口蓋形成術後の残孔が発音におよぼす影響に関する研究

抄録

This study undertaken to investigate the effect on the speech of fistula which had remained after palatoplasty. Thirtythree subjects were classified according to (1) the location of palatal fistula, (2) the dimension of palatal fistula, (3) its dimensional proportion to hard palate and (4) its plane and solid shapes. Examinations were also made on the relation among these 4 classifications and on the changes in nasality following the closure of palatal fistula. Then, 17 subjects were examined on respiratory nasal leakage by manometer, articulation, intelligibility and tendency of abnormal sounds were analyzed and investigated by soundspectrograph. The results were as follows ; 1. The dimension of fistula was the major factor over the effects on the speech. 2. Examinations based on the degree of the effects on the speech confirmed that the factor gave clear differences to the effects. The fistula which is less than 15mm^2 in the dimension, and/or 2% in the dimensional proportion to hard palate, is thought to cause no changes on the speech. The fistula which is 15mm^2 to 30mm^2 in the dimension, and/or 2 to 5% in the dimensional proportion to hard palate, is thought to cause moderate changes on the speech. The fistula which is more than 30mm^2 in the dimension and/or more than 5% in the dimensional proportion to hard palate, is thought to cause remarkable changes on the speech. 3. The difference of the effect on the speech by the locational classification of the palatal fistula, was not observed clearly. The alveolar fistula affected less than palatal fistula. 4. The funnel-shaped fistula which contracted toward nasal cavity affected the speech less than the tube-shaped fistula. 5. The characteristics obtained in analysis of abnormal hearing tendency were the substitution of h-sounds for p-sounds and nasalization of many sounds. It was inferred that such tendency was caused as the result of respiratory nasal leakage the through fistula and a decrease in inner oral pressure during phonation. 6. Analysis by soundspectrograph contributed to the visualization of the results in hearing.