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

目的：上颌骨切除患者的治疗目标是克服因上颌骨缺陷引起的口腔主要功能的恶化和言语功能、咀嚼功能和吞咽功能的障碍，从修复体的角度来看，要达到这些目的，必须用上颌骨假体完成对上颌骨缺损区的足够彻底的封闭。为了评价义齿的治疗效果，需要对义齿就位后上颌骨缺损的闭合程度和语言能力的改善程度进行定量评估。本研究探讨了临床治疗室安装上颌骨假体后语音功能恢复程度的评价方法。测量：使用全方位麦克风和单向麦克风以及MDRecorder(迷你光盘录音机)进行了以下实验：1)用两种麦克风在暗室里对一名成年人在暗室中朗读的一句日语短句《Sakura no Hana ga sa…More kimashita(樱花盛开)》进行了数字录音。这位读者有一套完整的天然牙齿，发音没有任何异常(以下称为“正常人”)。2)我还将正常人和在诊室安装上颌假体的患者读到的同一句话进行了数字录音。3)改变义齿托板的腭部形状后，我又对患者说的同一句话进行了进一步录音。4)然后，我分析了各种录音中的语言清晰度，让五名没有听力障碍的成年人听录音。结果与讨论1)正常人(1)在电波暗室中：全向和单向录音波形无差异。(2)在临床治疗室：两种麦克风在治疗室录音中均可听到各种外来噪音。然而，在比较了两个读数后，我判断单向麦克风接收的噪音更小，因此我决定它更适合在治疗室录音。2)安装上颌假体的患者(1)录音中的语音清晰度很好。这可能是因为义齿在口腔和鼻腔之间形成了良好的密封。3)义齿托板的腭部形状似乎很好地密封了两侧的口腔，这就解释了说话的清晰度。当我拿出一种假牙，可以改变假牙的腭部形状时，病人去世了。因此，我不得不提前退出这项实验。较少

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