The influence of the degree of maxillary defect closure and palatal shape of maxillary prosthses on the ability to speech

目的：上颌切除术患者的治疗目标是克服上颌缺损引起的口腔主要功能恶化和语言、咀嚼、吞咽功能障碍。从修复体的角度来看，为了达到这些目标，上颌修复体应该充分彻底地封闭上颌缺损区域。为了评价义齿的治疗效果，需要对义齿就位后上颌缺损的闭合程度和言语能力的改善程度进行定量评价。本研究探讨临床治疗室安装上颌假体后言语功能恢复程度的评估方法。测量：我使用全向和单向麦克风以及一个迷你光盘录音机进行了以下实验：1)我用两种类型的麦克风在消声室中对一个成年人读的一句日语“Sakura no hana ga sa…More kimashita（樱花盛开）”进行了数字录音。读者有一副完整的天然牙齿，他的发音没有任何异常（以下称为“正常人”）。2)我还对正常人和在临床室安装上颌义齿的患者朗读的同一句话进行了数字录音。3)在改变义齿板腭形后，对患者所说的同一句话进行进一步录音。4)然后，我让五名没有听力障碍的成年人听录音，分析了各种录音中语言的清晰度。此外，录音还在个人电脑上进行了分析。结果与讨论1)正常人(1)消声室：全向与单向记录波形无差异。(2)在门诊治疗室：两种类型的麦克风在治疗室录音中都能听到各种外来噪音。但是在对比两个读数后，我认为单向麦克风拾取的噪音更少，所以我认为它更适合在治疗室录音。2)患者安装上颌假体(1)录音语音清晰度良好。这可能是因为假牙在口腔和鼻腔之间形成了良好的密封。3)假牙板的腭形似乎可以很好地封闭口腔两侧，这说明说话清晰。当我做了一个假牙可以改变假牙的腭形病人就死了。因此，我不得不提前退出这个实验。少

Purpose : The goals of treatment to patient having maxillary resection is to overcome deterioration of the oral major functions and disorders in the speech function, the masticatory function and the swallowing function due to their maxillary defect.To achieve these goals from a prosthetic point of view, sufficiently thorough seal of maxillary defect area should be accomplished with a maxillary prosthesis. In order to evaluate the treatment effects of the denture, quantitative evaluation is required of the degree of maxillary defect closure and of the improved speech capabilities after the denture is in place. This study examined the method to evaluate the degree of recovery of speech function for installing a maxillary prosthesis in clinic treatment room.Measurements : Using both omni-directional and uni-directional microphones and an MDrecorder (Mini Disc recorder), I conducted the following experiment :1) I made digital recordings of a short sentence in Japanese "Sakura no hana ga sa … More kimashita (The cherry blossoms were in full bloom)" read by an adult in an anechoic chamber using both types of microphones. The reader had a full set of his natural teeth and did not have any abnormalities in his pronunciation (hereafter refereed to as the "normal person").2) I also made digital recordings of the same sentence read by normal persons and patients installing a maxillary prosthesis in clinical room.3) I made further recordings of the same sentence spoken by the patient after changing the palatal shape of denture plate.4) I then analyzed the clarity of speech in the various recordings by having five adults who did not have any hearing impairment listen to the recordings. In addition to, the recordings were analyzed on a personal computer.Results and Discussion1) Normal person(1) In the anechoic chamber : No difference was seen in the waveforms of the omni-directional and unidirectional recordings.(2) In the clinic treatment room : Various extraneous noises were heard in the treatment room recordings using both types of microphones. However, after comparing the two readings, the uni-directional microphone was judged to pick up less noise, so I decided that it was more suitable for recording voices in the treatment room.2) Patient installing a maxillary prosthesis(1) The speech clarity in the recordings was fine. This may be because a good seal was made between the oral and nose cavities by the denture.3) The palatal shape of the denture plate seemed to seal the oral cavity well on both sides, which accounts for the clarity of speech. When I produced a denture which could change the palatal shape of the denture the patient died. Therefore I had to quit this experiment prematurely. Less