非口蓋裂性口蓋咽頭機能不全症の異常音声に関する音声言語学的研究

抄録

The author described ten rare cases of abnormal speech due to congenital (five cases) or acquired (five cases) velopharyngeal insufficiency in the absence of cleft palate, and with no apparent malformation in the oral and velopharyngeal region. This abnormal speech of the disease is classified generally as hypernasality and articulatory disorders as in the case of cleft palate. Investigation in details on the abnormal speech of the diseased are not yet complete, in Japanese language and sounds. And also, treatment for abnormal speech of the diseased are not well established. The patients with the disease were examined as follows : 1) Hearing test by author's listening to the abnormal speech as to articulation of mono and three syllable sounds, articulation of a set of the same consonant sounds, tendency of abnormal hearing of all of the sounds, intelligibility of two and three syllable words and hypernasality in all cases. 2) Manometric measurement with and without the nostrills closed, in six cases. 3) Analysis on the sounds of electro-sonic observation by the sound-spectrograph as the visible speech, in seven cases. The results were as follows : 1. The abnormal speech of the diseased by the hearing test was similar to the speech of the cleft palate patients : the vowel, semi-vowel, nasal and H-sounds were not so abnormal ; but voiced, voiceless and R-sounds were greatly abnormal. And then, the number of articulation and inteligibility were the same as the cleft palate patient's, the tendency of abnormal speech was found in nasal, vowel and H-sounds in most cases. 2. The amount of nasal escape of the diseased was the same as that of cleft palate patients, therefore, the type of nasal escap was paralled ones in five out of six cases, which was clearly different from cleft palate patients. 3. Analysis of electro-sonic observation confirmed that the abnormalities are in the first parts of the consonant sounds, especially in consonatic wave of voiced, voiceless and R-sounds. The patients were treated with surgical constructive procedure by th velopharyngeal flap operation for narrowing naso-pharyngeal space and decreasing of hypernasality in the speech, or nasal escape. All cases were operated and traeted by the author. After the surgery, the results of hearing test of speech and manometric measnremeut of nasal escape, and of analysis of electro-sonic observation were summerized as follows : a) In the hearing test, all of the articulation (mono, three syllable and consonatic sounds), tendency of abnormal speech, all of the intelligibility (two and three syllable words) and hypernasality by hearing impression were improved clearly in all cases. b) Of the nasal escape of expiration in six cases, a complete elimination was seen in three cases, and the others also improved. c) Judging from analysis by the Sound-spectrograph, consonatic wave in the voiced, voiceless and R-sounds increased remarkably, and similality to the normal sounds on the pattern of Soundspectrogram was confirmed in most cases. As a conclusion, the constructive surgery of velopharyngeal flap operation should be a better procedure of treatment for abnormal speech of the patients with velopharyngeal insufficiency in the absence of cleft palate.