Pathophysiological Study on Phonatory Function after Phonosurgery

在这个项目中，高速数字成像系统已经开发出来，可以用来评估患者的声带功能。对部分喉切除术患者的声源进行了研究，发现会厌襞可以通过振动产生声音。这一发现为提高术后患者的语音质量提供了新的思路。利用高速数字成像系统，明确了嗓音障碍的一些病因。特别是，发声开始的方式不仅在发声开始时有影响，而且在接下来的静止发声时也有影响。这就意味着，声音的攻击应该是声音卫生最重要的因素之一。这也为制定声部手术后的临床康复方案提供了新的知识。近年来，功能性语音障碍患者的数量有增加的趋势，尤其是在专业语音使用者中。痉挛性发声障碍是一种较难治疗的功能性发声障碍。我们一直在用肉毒杆菌毒素。治疗前后分别评价声带振动、心理声学印象及声学参数。神经学背景是一种强烈的病因。对声部手术后的吞咽功能也进行了评估。很明显，发音功能和吞咽功能是一起改善的。从教育和医学的角度来看，儿童的声音和语言障碍都很重要。我们已经开始了一项试点研究，以找出儿童语音和语言障碍的评估系统。

In this project, the high speed digital imaging system has been developed and can be used to evaluate the vocal folds function of the patient. The sound source of the partial laryngectomized patient was investigated to find that the ary-epiglottic fold can vibrate to generate the voice. This finding gives us a new idea to improve the voice quality to the post operative patient.By using the high speed digital imaging system, some causative factors of the voice disorders have been clarified. Especially, the mode of the onset of the phonation has an effect not only at the beginning of the phonation but at the following stationary phonation. It means that the voice attack should be one of the most important factor for the vocal hyginene. This also provides the new knowledge to make a clinical program of the rehabilitation after phonosurgery.Recently, the number of the patients with functional dysphonia tends to be increasing especially, among the professional voice users. Spasmodic dysphonia is one of the functional dysphonia which is difficult to treat. We have been using the botulinum toxin. Vocal fold vibration, psychoacoustic impression and acoustic parameters were evaluated pre and post treatment. The neurological back ground as an etiologic factor was strongly suggested.Swallowing function after phonosurgery was also evaluated. It becomes clear that the phonatory function and the swallowing function improves together.Voice and speech disorders in the children are important from educational point of view as well as medical point of view. We have started a pilot study to find out the evaluation system for the voice and speech disorders in children.