一側性声帯麻痺の健側過内転に関する臨床的研究

单侧声带麻痹健侧过度内收的临床研究

• 批准号: 08771455
• 负责人: 井上 俊彦
• 金额: $ 0.51万
• 依托单位: Kurume University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Encouragement of Young Scientists (A)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 无数据
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-08771455/
• 关键词: 代償機能; 声門閉鎖不全; 声帯過内転

声門閉鎖不全の代償作用の一つとして、健側声帯の過内転が指摘されているが、具体的な運動様式や、代償の程度はよくわかっていない。声帯が過内転する喉頭を観察すると、過内転時に同側の仮声帯も内転し、声門上部に狭窄部を形成することが多い。そこで、声帯過内転の程度を、仮声帯の内転の程度で定量化し、発音機能などとの関連を調べた。対象は、過去10年間に当科を受診した一側声帯麻痺患者385名(男211、女174、平均59歳)で、そのうち経皮的シリコン声帯内注入術を211例(男132、女79)に施行した。全例、喉頭内視鏡下ストロボスコープを行い持続発声中の両側仮声帯の接近度を観察した。その結果、患側と健側の仮声帯が発声時に接触する症例は9例のみで、他の376例では患側仮声帯の運動は認められなかった。発声時に健側仮声帯が、同側声帯を観察できないほど内転する例が111例、声帯を部分的に観察できる程度に内転する例が124例、仮声帯の内転が全く認められない例が141例であった。経皮的シリコン声帯内注入術前の仮声帯内転例125例中、56例で経皮的シリコン声帯内注入術後に内転の程度が減少した。注入後の平均呼気流量(MFR)は、内転の程度の減少例では非減少例よりも有意に小さく、最長発声持続時間(MRT)は、内転の程度の減少例では非減少例よりも有為に大きかったので、声帯の内転は発声機能を代償しようとする努力であると考えられた。しかし、術前に仮声帯が内転する56例と内転しない71例とでは、発症からシリコン注入までの病悩期間、術前の声帯位、MFR、MPT、基本周波数変動率、最大振幅変動率に有意差を認めず、声帯の内転は、発声機能を実際には代償し得ていないと考えられた。今後、声門上部の狭窄のメカニズムについても研究していきたい。

The function of the voice is not complete, and the sound of the voice is used to criticize the training, the specific training mode, and the level of communication. The sound is used to detect the noise through the internal valve, the internal sound is detected at the same time, and the narrow part of the upper part of the sound gate is formed. The sound is measured, the sound is measured, the sound is quantified, and the sound machine is able to detect the sound. In the past 10 years, a total of 385 patients (211 males, 174 females, average 59 years) with anaesthesia and 211 patients (132 males, 79 females) were injected into the surgical procedures. In the whole case, the larynx is in the middle of the sound and the proximity is observed. The results showed that there were 9 patients and 376 patients who were in contact with dysphagia during the time of sound contact. During the sound cycle, 111 cases were recorded in the sound room, 124 cases in the sound room, and 141 cases in the sound room. The skin was injected into the front and back of the skin in 125 cases and 56 cases were injected into the skin. After injection, the average call flow (MFR), the level of internal sound, the average call flow (MFR), the level of internal sound, the average call flow (APCA), the level of internal voice, the average call flow (APCA), the level of internal voice, the average call flow (APCA), the level of internal voice, the average call flow (APCA), the level of internal voice, the average call flow (APCA), the level of internal voice, the average call flow (APCA), the level of internal sound, the average call flow (APCA), the level of internal sound, the average call flow (APCA), the level of internal sound, the average call flow (APCA), the level of internal sound, and the level of internal sound were injected. There were 56 cases of anechoic waves in 56 cases. 71 cases of chronic diseases and symptomatic diseases were injected during the period of illness, pre-anal sound position, MFR, MPT, basic cycle activity rate, maximum amplitude activity rate, intentional differential recognition, acoustic internal reading, and acoustic energy quotient. From now on, the upper part of the glottis is narrow and narrow.