Utilization of Articulatory Movements Observed by Palatography in Prosthetic Treatment

本研究的目的是利用腭部造影术评价上颌骨缺损修复术后语音障碍的改善情况。用纤维腭咽闭合镜观察不同活动的腭咽闭合运动。假体的腭部轮廓采用“包括牙齿的腭部造影术”进行检查和修改，以显示正确的舌腭部和牙齿接触。将黑色乙烯基座覆盖在上颌牙齿的腭面和咬合面制成的人工腭面，涂上白色海藻酸粉，植入受试者的口腔。发音后，用粉末润湿法显示舌面接触区。图像处理器系统对每个受试者的五个相同声音样本进行平均。受试者在戴上颌骨假体前(BT)和戴上颌骨假体后(AT)的语音变化通过发音测试进行评估：(1)声学语音清晰度测试；(2)鼻音测量(6200-2型)鼻音评分；(3)声谱(声图)分析声纹。受试者为10名正常牙列成年人和5名手术治疗的上颌骨缺损患者。根据骨缺损程度分为三组：I类；硬钢板内(2例)。II级；包括软板(一块)。结果如下：1.发音测试BT分较低，AT分较高。BT的I、II班的鼻音得分较高，而AT的鼻音得分与常模相当接近。三班的成绩高于一、二班。声图异常在I、II班有所减少，而在III班略有改善

The purpose of the study was to evaluate speech disorder improvement by the maxillary prostheses of which palatal shape were modified utilizing the palatography in the patients with maxillary defect after surgery.The velopharyngeal movements of various activities are observed by velopharyngeal fiberscope. The palatal contour of the prostheses were examined using "Palatography including teeth" and modified so as to show proper tongue-to-palate and teeth contact. The artificial palates made of black vinyl seat covering the palate and occlusal surfaces of maxillary teeth were coated with white alginate powder and inserted into the mouths of the subjects. After pronunciation of test sound, the tongue contact areas were demonstrated by wetting of powder. Each subject's five samples of same sound were averaged by the image processor system. The test sounds were voiceless plosive, voiced plosive and flapped sounds.Changes in speech of subjects before (BT) and after insertion of the maxillary prostheses (AT) were evaluated by the articulation tests : (1) The acoustical speech articulation test ; (2) the nasality measured by Nasometer (Model 6200-2) with reference to the nasalance scores ; (3) voice print analyzed by a sound spectrograph (sonagram).The subjects were ten normal dentulous adults and five patients with maxillary defect by operation. They were classified into three groups according to the extent of the defect : Class I ; within hard plate (two). Class II ; including soft plate (one). Class III ; reaching as far as posterior border of soft palate (two).The results were as follows :1. The articulation test score were low in BT., but became higher in AT..2. The nasalance scores of class I, II in BT.were high, but that in AT.were fairly close to that of normal subjects. In class III, the scores were higher than that in class I, II.3. Abnomality of the sonagram decreased in AT.of class I, II, but in class III, it showed a little improvement