryngeal movement, laryngeal closure, pharyngeal contraction, and esophageal opening, and disorders in this process are strongly associated with the onset of aspiration. Laryngeal movement is an important component of swallowing function assessment. Furthermore, accurate assessment of laryngeal movement during swallowing function assessment and rehabilitation training is essential for the implementation of effective measures to prevent aspiration. To achieve this, a noninvasive and simple test method that can be used in everyday life is highly desirable.

[0003] Laryngeal movement can be assessed by visual inspection, palpation, or qualitative assessment using video fluoroscopy (VF) under X-ray fluoroscopy. Quantitative assessment is possible by plotting VF test images, and software has been developed that semi-automatically tracks and plots indicators. However, VF tests are difficult to perform repeatedly due to radiation exposure and equipment limitations. For this reason, a noninvasive, simple method for quantitatively assessing laryngeal movement is needed. However, no method has been established for quantitatively assessing laryngeal movement in noninvasive swallowing monitoring.

[0004] In response to these challenges, non-invasive evaluation devices for swallowing movements have been proposed. For example, Non-Patent Document 1 discloses a method in which a rectangular piezoelectric element molded into a film is used as a sensor, which is attached to the surface of the neck with its longitudinal direction aligned with the direction of up and down movement of the larynx, and the movement of the laryngeal prominence during swallowing exerts a pressure change on the piezoelectric element sensor within the area covered by the sensor, and this change is detected to measure the time related to laryngeal movement. While this method can determine the timing of laryngeal elevation with a certain degree of accuracy, it has the problem of being unable to measure the distance the laryngeal elevates.

[0005] In relation to the above, Patent Document 1 and Non-Patent Document 2 propose a method of detecting the start and end points of swallowing by attaching a strip-shaped capacitance-type stretch sensor to the surface of the neck and detecting changes in the extension of the sensor due to the laryngeal prominence moving through the measurement area during swallowing. In this case, too, it was not possible to measure the laryngeal elevation distance.

[0006] It should be noted that Patent Document 2 describes that the moving speed of the laryngeal prominence can be measured by placing multiple similar capacitance-type stretchable sensors in close contact with the surface of the neck of a subject, but does not demonstrate its effectiveness based on examples. Even if it is possible to measure it, it is limited to measuring the average speed between each sensor when the laryngeal prominence passes through each sensor unit, each of which has a short side of 5 to 30 mm, and it is thought that detailed analysis would be difficult.

[0007] Furthermore, Patent Document 3 discloses a method for evaluating swallowing movements by configuring a sensor array, in which multiple similar stretchable sensors are arranged in parallel, as a measuring device including a pressing tool, and pressing the sensor array of the measuring device against the surface of the subject's neck. In this case, it is desirable to always fix the measuring device to the subject, and a method is shown in which the pressing tool is manually held and applied to two points, near the neck and clavicle. However, the only effectiveness demonstrated is the reduction of hand shake at rest (when there is contact with the clavicle fixing part, the fluctuation in sensor extension is on average 0.2-0.4 mm less than when there is no contact). In other words, the effect of reducing slight movements of the measuring device associated with swallowing movements was not demonstrated.

[0008] Furthermore, Non-Patent Document 3 discloses an example of a non-contact displacement sensor, which uses a 16-channel sensor array with photoelectric distance sensors arranged at 4 mm intervals to capture the change in the distance between the sensor and the midline of the neck in response to laryngeal movement during swallowing. In this case, the large sensor array required neck extension, making it difficult to swallow naturally. Furthermore, in cases where the subject is a woman, the larynx is positioned higher than in men, making it difficult to observe the laryngeal prominence. Furthermore, in cases where the laryngeal prominence is hidden by the mandible during elevation and the elevation process cannot be tracked, there is also the problem of being unable to measure laryngeal movement. Furthermore, it was necessary to use an intraaural click as an indicator of the onset of the swallowing reflex in the laryngeal elevation curve.

[0009] JP 2020-103429 A JP 2017-119100 A JP 2022-7091 A

[0010] Naomi Yagi et al., “A noninvasive swallowing measurement system using a combination of respiratory flow, swallowing sound, and laryngeal motion.” Medical & biological engineering & computing, 55, 1001-1017 (2017). Hiroyuki Nakamoto et al., “Development of a band-shaped device and detection algorithm of laryngeal elevation.” in 42nd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC), pp. 4475-4478 (2020). Tomoyuki Haji, “Evaluation of laryngeal movement during swallowing using a laryngeal movement measurement system with a photoelectric distance sensor.” Otolaryngology and Clinical Practice, 67(3), 200-210 (2021).

[0011] In non-invasive swallowing movement monitoring, there are issues with subject-related factors, such as the larynx being high or hidden by the mandible during swallowing, or swallowing movement monitor-related factors, such as a small monitor device with a limited number of sensors, limiting the measurable area of ​​the neck. Tracking only the convex portion representing the laryngeal prominence in the midline neck shape can result in gaps in the laryngeal movement curve. Another issue is that tracking the laryngeal prominence leaves no clear direction for laryngeal movement to be evaluated as elevation. The present invention aims to provide a method, program, and device for quantitatively evaluating laryngeal movement during swallowing and other situations in a non-invasive and simple manner, capable of creating a gapless laryngeal movement curve and evaluating laryngeal elevation speed, laryngeal elevation distance, and laryngeal elevation duration based on the laryngeal movement curve.

[0012] To solve the above-mentioned problems, the present invention provides a method for quantitatively evaluating laryngeal movement. The method acquires a subject's midline neck shape, detects shape feature points from the acquired shape, creates a laryngeal movement curve based on the time changes in the positions of the shape feature points associated with a predetermined movement, and quantitatively evaluates laryngeal movement based on the laryngeal movement curve. The predetermined movement may be a swallowing movement or a vocalization movement. The shape feature points used are characteristic features of the midline neck shape, such as the midline neck convexity corresponding to the laryngeal prominence and the midline neck depressions located above and below the midline neck convexity. The midline neck shape can be acquired using a contact or non-contact displacement sensor, or images captured by a camera, etc. The method tracks shape feature points, including the convexity, of the midline neck shape. If the position of the convexity cannot be tracked (for example, because it has moved outside the measurement area or is hidden by the mandible even within the measurement area), a complete laryngeal movement curve is created by using the time changes in the positions of shape feature points other than the midline neck convexity, including the midline neck depressions located above and below the midline neck convexity.

[0013] Examples of contact-type displacement sensors used to acquire the neck midline shape include film-type stretch sensors and film-type piezoelectric sensors. Stretch sensors are preferably used as stretchable strain sensors that contact the neck skin to measure the sensor's elongation. Stretchable strain sensors may be either capacitive or resistive. While piezoelectric sensors are technically distinct from displacement sensors because the displacement is determined by integrating the sensor output, they may be described herein as a type of displacement sensor for convenience. Examples of non-contact sensors include optical displacement sensors that can directly measure the distance to the neck skin. When using these displacement sensors, multiple independent displacement sensors are placed parallel to the neck, close to or in close contact with the surface of the neck midline, and responses from the multiple displacement sensors are recorded to estimate the neck midline shape.

[0014] Although it is difficult to use a telescopic sensor to measure the anterior-posterior position of the neck midline shape, the quantitative evaluation method for laryngeal movement of the present invention can be configured to be practical for vertical movement even when the output of the telescopic sensor is considered as the position and analyzed. The quantitative evaluation method for laryngeal movement of the present invention may acquire the neck midline shape of a subject by analyzing image data captured by a neck imaging camera during movement. Specifically, for example, to acquire the neck midline shape, a method of capturing the neck with a video camera or the like and analyzing the image can be used. When using a video camera, the neck midline shape may be acquired from image data captured from the side of the subject's neck, or the midline shape may be acquired from the three-dimensional shape of the neck with a 3D camera. The type of camera constituting the neck imaging camera is not particularly limited, and a wide variety of known cameras can be used. Furthermore, the images captured are also not limited, and either moving images or still images may be used.

[0015] In the quantitative evaluation method for laryngeal movement of the present invention, the initial movement direction of the laryngeal prominence from rest can be set as the laryngeal elevation direction based on the time change in the neck midline shape. When a displacement sensor is used, the inclination of the displacement sensor during laryngeal movement is corrected so that the sensor surface of the displacement sensor at the start of measurement and the initial movement direction of the protruding point of the laryngeal prominence from rest are approximately parallel. Furthermore, a motion sensor can be used to sequentially correct changes in the position and inclination of the displacement sensor during laryngeal movement. When using images of the neck captured with a video camera or the like, the initial movement direction of the laryngeal prominence from rest can be defined as the elevation direction for the neck midline shape obtained from the images, allowing for analysis of position changes of shape feature points. Furthermore, in the quantitative evaluation method for laryngeal movement of the present invention, changes in the inclination and position of the measurement device during laryngeal movement can be corrected using a marker detection camera provided in a measurement device having a displacement sensor and a marker attached to the subject as the detection target of the marker detection camera. The marker is attached to the subject's body near the larynx and at a location with minimal movement, specifically, near the subject's manubrium. The marker on the manubrium may move with the subject's breathing. However, breathing stops during swallowing, particularly during laryngeal movement, so breathing-related marker movement need not be considered when measuring swallowing. During inspiration, the manubrium rises as the rib cage expands, and during expiration, the manubrium descends. Therefore, exhalation and inhalation can be distinguished by measuring the relative position of the marker detection camera attached to the device and the subject's marker. Based on the movement of the marker immediately before or after swallowing, it can be determined whether the breath immediately before or after swallowing is exhalation or inhalation, and this data can be used to assess the risk of aspiration.

[0016] When the quantitative evaluation method for laryngeal movement of the present invention obtains the shape of the subject's neck midline by analyzing image data captured by a neck imaging camera during movement, the change in tilt and position of the measurement device during laryngeal movement may be corrected using a marker detection camera provided in a measurement device having a neck imaging camera and a marker attached to the subject as a detection target for the marker detection camera.

[0017] The quantitative evaluation method for laryngeal movement of the present invention can perform quantitative evaluation of laryngeal movement based on a created laryngeal movement curve. A movement characteristic point is detected from the laryngeal movement curve by combining laryngeal velocity and acceleration, and the laryngeal elevation distance and laryngeal elevation duration during a predetermined movement are calculated. The movement characteristic points are points where acceleration peaks positive and velocity is positive, points where laryngeal acceleration peaks negative and velocity is positive, and points where laryngeal acceleration peaks negative and velocity is negative. The movement characteristic points are referred to as the laryngeal elevation start point, laryngeal elevation end point, and laryngeal descent start point, respectively. Using these, the laryngeal elevation velocity, laryngeal elevation distance, and laryngeal elevation duration during a predetermined movement can be calculated from only the laryngeal movement curve.

[0018] The program of the present invention causes a computer to execute the following steps: acquiring a subject's midline neck shape; detecting shape feature points from the acquired shape; creating a laryngeal movement curve from the time changes in the positions of the shape feature points associated with a predetermined movement; and quantitatively evaluating laryngeal movement based on the laryngeal movement curve during the movement. When acquiring the subject's midline neck shape data, if the data is discrete data obtained from multiple displacement sensors or the like, the data is smoothly interpolated to estimate the midline neck shape. If the data is image data or the like, the midline neck shape data is sufficiently detailed and can be used as is. In the step of creating the laryngeal movement curve, the position of the midline neck convexity corresponding to the laryngeal prominence is tracked, and if the position of the midline neck convexity cannot be detected, the laryngeal movement curve is created by using the time changes in the positions of shape feature points other than the midline neck convexity, including the midline neck depressions located above and below the midline neck convexity. The program of the present invention can be installed on a personal computer (PC), tablet device, or smartphone app. Alternatively, it may be installed as a program on a server computer, and a laryngeal movement curve may be displayed on a network terminal, and the calculated results of laryngeal elevation speed, laryngeal elevation distance, and laryngeal elevation duration during movement may be displayed.

[0019] Next, the device of the present invention will be described. The device of the present invention comprises a neck midline shape acquisition unit for acquiring the neck midline shape of a subject, a shape feature point detection unit for detecting shape feature points from the neck midline shape, a laryngeal movement curve creation unit for creating a laryngeal movement curve from the time change in the positions of the shape feature points accompanying a predetermined movement, and a laryngeal movement quantitative evaluation unit for quantitatively evaluating laryngeal movement based on the laryngeal movement curve during the predetermined movement.

[0020] The apparatus of the present invention preferably further comprises a measurement device having a plurality of independent displacement sensors that are parallel to the surface and placed close to or in close contact with the surface of the cervical midline. In the apparatus of the present invention, the measurement device may comprise a measurement device main body provided with a displacement sensor and a marker detection camera, and a marker attached to the subject and used as a detection target for the marker detection camera. The displacement sensor may be a contact-type displacement sensor, a non-contact-type displacement sensor, or an optical displacement sensor. A near-infrared distance sensor or a piezoelectric sensor may also be used. In such a case, the apparatus of the present invention preferably has the marker detection camera installed below the housing of the measurement device main body, and the marker is located near the manubrium of the subject. Furthermore, the orientation of the marker detection camera may be adjustable depending on the attachment position of the marker, for example.

[0021] In the device of the present invention, the measuring device may be a wrap-around device that is wrapped around the neck of the subject and may be provided with a film-like stretch sensor. The wrap-around type measuring device enables quantitative evaluation of laryngeal movement without the need to grip the measuring device, improving convenience. In addition, in the device of the present invention, the measuring device may be a stick-on type device that is attached to the surface of the midline of the neck of the subject and may be provided with a film-like stretch sensor. The stick-on type measuring device enables quantitative evaluation of laryngeal movement without the need to grip the measuring device, improving convenience. Furthermore, unlike wrap-around type measuring devices, the measuring device does not cover the entire circumference of the neck, improving comfort.

[0022] The apparatus of the present invention may further include a measurement device provided with a neck imaging camera that acquires the neck midline shape of the subject by analyzing image data capturing the subject's movements. The measurement device may also include a measurement device main body provided with a neck imaging camera and a marker detection camera, and a marker attached to the subject and used as a detection target for the marker detection camera.

[0023] According to the present invention, it is possible to non-invasively and simply create a laryngeal movement curve without any defects during swallowing movements, etc. Furthermore, by analyzing the laryngeal movement curve, it is possible to calculate the laryngeal elevation speed, laryngeal elevation distance, and laryngeal elevation duration. When measuring swallowing movements, the measurement device can be used at a natural angle without requiring excessive extension of the neck.

[0024] 1. Functional block diagram of a device for quantitatively evaluating laryngeal movement. 2. Schematic diagram of a device for quantitatively evaluating laryngeal movement. 3. Oblique view of the appearance of the measurement device of Example 1. 4. Schematic diagram of the use of the measurement device of Example 1. 5. Flow diagram of creating a laryngeal movement curve in the quantitative evaluation method of laryngeal movement. 6. Example of estimating the actual neck midline shape. 7. Schematic diagram of the contact between the neck midline and the stretch sensor. 8. Example of creating an actual laryngeal movement curve using convex and concave parts. 9. Comparison diagram of a laryngeal movement curve created based on the laryngeal movement evaluation method and a laryngeal movement curve created from a videofluoroscopic swallowing test. 10. Example of analyzing an actual laryngeal movement curve. 11. Other examples of creating a laryngeal movement curve. 12. Schematic diagram of angle correction. 13. Time change in the position of shape feature points when angle correction is not performed. 14. Example of creating a laryngeal movement curve when angle correction is performed. 15. Functional block diagram of a device for creating a laryngeal movement curve. 16. Schematic diagram of the osteochondral part of the human larynx. 17. Schematic diagram of the use of the measurement device of Example 4. 18. Oblique view of the appearance of the measurement device of Example 5. 19. 20. Schematic diagram of the use of the measurement device of Example 5. 21. 22. Schematic diagram of the use of the measurement device of Example 6. 23. 24. Schematic diagram of the use of the measurement device of Example 7.

[0025] The present invention relates to a method for measuring laryngeal movement, primarily during swallowing, based on observing the external surface of a subject's neck. A feature of the present invention is that, when the midline neck convexity corresponding to the laryngeal prominence can no longer be tracked in the temporal change of the neck midline shape, laryngeal movement is replaced with the movement of the depressions present above and below the laryngeal prominence (depressions on the neck surface near the hyoid bone or depressions corresponding to the gap between the thyroid cartilage and the cricoid cartilage). It is also possible to replace it with the movement of the inflection point, which is the transition point between the convex and concave portions. This compensates for missing portions of the laryngeal movement curve, allowing a continuous laryngeal movement curve to be created.

[0026] In particular, the depression corresponding to the gap between the thyroid cartilage and the cricoid cartilage has relatively little subcutaneous tissue and is less susceptible to errors compared to the depression near the hyoid bone, making it useful as important data. Furthermore, if the protuberance caused by the cricoid cartilage below the laryngeal prominence can be tracked, it will be possible to replace laryngeal movement with the movement of the protuberance caused by the cricoid cartilage. Convexities and concaves are detected by evaluating the change in slope of the shape of the midline of the neck, and the point where the sign of the differentiation or difference changes corresponds to a protuberance or depression. The point where the sign changes when differentiation or difference is performed twice corresponds to the inflection point.

[0027] When acquiring the shape of the midline of the neck, examples of the displacement sensor include a contact-type displacement sensor and an optical displacement sensor. A method of photographing the neck with a video camera or the like may also be used. The contact-type displacement sensor may be an expansion sensor as described in Patent Documents 1 to 3. The optical displacement sensor may be a photoelectric distance sensor as described in Non-Patent Document 3, but the present invention is not limited to these examples, and any sensor that can numerically capture the time change in the surface irregularities of the laryngeal swallowing movement at the midline of the neck using a physical measurement method may be preferably used.

[0028] In the case of a contact-type displacement sensor, the short side of the sensor is preferably 5 mm or less, and in the case of an optical displacement sensor, the irradiation spot width is preferably about 1 to 2 mm or less. These displacement sensors are preferably arranged in parallel, each of which serves as an independent channel to acquire displacement data, and the analog output from each channel is preferably AD converted and recorded as digital data on a multi-channel input sampling digital oscilloscope or data logger. In this case, the number of channels is preferably at least 5 or more. Furthermore, in the case of a sensor attached to the neck, the size of the area where the sensor is located is also important. If the area where the sensor is located is too large, neck extension is required, which can lead to the problem of preventing natural swallowing movements.

[0029] The method using a photoelectric distance sensor can obtain changes in the shape of the midline of the neck over time by smoothly interpolating the data between sensors. The method using an extension sensor makes it difficult to measure the shape of the midline of the neck, as the extension of the sensor differs from the amount of forward and backward movement of the midline of the neck. However, it is possible to treat the smoothly interpolated data between sensors as an approximate shape of the midline of the neck. A laryngeal movement curve can be created by analyzing and calculating these uneven changes in the shape of the midline of the neck.

[0030] When evaluating laryngeal movement from the neck midline shape, a problem arose as to which direction laryngeal movement should be evaluated as elevation. When using a sensor array as a device for measuring laryngeal movement, the issue of how to align the sensor surface of the sensor array with the direction of laryngeal elevation became a problem. During swallowing, the larynx not only elevates but also moves toward the mandible, thereby assisting in the opening of the esophageal entrance. The vector of the larynx elevating a small distance from rest is considered to be less influenced by the component toward the mandible, and the direction of this slight elevation vector is defined as the direction of laryngeal elevation, allowing for evaluation of laryngeal movement from the neck midline shape. In the case of a sensor array, the angle is corrected by assuming that the sensor surface is approximately parallel to the slight elevation vector, which is the initial direction of the larynx's movement from rest. The neck midline shape is corrected by slightly increasing or decreasing it by the correction angle. The corrected neck midline shape is then subjected to the concave / convex shape analysis described above. When obtaining the shape of the midline of the neck from an image, the initial direction of movement of the protruding point of the laryngeal prominence from a resting state is defined as the direction of elevation, and then the concave-convex shape is analyzed.

[0031] In the present invention, the laryngeal elevation distance and elevation duration are calculated from only the laryngeal movement curve. Specifically, based on three elements: position, velocity, and acceleration, the laryngeal elevation start point, laryngeal elevation end point, and laryngeal descent start point are set as movement characteristic points. When the head side is defined as positive and the foot side as negative, the point at which laryngeal acceleration due to the swallowing reflex reaches a positive peak and velocity also becomes positive is defined as the laryngeal elevation start point. The point at which acceleration reaches a negative peak and velocity also becomes positive is defined as the laryngeal elevation end point. The point at which acceleration reaches a negative peak and velocity also becomes negative is defined as the laryngeal descent start point. In this case, the laryngeal elevation end point and the laryngeal elevation peak point are different points. The point at which acceleration reaches a positive peak and velocity becomes negative can also be defined as the laryngeal descent end point, but this point is not used to calculate the laryngeal elevation distance and laryngeal elevation duration. In this case, the laryngeal descent end point differs from the larynx height at rest or the height at which the larynx is fully lowered after swallowing. The laryngeal elevation distance due to the swallowing reflex is calculated as the distance to the highest point of laryngeal elevation when the starting point of laryngeal elevation is set as the reference height, and the laryngeal elevation duration is calculated as the time required from the end point of laryngeal elevation to the start point of laryngeal descent. The laryngeal elevation distance from rest can be calculated as the distance from the laryngeal height at rest to the highest point of laryngeal elevation. This makes it possible to calculate the laryngeal elevation distance and elevation duration from the laryngeal movement curve alone. Because laryngeal movement occurs due to contraction of the muscles attached to the larynx, the point at which a sudden force is applied during the swallowing reflex, i.e., the point at which acceleration peaks, is considered to be the switching point of the movement, and a movement characteristic point was set. Since laryngeal elevation velocity corresponds to the slope of the laryngeal movement curve, it can be calculated by taking the derivative or difference of the laryngeal movement curve.

[0032] There are problems associated with the method of acquiring the neck midline shape. When using a method in which part of a swallowing movement monitor is brought into contact with the neck, the position of the monitor relative to the neck can move slightly as the swallowing movement occurs, affecting the time-dependent change in neck midline shape and causing deviations in the laryngeal movement curve. In this invention, by equipping the measurement device itself with a motion sensor, it is possible to correct the neck midline shape each time it occurs in response to slight changes in the position and angle of the monitor.

[0033] Hereinafter, examples of embodiments of the present invention will be described with reference to the drawings. Note that the scope of the present invention is not limited to the following examples and illustrated examples, and many modifications and variations are possible.

[0034] FIG. 1 shows a functional block diagram of the laryngeal movement quantitative evaluation device of this embodiment. The laryngeal movement quantitative evaluation device 1 includes a neck midline shape acquisition unit 1a, a shape feature point detection unit 1b, a laryngeal movement curve creation unit 1c, and a laryngeal movement quantitative evaluation unit 1d. The neck midline shape acquisition unit 1a interpolates the subject's neck data acquired from a laryngeal movement measurement device 5 to estimate the neck midline shape. The shape feature point detection unit 1b detects shape feature points from the subject's neck midline shape. The laryngeal movement curve creation unit 1c creates a laryngeal movement curve from the time change in the position of shape feature points accompanying a predetermined movement. The laryngeal movement quantitative evaluation unit 1d quantitatively evaluates laryngeal movement based on the laryngeal movement curve during the movement. The functional block diagram of the laryngeal movement quantitative evaluation device shown in FIG. 1 is also applicable to Example 2.

[0035] A measurement device 5 and a tablet terminal 8 as shown in FIG. 2 were used to collect data for estimating the neck midline shape. The measurement device 5 is equipped with an expansion sensor and can measure the expansion of the expansion sensor due to laryngeal prominence. The data acquired by the measurement is sent to and recorded on the tablet terminal 8. Waveform data 8a is output on the display of the tablet terminal 8. The measurement device 5 and the tablet terminal 8 transmit and receive data via wireless communication (or wired communication). In this example, laryngeal movement was evaluated based on the data recorded on the tablet terminal 8 using a laryngeal movement quantitative evaluation device 1 equipped with a neck midline shape acquisition unit 1a, a shape feature point detection unit 1b, a laryngeal movement curve creation unit 1c, and a laryngeal movement quantitative evaluation unit 1d.

[0036] Here, we will explain the structure of the human larynx and its vicinity, which is the measurement target. Figure 16 is a schematic diagram of the bone cartilage portion near the human larynx, showing the bone cartilage portion located deeper than the subcutaneous tissue and muscle. As shown in Figure 16, there is a hyoid bone 101, a thyrohyoid membrane 102, a thyroid cartilage 103, a laryngeal prominence (Adam's apple) 104, a cricothyroid ligament 105, and a cricoid cartilage 106. The convex feature point mainly corresponds to the laryngeal prominence (Adam's apple) 104, but may also correspond to the cricoid cartilage 106. The concave feature point roughly corresponds to the cricothyroid ligament 105 or the thyrohyoid membrane 102.

[0037] Next, the measurement device 5 of Example 1 will be described. As shown in FIG. 3, the measurement device 5 includes a holder 6 and an expansion sensor unit 7. The expansion sensor unit 7 is suspended over the holder protrusions (6a, 6b) under tension, with both ends (not shown) housed within the holder protrusions (6a, 6b). The expansion sensor unit 7 is provided with expansion sensors (7a-7e), with expansion sensor 7a designated "ch1," expansion sensor 7b designated "ch2," expansion sensor 7c designated "ch3," expansion sensor 7d designated "ch4," and expansion sensor 7a designated "ch5." The width W of the expansion sensors (7a-7e) is 5 mm, and the spacing D between the expansion sensors (7a-7e) is 3 mm. In this example, a swallowing movement monitor (B4S) manufactured by Bando Chemical Industries, Ltd. was used as the measurement device 5.

[0038] 4 shows a schematic diagram of the use of the measurement device 5 of Example 1. When performing the measurement, the stretchable sensor unit 7 of the measurement device 5 was pressed against the midline of the neck of the subject 100 to be measured so that it was parallel to the neck. During the measurement, the subject 100 held the holding unit 6 of the measurement device 5 with his or her hand, trying not to move it.

[0039] Figure 5 shows a flow diagram for creating a laryngeal movement curve in the quantitative evaluation method for laryngeal movement. Step S01 is a step in which the displacement sensor measures the relative position of the neck midline during laryngeal movement. In Example 1, the extension of each extension sensor (7a-7e) associated with swallowing was measured as shown in Figure 4. Although the extension itself is different from the anterior-posterior position change of the neck midline, by regarding it as an anteroposterior position change, the neck midline shape acquisition unit 1a smoothly interpolates between each measurement point to estimate the neck midline shape (step S02). The shape feature point detection unit 1b detects each shape feature point based on the estimated neck midline shape (step S03) and calculates the time change in the position of each shape feature point (step S04).

[0040] Based on the calculated changes in the position of each shape feature point over time, the laryngeal movement curve creation unit 1c determines whether the cervical midline convexity can be detected (step S05), and if the cervical midline convexity cannot be detected, the changes in the positions of parts other than the cervical midline convexity, including the cervical midline concavity, are considered to be the changes in the position of the cervical midline convexity over time (step S06), and the changes in the positions of each shape feature point over time are integrated to create a laryngeal movement curve (step S07). Also, if the cervical midline convexity can be detected in step S05, step S06 is not performed and a laryngeal movement curve can be created (step S07).

[0041] Figure 6 shows an actual example of the estimated neck midline shape during swallowing and its shape feature points, arranged in chronological order from (1) to (4). Figure 7 is a schematic diagram of the contact between the neck and the stretch sensor in Figure 6. In Figures 6 and 7, (1) corresponds to a state in which the neck midline convexity is located at the bottom within the measurement area of ​​the displacement sensor, (2) corresponds to a state in which the neck midline convexity is located at the top within the measurement area of ​​the displacement sensor, (3) corresponds to a state in which the neck midline convexity has moved outside the measurement area of ​​the displacement sensor, and (4) corresponds to a state in which the neck midline convexity has returned to the measurement area of ​​the displacement sensor. In Figures 6 and 7, the neck midline convexity corresponds to the laryngeal prominence.

[0042] FIG. 6(1) shows the neck midline shape estimated by smoothly interpolating the measurement points between ch1 and ch5, and the shape feature point P １ and the shape feature point P ２ showed.

[0043] FIG. 6(2) shows the neck midline shape estimated by smoothly interpolating the measurement points between ch1 and ch5, and the shape feature point P ２ and the feature point P ３ In FIG. 7(2), the shape characteristic point P １ The shape feature point P ３ is moving into the measurement area of ​​the displacement sensor.

[0044] FIG. 6(3) shows the neck midline shape estimated by smoothly interpolating the measurement points between ch1 and ch5, and the shape feature point P ３ In FIG. 7(3), the shape characteristic point P １ Not only that, but also the shape feature point P ２ The shape characteristic point P ３ The figure shows a schematic diagram of how only α- and β-actin are detected.

[0045] FIG. 6(4) shows the neck midline shape estimated by smoothly interpolating the measurement points between ch1 and ch5, and the feature point P ２ In FIG. 7(4), the shape characteristic point P ３ The shape feature point P ２ has moved into the measurement area of ​​the displacement sensor, the shape feature point P ２ The figure shows a schematic diagram of how only α- and β-actin are detected.

[0046] An example of a created laryngeal movement curve is shown in Figure 8. Figure 8(1) shows the change in the position of each shape feature point over time, and Figure 8(2) shows a laryngeal movement curve created by integrating the change in the position of each shape feature point over time. Missing data in Figure 8(1) means that the shape feature point was not found in the neck midline shape at that time.

[0047] In FIG. 8(1), the shape characteristic point P ２The missing part of the position of the change over time is represented by the shape characteristic point P １ Or P ３ By replacing the position of the characteristic point P with the position of the characteristic point P, a laryngeal movement curve was created as shown in Figure 8 (2). ２ The missing part of the time change in the position is indicated by a double arrow.

[0048] 9 is a comparative diagram of a laryngeal movement curve (Example) created based on the laryngeal movement evaluation method of Example 1 and a laryngeal movement curve (Comparative Example) created based on a videofluoroscopic examination of swallowing, for the same swallowing movement when swallowing saliva. In the videofluoroscopic examination of swallowing, the swallowing movement was recorded as a video at 15 fps, and the laryngeal movement curve was created by visually tracking the calcified area of ​​the thyroid cartilage from the frame-by-frame images. ２ If the position of the central cervical depression cannot be detected, the shape feature point P １ , P ３ The time change of the displacement of the position of the shape characteristic point P ２ By regarding this as the time change in the displacement of the position of the pharyngeal wall, and replacing it with this, a curve with roughly the same shape as the laryngeal movement curve created from the videofluoroscopic swallowing test was obtained, as shown in Figure 9. The discrepancy between the two was thought to be caused by the slight movement of the measuring device (not shown) that accompanied the swallowing movement.

[0049] Figure 10 shows an example of a laryngeal movement curve analysis. The curve indicated by position corresponds to the laryngeal movement curve, with the corresponding velocity and acceleration superimposed. Point a corresponds to the start point of laryngeal elevation, point b corresponds to the end point of laryngeal elevation, and point c corresponds to the start point of laryngeal descent. Line <1> indicates the laryngeal position at rest, and line <2> indicates the position of the maximum laryngeal elevation distance. The laryngeal elevation distance A due to the swallowing reflex was evaluated as the distance (mm) between point a and the position of the maximum laryngeal elevation. The laryngeal elevation distance A' from rest was evaluated as the distance (mm) between the laryngeal position at rest and the position of the maximum laryngeal elevation. The laryngeal elevation duration B was evaluated as the time (seconds) between point b and point c. In this way, laryngeal movement was quantitatively evaluated solely from the laryngeal movement curve. Note that Figures 6, 8, 9, and 10 show the analysis results for the same swallowing movement in the same subject.

[0050] Figure 11 shows an example of a laryngeal movement curve created for a different swallowing action when the measurement device 5 is reapplied to the neck of the same subject as in Figures 6, 8, 9, and 10. Figure 11(1) shows the time change in the position of each shape feature point, and Figure 11(2) shows a laryngeal movement curve created by integrating the time change in the position of each shape feature point. Missing data in Figure 11(1) means that the shape feature point was not found in the neck midline shape at that time. In Figure 11(1), the shape feature point P ２ The missing part of the position of the change over time is represented by the shape characteristic point P ３ By replacing the position of the characteristic point P with the position of the characteristic point P, a laryngeal movement curve was created as shown in FIG. ２ The missing part of the time change in the position is indicated by a double arrow.

[0051] In Example 2, the effect of angle correction and the detection of cricoid cartilage prominence are demonstrated. Figure 12 is a schematic diagram of angle correction, showing how the tilt of the displacement sensor during laryngeal movement is corrected so that the sensor surface of the displacement sensor at the start of measurement is approximately parallel to the initial direction of the laryngeal prominence from rest. The arrow indicates the initial direction of the laryngeal prominence from rest, which corresponds to the direction of larynx elevation. When correcting the dotted line to a solid line, the measurement data is corrected because L1 = L1', L2 = L2' + a × sin θ, and L3 = L3' + 2a × sin θ can be assumed only when the rotation angle θ is small. The measurement data after angle correction is smoothly interpolated to estimate the neck midline shape. A small correction angle is adjusted so that the initial direction of the laryngeal prominence obtained from the estimated neck midline shape is approximately parallel to the sensor surface. For comparison before and after this angle correction, Fig. 13 shows the time change in the position of the shape feature point without angle correction, and Fig. 14(1) shows the time change in the position of the shape feature point with angle correction. In Fig. 13, there are times when no shape feature point is detected, which indicates that if the laryngeal elevation direction is not set correctly, a correct laryngeal elevation curve cannot be drawn. In Fig. 14(1), shape feature points are detected at all times, and the shape feature point P ２ is the midline convex part of the neck corresponding to the laryngeal prominence, and the shape feature point P ３ is the cervical midline depression corresponding to the cricothyroid ligament, and the shape feature point P４ is the midline convex part of the neck that corresponds to the prominence of the cricoid cartilage. ２ The missing part of the time change of the position of the shape feature point P ３ and replace it with the time change of the position of the shape feature point P ４ In the part where the shape feature point P ３ The time change of the position of the shape feature point P ４ By replacing the position of the larynx with the time change, a continuous laryngeal movement curve was created as shown in Figure 14 (2). Note that the subject in Example 2 is different from the subject in Example 1.

[0052] As in Example 1, Example 2 also uses an elastic sensor, which makes it difficult to measure the anterior-posterior depth of the neck midline shape. However, when an optical displacement sensor is used, the anterior-posterior depth of the neck midline shape can be measured directly, so the estimated neck midline shape is more accurate, and it is thought that the method of the present invention can be used to draw movement curves not only for the up and down movement of the larynx, but also for the anterior-posterior movement.

[0053] 15 shows a functional block diagram of the laryngeal motion curve creation device of this embodiment. The laryngeal motion curve creation device 11 includes a neck midline shape acquisition unit 11a, a shape feature point detection unit 11b, and a laryngeal motion curve creation unit 11c. As with the laryngeal motion quantitative evaluation device 1 of Example 1, the neck midline shape acquisition unit 11a interpolates neck data of the subject acquired from the laryngeal motion measurement device 5 to estimate the neck midline shape, the shape feature point detection unit 11b detects shape feature points from the neck midline shape of the subject, and the laryngeal motion curve creation unit 11c creates a laryngeal motion curve from changes over time in the positions of the shape feature points associated with a predetermined movement.

[0054] FIG. 17 is a schematic diagram illustrating the use of the measurement device of Example 4. As shown in FIG. 17 , the measurement device 5a of Example 4 differs from the measurement device 5 of Example 1 in that a marker detection camera 9a whose angle can be adjusted downward is provided at the bottom of the holding unit 60, which is the housing of the measurement device main body. A marker 9b is also attached near the manubrium of the subject 100 to be measured. The marker 9b is used as the detection target for the marker detection camera 9a. Prior to measurement, the marker detection camera 9a is calibrated in advance so that the relative positional relationship between the measurement device 5a and the marker 9b can be measured. Then, the expansion sensor unit 7 of the measurement device 5a is pressed against the midline surface of the neck of the subject 100 so as to be parallel to the neck. Because both the expansion sensor unit 7 and the marker detection camera 9a are provided in the measurement device 5a, the three-dimensional positions of the expansion sensor unit 7 and the marker detection camera 9a are fixed. Therefore, by measuring the positional relationship between the marker detection camera 9a and the marker 9b in real time, it is possible to correct changes in the tilt and position of the telescopic sensor unit 7 during laryngeal movement. As in Example 1, it is preferable that the subject 100 hold the holding unit 60 of the measurement device 5a in his or her hand and not move it during measurement. However, even if the position or orientation of the holding unit 60 changes, correction is possible using the configuration of Example 4. The attachment location of the marker 9b is not limited to the vicinity of the manubrium of the subject 100, and may be any location on the subject's body that is near the larynx and has little movement.

[0055] FIG. 18 is a perspective view of the appearance of a measuring device according to a fifth embodiment. As shown in FIG. 18, a measuring device 5b according to the fifth embodiment includes a holder 61, an expansion sensor 7, and bands (12a, 12b). The holder 61 is provided with holder protrusions (61a, 61b). The expansion sensor 7 is suspended across the holder protrusions (61a, 61b) under tension, with both ends (not shown) housed within the holder protrusions (61a, 61b). A gap 61c is provided between the holder protrusions 61a and 61b, preventing interference with the holder 61 when the expansion sensor 7 is pressed against the area to be measured. The expansion sensor 7 has the same configuration as the single expansion sensor 7 according to the first embodiment and includes five expansion sensors. However, the number of expansion sensors may be increased or decreased to improve measurement accuracy.

[0056] FIG. 19 shows a schematic diagram of the measurement device of Example 5 in use. As shown in FIG. 19 (1) or (2), the measurement device 5b of Example 5 is a wrap-type measurement device that is wrapped around the neck of the subject 100. The stretch sensor unit 7 of the measurement device 5b is pressed against the midline of the neck of the subject 100 to be measured so as to be parallel to the neck. The straps (12a, 12b) are made of a non-stretchable or low-stretchable material and are designed to be easily attached and detached using a buckle or the like (not shown). In this example, two straps (12a, 12b) are provided to increase stability when worn, but one or more straps may be used. Because the measurement device 5b is a wrap-type measurement device, quantitative evaluation of laryngeal movement is possible without grasping the measurement device 5b, making it highly convenient. In order to prevent the bands (12a, 12b) from shifting due to laryngeal movement of the subject 100 during measurement, an adhesive member may be provided on the surface of the bands (12a, 12b) that comes into contact with the subject 100, or the bands (12a, 12b) themselves may be made of an adhesive material. Data measured by the measurement device 5b is transmitted to and recorded on a terminal such as the tablet terminal 8, as in the first embodiment.

[0057] FIG. 20 shows a schematic diagram of the measurement device of Example 6 in use. As shown in FIG. 20, the measurement device 5c of Example 6 is a patch-type measurement device that is attached to the surface of the midline neck of the subject 100. A pair of holders (62a, 62b), which are the main body of the patch-type device, are attached to the surface of the midline neck of the subject 100, straddling the midline neck. Although not shown, an adhesive member is provided on the contact surface of the holders (62a, 62b) with the subject 100, preventing the holders (62a, 62b) from peeling off due to laryngeal movement of the subject 100 during measurement. The structure of the elastic sensor unit 7 is the same as that of Example 5. Because the measurement device 5c is a patch-type device, quantitative evaluation of laryngeal movement is possible without gripping the measurement device 5c, making it highly convenient. Furthermore, unlike the wrap-around measurement device 5b, the measurement device does not cover the entire neck, improving comfort. The data measured by the measuring device 5c is transmitted to a terminal such as the tablet terminal 8 and recorded, similarly to the first embodiment.

[0058] FIG. 21 shows a schematic diagram of the measurement device of Example 7 in use. As shown in FIG. 21, the measurement device 5d of Example 7 is composed of a holder 63, a band 12, and a marker detection camera 9a. The holder 63, which is the housing of the measurement device body, is provided with an elastic sensor unit 7, similar to the holder 61 of Example 5, although not shown. As shown in FIG. 21, the measurement device 5d is a wrap-type measurement device that is used by wrapping it around the neck of the subject 100. The elastic sensor unit 7 of the measurement device 5b is pressed against the midline of the neck of the subject 100 to be measured so as to be parallel to the neck. The band 12 is formed of a non-elastic or low-elastic material and has a structure that allows for easy length adjustment and attachment / detachment using a buckle or the like, although not shown. In this example, a single band 12 is provided that is thicker than the bands (12a, 12b) of Example 5. In this way, by providing bands of different thicknesses or increasing or decreasing the number of bands, it is possible to provide a device that suits the user's preferences, body shape, etc.

[0059] Similarly to the measurement device 5a of Example 4, the measurement device 5d is provided with a marker detection camera 9a, the angle of which can be adjusted downward, at the bottom of the holding unit 63, which is the housing of the measurement device main body. A marker 9b is also attached near the manubrium of the subject 100 to be measured. The attachment location of the marker 9b is not limited to near the manubrium of the subject 100, but may be any location on the subject's body near the larynx that exhibits minimal movement. Prior to measurement, the marker detection camera 9a is calibrated so that the relative positional relationship between the measurement device 5a and the marker 9b can be measured. Then, the expansion sensor unit 7 of the measurement device 5d is pressed against the midline surface of the neck of the subject 100 so as to be parallel to the neck. Because both the expansion sensor unit 7 and the marker detection camera 9a are provided in the measurement device 5d, the three-dimensional positions of the expansion sensor unit 7 and the marker detection camera 9a are fixed. Therefore, by measuring the positional relationship between the marker detection camera 9a and the marker 9b in real time, it is possible to correct changes in the tilt and position of the expansion / contraction sensor unit 7 during laryngeal movement.

[0060] As described above, because measurement device 5d is a wrap-around type, quantitative evaluation of laryngeal movement is possible without gripping measurement device 5d, and even if the position or orientation of holding portion 63 changes, correction is possible based on the positional relationship between marker detection camera 9a and marker 9b. Note that to prevent slippage of band 12 due to laryngeal movement of subject 100 during measurement, an adhesive member may be provided on the surface of band 12 that contacts subject 100, or band 12 itself may be made of an adhesive material. Data measured by measurement device 5d is transmitted to and recorded on a terminal such as tablet terminal 8, as in Example 1.

[0061] (Other Examples) In a stick-on measuring device that is attached to the surface of the midline of the neck of a subject, a marker detection camera that can be adjusted to face downwards may be provided at the bottom of the holding part, which is the housing of the main body of the measuring device, and a marker may be attached near the manubrium of the subject to be measured.

[0062] This invention enables quantitative evaluation of laryngeal movement non-invasively and easily. It may be used not only to assess the effectiveness of rehabilitation but also for diagnosis. It may be applicable to optimizing the number of sensors and sensor spacing in non-invasive swallowing movement monitors, as well as optimizing and miniaturizing the size of monitors.

[0063] 1 Laryngeal movement quantitative evaluation device 1a, 11a Cervical midline shape acquisition unit 1b, 11b Shape feature point detection unit 1c, 11c Laryngeal movement curve creation unit 1d Laryngeal movement quantitative evaluation unit 5, 5a to 5d Measurement device 6, 60, 61, 62a, 62b, 63 Holding unit 6a, 6b, 61a, 61b Holding unit protrusion 6c, 61c Gap 7 Stretch sensor unit 7a to 7e Stretch sensor 8 Tablet terminal 8a Waveform data 9a Marker detection camera 9b Marker 10 Cervical midline shape 11 Laryngeal movement curve creation device 12, 12a, 12b Band 100 Subject 101 Hyoid bone 102 Thyrohyoid membrane 103 Thyroid cartilage 104 Laryngeal prominence (Adam's apple) 105 Cricothyroid ligament 106 Cricoid cartilage D Interval P １ ~P ４ Shape feature point W width

Claims

1. A method for quantitatively evaluating laryngeal movement, which comprises acquiring a subject's midline neck shape, detecting shape feature points from the acquired shape, and creating a laryngeal movement curve from the time change in the position of the shape feature points associated with a specified movement, thereby quantitatively evaluating laryngeal movement during the movement.

2. A method for quantitatively evaluating laryngeal movement as described in claim 1, wherein, during the movement, the change over time in the position of the cervical midline convexity corresponding to the laryngeal prominence is measured, and if the position of the cervical midline convexity cannot be detected, a laryngeal movement curve is created by using the change over time in the position of the shape characteristic points other than the cervical midline convexity, including the cervical midline concavities located above and below the cervical midline convexity.

3. A method for quantitatively evaluating laryngeal movement as described in claim 2, in which, during the movement, a plurality of independent displacement sensors are placed parallel to the neck in close proximity to or in close contact with the surface of the midline of the neck, and responses from the plurality of displacement sensors are recorded to estimate the shape of the midline of the neck and create a laryngeal movement curve.

4. A method for quantitatively evaluating laryngeal movement as described in claim 1, wherein the movement is a swallowing movement.

5. A method for quantitatively evaluating laryngeal movement as described in claim 3, wherein the displacement sensor is a film-type elastic sensor or a film-type piezoelectric sensor.

6. The method for quantitatively evaluating laryngeal movement according to claim 3, wherein the displacement sensor is an optical displacement sensor.

7. A method for quantitatively evaluating laryngeal movement as described in claim 1, in which the initial direction of laryngeal prominence from a resting state is set as the direction of laryngeal elevation to correct the inclination and perform laryngeal movement analysis.

8. A method for quantitatively assessing laryngeal movement as described in claim 3, further comprising the step of: compensating for changes in tilt and position of the displacement sensor during laryngeal movement using a motion sensor.

9. A method for quantitatively evaluating laryngeal movement according to any one of claims 1 to 8, further comprising the steps of: detecting a movement characteristic point in the laryngeal movement curve using a combination of laryngeal velocity and acceleration; and calculating at least one of the laryngeal elevation distance and laryngeal elevation duration from only the laryngeal movement curve.

10. A method for quantitatively evaluating laryngeal movement as described in claim 9, wherein the movement characteristic point is a laryngeal elevation start point in the case of laryngeal elevation distance, and is a laryngeal elevation start point and a laryngeal descent start point in the case of laryngeal elevation duration.

11. A program for causing a computer to execute the steps of: acquiring a neck midline shape of a subject; detecting shape feature points from the acquired shape; and creating a laryngeal movement curve from the time changes in the positions of the shape feature points associated with a specified movement.

12. The program described in claim 11 for causing a computer to execute the steps of: measuring, during said operation, a change in position of the midline cervical convexity corresponding to the laryngeal prominence over time; and, when the position of the midline cervical convexity cannot be detected, creating a laryngeal movement curve by using the change in position of the shape characteristic points other than the midline cervical convexity, including the midline cervical concavities present above and below the midline cervical convexity.

13. The program according to claim 11 or 12, for causing a computer to execute a step of quantitatively evaluating laryngeal movement based on said laryngeal movement curve.

14. An apparatus comprising: a neck midline shape acquisition unit that acquires the neck midline shape of a subject; a shape feature point detection unit that detects shape feature points from the acquired shape; and a laryngeal movement curve creation unit that creates a laryngeal movement curve from the time change in the position of the shape feature points associated with a specified movement.

15. The device according to claim 14, further comprising a laryngeal movement quantitative evaluation unit that quantitatively evaluates laryngeal movement based on the laryngeal movement curve.

16. The apparatus according to claim 14 or 15, further comprising a measuring device provided with a plurality of independent displacement sensors each arranged parallel to the surface while being placed in close proximity to or in close contact with the surface of the midline shape of the neck.

17. The apparatus according to claim 16, comprising: a measurement device main body in which the displacement sensor and a marker detection camera are provided; and a marker attached to the subject and used as a detection target for the marker detection camera.

18. The apparatus according to claim 17, wherein the marker detection camera is installed on the underside of a housing of the measurement device main body, and the marker is provided in the vicinity of the subject's manubrium.

19. The apparatus according to claim 16, wherein the measuring device is a wrap-around type device that is wrapped around the neck of a subject and is provided with a film-like elastic sensor.

20. The apparatus according to claim 16, wherein the measuring device is an adhesive type device that is attached to the surface of the subject's neck at the center, and is provided with a film-like elastic sensor.

21. The apparatus according to claim 14 or 15, further comprising a measuring device equipped with a neck imaging camera that obtains the neck midline shape of the subject by analyzing image data capturing the subject's movements.

22. The apparatus according to claim 21, comprising: a measurement device main body in which the neck imaging camera and a marker detection camera are provided; and a marker attached to the subject and used as a detection target for the marker detection camera.

23. A method for quantitatively evaluating laryngeal movement as described in claim 3, wherein changes in inclination and position of the measuring device during laryngeal movement are corrected using a marker detection camera provided on a measuring device having the displacement sensor and a marker attached to the subject as a detection target for the marker detection camera.

24. A method for quantitatively evaluating laryngeal movement as described in any one of claims 1, 2 and 7, in which the shape of the subject's midline neck is obtained by analyzing image data captured by a neck imaging camera during the movement.

25. A method for quantitatively evaluating laryngeal movement as described in claim 24, wherein changes in inclination and position of the measurement device during laryngeal movement are corrected using a marker detection camera provided in a measurement device having the neck imaging camera and a marker attached to the subject as a detection target for the marker detection camera.

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