Utilization of Articulatory Movements Observed by Palatography in Prosthetic Treatment

本研究的目的是利用腭咽造影术对上颌骨缺损术后患者的腭部形态进行改良，通过纤维鼻咽镜观察患者的各种活动情况，评价上颌骨修复对语音障碍的改善效果。使用“包括牙齿在内的腭造影术”检查修复体的腭轮廓，并进行修改，以显示适当的舌腭和牙齿接触。将覆盖腭部和上颌牙齿咬合面的黑色乙烯基座制成的人工腭涂上白色藻酸盐粉末并插入受试者的口中。在发出测试音后，通过润湿粉末来证明舌接触面积。每个受试者的五个相同声音样本由图像处理器系统平均。测试音为清塞音、浊塞音和瓣音，通过语音清晰度测试（1）语音清晰度测试（2）鼻音测量仪（Nasometer）测量受试者安装上颌义齿前后的语音变化（3）声图分析。受试者为10名正常成人和5名手术切除的上颌骨缺损患者。根据缺损程度将其分为三组：I类;硬钢板内（2例）。II类;含软板（1个）。Ⅲ级，远及软腭后缘2例。BT的清晰度测试得分较低。，但在AT中变得更高。2. BT组Ⅰ、Ⅱ类鼻平衡评分较高，AT组与正常组比较接近。3.三年级学生的成绩高于一、二年级学生。Ⅰ、Ⅱ级房性心动过速的音图异常减少，Ⅲ级房性心动过速的音图异常稍有改善

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