耳鼻と臨床

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The speech articulation in the 67 single speech sound was examined and the tendency of mishearing these sounds in normal ears was observed after the total resection of the maxilla and in case of the nasal polypi. Further, the frequency analysis (a visible frequency analysator-TS-6 type) was investigated, and the change with time in the sound spectrum was pursued by the 8mm cinematography, and the relation between the mishearing and a monosyllable was studied.
1) The examined speech sound was subjected to inspection in normal ears, divided in each case, and was classified into a good, a moderate and a hard hearing to be compared and studied conveniently.
2) In case of the total resection of the maxilla, it was observed by dividing into no packing, the prothesis and gauze packing. In case of the nasal polypi, the nasal polypi, obstrating the bilateral nasal cavities, and causing the tipycal obstrated voice, were observed.
3) On the tested score of speech articulation in each case it was almost obscure in the nopacked and was remarkably disturbed in every series and row. In the gauze packed or prothesis, it was increased by 20-30%, and the significant impediment was observed in the ya and the sonant series. In the cases of nasal polypi the articulation showed 82%, while the impediment in the na and ma series and in the i and u rows was comparatively remarkable.
4) On the tested score of frequency analysis in each case, each speech sound was obscure and no frequency characteristic could be obtained in the no packed. In the gauze packed (prothesis), the range of frequency in each tested speech sound was partial to the low and the peaks of it often make a rundam type. In case of the nasal polypi, it was partial to the low, and was comparatively similar to the normal.
5) From the above mentioned facts, an ideal prothesis used in the total resection of the maxilla requires a close adherence over the all operation wounds, as well as enabling the patient to pronounce the voice of the ya and sonant series clearly.

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Objective audiometric examinations were performed, supposing the skin-electrical response in humans as the sign of conditional response. The sound, electrical shock, pure sound and white noise were used as conditional stimulus, unconditional stimulus, positive conditional stimulus and negative it was necessary for the method of examination to be, simple in operation and conditional stimulus, respectively.
For the purpose of making an audiogram, easy in performance. Therefore, trials were made of improving the examination apparatus and simplifying its operation.
1.41 cases (ages ranging from 2 to 56) were classified into 3 groups with normal hearing high degree hearing difficulty and moderate degree hearing difficulty. In each group, the processes were carefully observed of the formation of conditional response, developing and generalization.
2. To strengthen the establishment of conditional response, the high tone (2000-4000 cps) seemed to be more effective than the low tone as conditional stimulus.
3. The children took less stimuli than adults in times for the formation of conditional response and development.
4. The minimum stimulus of pure positive sound volume to recognize the GSR curve was considered as the hearable threshold and objective audiograms were drawn of the cases which went through the processes of conditional response formation and development.
5. The comparison between the objective and subjective audiograms suggested the lowering of objective hearing capacity in the low cycle area and the lowering of subjective hearing capacity in the high cycle area.

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