著者

児嶋 剛 庄司 和彦 一色 信彦 中村 一博

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.101, no.1, pp.39-43, 2008-01-01 (Released:2011-10-07)

参考文献数

21

被引用文献数

1 6

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We report a case of GID (gender identity disorder) of the female-to-male type, where her vocal pitch was lowered to her satisfaction by Thyroplasty type 3. The distress of GID patients derives from the contradiction between their sexual physical features and gender self-consciousness. As to the levels of distress and the means patients select to resolve the problems they face, individual variations are great. The present patient did not want either transsexual surgery or hormonal treatment, but merely her vocal pitch lowered. Thyroplasty type 3 successfully lowered her vocal pitch as desired without any complication. Surgical details and key points were described.

著者

讃岐 徹治 一色 信彦 中村 一博 湯本 英二

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.19, no.2, pp.54-58, 2007

被引用文献数

1

---

Thyroplasty was performed under local anesthesia on male-to-female transsexuals (MTF/GID) as well as patients with adductor spasmodic dysphonia (AdSD).<BR>There were 31 patients with MTF/GID who underwent type 4 thyroplasty during the period from 1999 to 2006. Voice fundamental frequency (F<SUB>0</SUB>) rose in all patients. Mean preoperative F<SUB>0</SUB> was 135Hz, and postoperatively the mean value was 236Hz. Type 4 thyroplasty requires specialized skill, and was found to be effective for pitch elevation surgery in MTF/GID. <BR>Forty-one patients with AdSD underwent type 2 thyroplasty with Titanium Bridge between December 2002 and December 2005. These patients were followed up 1 year postoperatively with a questionnaire. 70% of the patients judged their voice as "excellent, " and the remaining patients as improved to "good" or "fair". Type 2 thyroplasty is a highly effective therapy for AdSD.

著者

一色 信彦

出版者

The Japan Society of Logopedics and Phoniatrics

雑誌

音声言語医学 (ISSN:00302813)

巻号頁・発行日

vol.44, no.2, pp.153-158, 2003-04-20 (Released:2010-06-22)

参考文献数

22

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One-hour discussion after the lecture was focussed on rather basic voice problems, a little apart from the clinical problems the author emphasized. They include 3 main topics.1. The function of the vocal muscleAccording to recent reports, replacement of the vocal muscle with fat tissue, which was performed for spasmodic dysphonia, demonstrated that a fairly good voice could be obtained. Taking into account the clinical facts together with numerous experimental findings, the discussion tended to be settled at “the vocal muscle may not be essential for phonation but it is probably so for the control of voicing”.2. Model for phonationVarious models for phonation were discussed, including the Schoenhaerl, Hirano, Ishizaka, and Titze. The Hirano's “body and cover” model is essentially the same as the Schoenhaerl's concept emphasizing the mobility of the mucosa, the author thought. Since it is impossible to define the “body” discretely, whether it means the vocal muscle only or not, it may be misleading sometimes. In Titze's model, the figures for the body in terms of mass, location, and stiffness, is very difficult to assign on the anatomical basis. The only possible means to judge whether the model and hypothetical figures are correct or not would be to examine whether the model output curve matches well with the real vocal output under various physiological conditions.3. DiplophoniaThis terminology is sometimes confusing. The voice of vocal fold paralysis is often referred to as diplophonia. But it should be realized that the two different musical tones are not being produced. It is a kind of irregular tone, or hoarseness. The two vocal folds with different tension do not produce twopitched tone. One vibrating vocal fold perse cannot be a source of sound in a practical sense. Possibility of producing a sound such as confusing with glottal sound in the articulatory organ was discussed.

著者

佐藤 公則 松島 康二 一色 信彦 田辺 正博 渡邊 雄介 枝松 秀雄

出版者

THE JAPAN LARYNGOLOGICAL ASSOCIATION

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.26, no.1, pp.1-5, 2014-06-01 (Released:2014-12-17)

参考文献数

11

被引用文献数

1 2

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When Type II thyroplasty is performed, surgical management of the dihedral angle of the midline of the thyroid cartilage is very important. Clinical histoanatomy around the anterior commissure was investigated using whole organ serial sections of the human larynx to make Type II thyroplasty successful. An inner perichondrium did not exist at the dihedral angle in the upper three-forths of the midline of the thyroid cartilage. On the other hand, the inner perichondrium was present at the lower one-forth of the midline of the posterior surface of the thyroid cartilage. The attachment of the collagenous fiber (anterior commissure tendon, Broyles, 1943) extends from the upper portion of the thyroid notch caudalward for approximately upper three-forths of the midline of posterior surface of the thyroid cartilage. The midline of the posterior surface of the thyroid cartilage is only covered with thin mucosa at the laryngeal ventricle level. It is important not to perforate the mucosa when the laryngofissure is performed. In order to make the anterior commissure the proper width, it is important to split the anterior commissure tendon at the mid-line and to spread the glottis while making sure the tendons remain attached to the bilateral thyroid cartilage.

著者

井野 千代徳 一色 信彦 松島 康二 多田 直樹 井野 素子 溝口 兼司 田邉 正博

出版者

耳鼻と臨床会

雑誌

耳鼻と臨床 (ISSN:04477227)

巻号頁・発行日

vol.59, no.4, pp.147-161, 2013-07-20 (Released:2014-08-01)

参考文献数

14

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痙攣性発声障害(SD)は心因性疾患ではなく局所性ジストニアとされているが、多数例を診る中で SD 患者にも陰性の感情を認めることも少なくない。そこで、62 例の SD 患者を対象にしてその特徴を調べる目的で問診、心理検査そしてアンケートなどを行い、その結果を心因性疾患とされるほかの耳鼻咽喉科疾患と比較を行うことで検討した。SD 患者は 30 歳未満の症例が多数を占め、病悩期間が 2 年以上の症例が多かったことが咽喉頭異常感症と舌痛症と大いに異なっていた。CMI (Cornell Medical Index) で神経症傾向以上を示した症例は 12.9%とほかの心因性疾患とされるそれら疾患に比して著しく低かった。 しかし、その内容の検討より SD 患者は「易怒性」と判定される例が上記疾患に比して高かった。SD 患者の多くはその発症時、声をよく使う環境下にあり原因のいかにかかわらず声の詰まりを経験し悩んでしまう不安障害 (SAD) のごとく神経症的に不安・怯えでは無く、ある種のいら立ちをもって悩んでしまう。SD 患者の多くは電話を苦痛にとらえているが、特に騒音下での電話に苦痛を覚えることを特徴とする。大きな声を出そうとすることが原因ととらえているが、コミュニケーションスタイルのゆがみも疑われる。SD は「性格」、「環境」そして「予期不安・身構え」、「長い病悩期間」があり発症し、「予期不安・身構え」より生じる「声門下圧の上昇」とそれによって生じる「声帯の締まりの増強」によって生じる二次的な回路で強化される。治療はこの二次的に生じた回路の解消であるが容易ではなく、治療法としては一色の甲状軟骨形成術 (Ⅱ型) が最良と論じた。

著者

国吉 京子 井上 幸 中島 誠 川野 通夫 澤田 正樹 一色 信彦

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.82, no.11, pp.1587-1592, 1989-11-01 (Released:2011-11-04)

参考文献数

20

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In order to study the development of speech in infants with cleft palate, we investigated the development of consonant articulation in two cases (A, B) with cleft soft palate and in two cases (C, D) with cleft lip and palate before and after palatoplasty. We taperecorded their consonants in meaningful speech sounds and transcribed them.We made the following observations: (1) The frequency of consonants in meaningful speech sounds did not vary with the type of cleft or the timing of palatoplasty, and increased radically in the latter half of the second year and the first half of the third year. (2) Glottal stops occurred in the pre-palatoplasty periods but had almost disappeared three to ten months after palatoplasty in cases A, B, and C, whose velopharyngeal function was competent. (3) The speech sounds of these three cases were judged to be intelligible when the numbers of glottal stops decreased, the numbers of voiceless stops accounted for over 50% of all stops, and bilabial voiceless stops [p] appeared.

著者

田辺 正博 一色 信彦 北嶋 和智

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.71, no.8, pp.1141-1148, 1978-08-01 (Released:2011-11-04)

参考文献数

9

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A reflectionless tube described by Sondhi is utilized to obtain the glottal waveform.The rationale of this method is that the effect of vocal-tract resonances on glottal waveform is considerably reduced by phonating into a reflectionless uniform tube.Measurement of the transmission characteristic (frequency response) of the tube proved minimal attenuation caused by the tube.The obtained glottal waveform in four normal subjects and in nine patients with laryngeal pathologies are reported herein and methods presently available for estimating the glottal waveform are also discussed. The glottal waveform with reflectionless tube proved to be simpler and more practical for clinical use.

著者

松島 康二 金沢 英哲 一色 信彦 田辺 正博 枝松 秀雄

出版者

THE JAPAN LARYNGOLOGICAL ASSOCIATION

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.23, no.1, pp.26-29, 2011-06-01 (Released:2011-09-01)

参考文献数

12

被引用文献数

3 2

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The Type 1 Thyroplasty or Medialization Thyroplasty was first reported in the 1970s by Isshiki et al for treating voice disorders resulting from vocal fold paralysis or atrophy. Since then, this therapeutic modality has gained world-wide popularity, and a number of modified methods were also reported with generally satisfactory results.Silicone block fabricated in situ had long been utilized to fix the window cartilage without any significant complication, however, containment failures from silicone bag breast implants and their resultant negative side-effect led to difficulties in obtaining silicone for any surgical treatment whatsoever. Gradually, Gore-tex, as used for correcting vascular problems, had replaced silicone, because of its ease in handling and of its excellent biocompatibility. However, it did not guarantee precision in the adjustment of medialization, especially when the window-cartilage was removed and/or when the Gore-tex sheet was packed in a wrong direction. In this respect, Titanium, well known for its excellent biocompatibility, seems better suited for precision and long-lasting effectiveness. Friedrich had already reported excellent results. Based on our abundant experience with Titanium Bridges in type 2 thyroplasty for spasmodic dysphonia, we utilized a simple thin and bendable Titanium plate so as to realize adequate medialization on site.

著者

本庄 巌 一色 信彦

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.63, no.12, pp.1119-1121, 1970-12-01 (Released:2011-10-14)

参考文献数

2

著者

大川 正直 一色 信彦

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.93, no.10, pp.867-878, 2000-10-01 (Released:2011-11-04)

参考文献数

24

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The glottal flow efficiency (GFE), defined as alternating current component/direct current component of glottal air flow, or AC/DC by Isshiki, and the glottal power efficiency (GPE), defined as acoutic glottal power/aerodynamic glottal power by van den Berg were studied to compare the flow rate, vocal intensity, subglottal pressure, and glottal area.The GFE was found to be a good indicator of the glottal area and vocal fold stiffness, while the GPE was not a good indicator because the noise produced at the glottic also contained acoustic energy.The drawback of the GFE was its inability to correctly reflect the glottal condition, when the air flow provided for phonation was at an unusually low rate or the vocal intensity was at an extremely low level.The critical GFE value indicating a complete glottal closure was estimated at around 50.

著者

一色 信彦 山本 ゆき子 前田 秀夫

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.92, no.1, pp.81-87, 1999-01-01 (Released:2011-11-04)

参考文献数

16

被引用文献数

1 4

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A 40 year-old woman with adductor spasmodic dysphonia was successfully treated with type 2 thyroplasty, that aimed at lateralization of the vocal folds. Her voice had been characteristic of spasmodic dysphonia; strained, constricted and requiring effort. She had not responded to voice therapy.Under local anesthesia, the thyroid cartilage was incised at the midline and the incised edges were pulled apart to lateralize the vocal folds. A perforation was created at the anterior commissure to enhance the lateralization. The hole was closed with a free composite graft, and the incised thyroid alae were kept 4mm apart with silicone shims. A part of the sternohyoid muscle was shifted medially to cover the free graft for better survival and to block the space between the graft and the silicone shim to prevent infection.The postoperative course was uneventful, and the voice has been restored to normal, without any sign of recurrence as of 1 year postoperatively.The advantages of the technique include: 1. node privation of the physiological functions; 2. less likelihood of recurrence because no nerve regrowth is involved; and 3. revisionis simple in the unlikely event of recurrence (the silicone shimis replaced with a wider one).

著者

一色 信彦

出版者

日本音声言語医学会

雑誌

音声言語医学 (ISSN:00302813)

巻号頁・発行日

vol.7, no.1, pp.15-21, 1966-05-01 (Released:2010-06-22)

参考文献数

12

被引用文献数

9 6

著者

中村 一博 一色 信彦 讃岐 徹治 三上 慎司

出版者

The Japan Broncho-esophagological Society

雑誌

日本気管食道科学会会報 (ISSN:00290645)

巻号頁・発行日

vol.58, no.3, pp.310-319, 2007-06-10

被引用文献数

10 15

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Gender Identity Disorder (GID)は性同一性障害といわれ,生物学的性別と心理社会的性別が解離している病態である。<br>今回われわれはmale to femaleのGID (MTF/GID)症例に対し,話声位(SFF)の基本周波数を上昇させる目的でPitch Elevation Surgeryを施行した。その成績について報告する。<br>症例は1999~2006年に当院を受診し手術を施行したMTF/GIDの32例である。32例に対し甲状軟骨形成術4型(4型)を施行した。そのうち24例には喉頭隆起切除術を併せて施行した。<br>32例全例のSFFは上昇した。術前の平均SFFの基本周波数は133.8 Hz,術後は平均237.8 Hzであった。局所麻酔にて手術を施行しているため,全例ともに術中に患者の納得のいく基本周波数に調節することができ満足が得られた。<br>4型はMTF/GID症例におけるPitch Elevation Surgeryとして有用であると思われた。

著者

讃岐 徹治 一色 信彦

出版者

耳鼻と臨床会

雑誌

耳鼻と臨床 (ISSN:04477227)

巻号頁・発行日

vol.51, no.5, pp.381-386, 2005-09-20 (Released:2013-05-10)

参考文献数

7

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痙攣性発声障害は、まれな疾患で病態も全く不明といってよく、有効な治療もないと考えられてきた。現在、神経筋接合部に作用するボツリヌストキシンが痙攣性発声障害に応用され、外来で治療でき恒久的な障害も残さない利点があることから、世界的に普及している。しかし有効期間が3-6カ月であり再注射が必要という問題点もある。われわれは、内転型痙攣性発声障害患者に対して声門過閉鎖の防止を目的に喉頭枠組みを開大し、持続的で再発の可能性が少ない甲状軟骨形成術2型を1997年6月から行い、極めて良好な結果を得ている。そこで2004年10月までに得られた手術実績 (64症例、66件) をもとにそれらの症例をまとめ、その手術適応と手術のコツを中心に述べた。本手術の術式は決して難しくはないが、甲状軟骨の切開、剥離さらに開大幅の調節を慎重に正確に行うことが、手術成功に必要な条件であると考えられた。

著者

讃岐 徹治 一色 信彦 中村 一博 湯本 英二

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.19, no.2, pp.54-58, 2007-12-01 (Released:2012-09-24)

参考文献数

20

被引用文献数

1 1

---

Thyroplasty was performed under local anesthesia on male-to-female transsexuals (MTF/GID) as well as patients with adductor spasmodic dysphonia (AdSD).There were 31 patients with MTF/GID who underwent type 4 thyroplasty during the period from 1999 to 2006. Voice fundamental frequency (F0) rose in all patients. Mean preoperative F0 was 135Hz, and postoperatively the mean value was 236Hz. Type 4 thyroplasty requires specialized skill, and was found to be effective for pitch elevation surgery in MTF/GID. Forty-one patients with AdSD underwent type 2 thyroplasty with Titanium Bridge between December 2002 and December 2005. These patients were followed up 1 year postoperatively with a questionnaire. 70% of the patients judged their voice as “excellent, ” and the remaining patients as improved to “good” or “fair”. Type 2 thyroplasty is a highly effective therapy for AdSD.