著者

小島 美子

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.9, no.2, pp.91-95, 1997-12-01 (Released:2012-09-24)

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When we speak of traditional Japanese music, we are refering to a variety of music ···from artistic music to folkloric music. Despite the variety, there are certain characteristics running through them in terms of the Japanese sensibility toward music. It is this musical sense of the Japanese that will provide an important base for the new Japanese music to develop in the future.A sense of rhythm is determined over a long period of certain group's history by the way how they have used their physical body. A majority of the Japanese, for instance, have a “static” sense of rhythm characteristic of the rice paddy farmers. People in the mountains, on the other hand, use their limbs in a flexible way, resulting in a “supple” sense of rhythm. People who live on the islands of Okinawa and Amami, as well as people who live on coastal areas, have a “swinging” sense of rhythm in correspondence to the undulation of ocean waves.A sense of timber is determined over a long period of time by the kind of life style and natural environment people live in. People in Japan have lived mainly by farming and fishing in a climate where the four seasons are distinct. Consequently they developed sharp sensitivity toward changes in weather, making them alert to natural sounds such as a rain and a wind. It is for this reason that the Japanese favor songs and instruments that sound close to natural sounds.Japanese melodies and based on six pentatonic scales. Each consists of two sets of the perfect fourth called the tetrachord. These scales have much in common with the music of Asia and Africa.The Japanese subconsciously feel, though vaguely, the presence of a god or spirit in every object. Such a tendency, or a habit of the mind, is also revealed in music and songs. This attitude, which may correspond to the idea of symbiotism, is demonstrated in the Japanese way of thinking that songs too possess spiritual power.

著者

佐藤 公則

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.30, no.2, pp.57-65, 2018-12-01 (Released:2019-06-17)

参考文献数

29

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1. Phonosurgery is performed on the human larynx to treat phonatory dysfunction and improve the quality of voice. 2 . There are two major categories of phonosurgery. One surgical option is open-neck laryngeal surgery, which is performed via an extralaryngeal approach. The other is endolaryngeal microsurgery and endoscopic surgery, which are performed via an intralaryngeal approach. 3. When performing phonosurgery via an extralaryngeal approach, it is very important to be able to visualize the internal laryngeal structures by looking at the laryngeal cartilage. Furthermore, when performing phonosurgery via an intralaryngeal approach, it is important to be able to visualize the internal laryngeal structures, including histoanatomy, by observing the mucosa of the lumen. An understanding of the histologic structures of the vocal fold is also essential when performing phonosurgery. 4. Knowledge of the three-dimensional structure, histology and histopathology of the larynx is indispensable when performing phonosurgery.

著者

石田 愛 永井 世里 小山 新一郎 江崎 伸一 濱島 有喜 村上 信五

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.29, no.1, pp.14-16, 2017-06-01 (Released:2017-10-27)

参考文献数

10

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Vocal cord paralysis often occurs due to unknown reasons. Since bilateral paralysis can cause dyspnea,we have to carefully watch the state of the patient while investigating the causes of paralysis. We herein report a case of bilateral vocal cord paralysis in a patient who was a vegetarian. The patient’ paralysis was improved by the administration of mecobalamin.

著者

川副 みちる 前山 忠嗣 和田 繁 進 武幹

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.1, no.2, pp.93-95, 1989-12-01 (Released:2012-09-24)

参考文献数

7

被引用文献数

1 1

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Noradrenergic nerve fibers contribute to the sympathetic control of blood flow and glandsecretion. Distribution of noradrenergic nerve fibers in and around canine vocal folds was investigated by means of the fluorescence method. In addition, the spatial relationship of noradrenergic nerve fibers to the blood vessels and glands was determined with the use of the peroxidase anti-peroxidase method. Noradrenergic nerve fibers were found around arteries and arterioles whose diameter was 15μm or greater. No noradrenergic fibers, however, were observed around capillaries and veins. In the laryngeal glands, noradrenergic nerve fibers were observed adjacent to the arteries which entered the glands and near the basement membrane of acinous cells. The results suggest that noradrenergic nerve fibers regulate the blood flow in the arteries and arterioles and gland secretion in the larynx.

著者

小山 新一郎 川北 大介 近藤 雅幸 吉岡 正展 村上 信五 吉田 梨帆

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.18, no.2, pp.146-148, 2006-12-01 (Released:2012-09-24)

参考文献数

5

被引用文献数

1

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We reported on a rare case of morning glory seeds as bronchial foreign bodies. The patient was a five-month-old male infant. He accidentally inhaled morning glory seeds after placing them in his mouth and coughing. The consulting doctor diagnosed that he had caught a cold after examining a chest x-ray image and observing normal sounding respiration. Three days later, his body temperature was 40 degrees and his cough was persisting. Medical consultation was sought again. His chest x-ray revealed that the mediastinum had moved to the right side and the left pulmonary field had inflated abnormally. CT imaging clearly indicated foreign bodies in the left bronchus. We performed a ventilation bronchoscopy. His left bronchus was obstructed by morning glory sprouts. After we removed the sprouts, the child's respiratory sound and chest x-ray results improved. We determined that the morning glory seeds had germinated in the warm and wet bronchus and the enlarged seeds had obstructed his left bronchus.

著者

菊池 淳

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.17, no.1, pp.1-6, 2005-06-01 (Released:2012-09-24)

参考文献数

12

被引用文献数

1 1

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For the purpose of studying the clinical characteristics of vocal fold bowing, the correlation between the quantitative analysis and vocal function tests was investigated in 287 patients with unilateral recurrent laryngeal nerve paralysis. Parameters for the quantitative analysis included patient's age, sex, period of unilateral recurrent laryngeal nerve paralysis, fixed position of the vocal fold, cause of paralysis, and degree of aspiration. For vocal function tests, phonatory parameters (MPT, MFRc, SPLrange, FOrange) and acoustic parameters (PPQ, APQ) were analyzed. The following results were obtained : 1) The vocal fold bowing ranged from 5% to 15% in most (236 of 286) cases with the average being 11.5%. 2) The degree of vocal fold bowing increased from the age group of forty or older. 3) The degree of vocal fold bowing showed a tendency to decrease from 270 days after the onset of recurrent laryngeal nerve paralysis. 4) In the vocal function tests, FOrange, PPQ, APQ showed a relationship to the degree of vocal fold bowing.

著者

鹿野 真人 高取 隆 小針 健大 佐藤 廣仁 木田 雅彦

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.28, no.1, pp.16-23, 2016-06-01 (Released:2016-10-28)

参考文献数

24

被引用文献数

12 13

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In 2007, we reported a newly-developed surgical airway-opening technique(cricoid fenestration)using a partial resection of the cricoid cartilage to form a stoma. From 2006 to 2014, a total of 57 cricoid fenestration procedures were performed at our hospital. The reasons for surgery included cervical disturbances such as low-set larynx, obesity, short neck, thyroid tumor, cervical abscess, and tortuous brachiocephalic and common carotid artery. Surgeries were also performed in high-risk patients who required long-term airway management, hemostasis, and urgent airway establishment. In this study, only one patient developed subcutaneous emphysema as an intra- or postoperative complication.Cricoid fenestration enables us to easily create a stoma at a higher level of the cricoid cartilage without transecting the thyroid gland. In addition, this technique can quickly establish a controlled airway with a low risk of intraoperative bleeding. Finally, long-term airway management can be performed easily using this technique without tube-related complications including scarring or stenosis, despite the resection of the cricoid cartilage. Cricoid fenestration is therefore considered to be a safe and effective surgical airway-opening technique.

著者

室野 重之

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.33, no.02, pp.86-88, 2021-12-01 (Released:2022-03-25)

参考文献数

15

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Although laryngo-tracheal papilloma, also known as recurrent respiratory papillomatosis, is a benign disease, it tends to recur and spread throughout the larynx and trachea. The incidence rate in Western countries has been reported to be less than 1 per 100,000 for both juvenile-onset and adult-onset types. Surgical approaches to managing this disease have varied over time. For example, a carbon dioxide laser was the most popular modality in the 1990s in the United States, whereas a microdebrider has been widely used since the 2000s in both the United States and Europe. Our previous survey revealed that a carbon dioxide laser, microdebrider, and cold steel surgery were used with almost equal frequency in Japan. We are currently conducting a nationwide survey that will help clarify the epidemiology of this morbid disease in Japan. The disease is caused by human papillomavirus (HPV), especially the low-risk types of HPV6 and HPV11. Therefore, the 4- and 9-valent HPV vaccine may reduce the incidence of this disease, as observed in anogenital warts.

著者

田口 亜紀 有友 宏

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.32, no.01, pp.37-42, 2020-06-01 (Released:2020-09-04)

参考文献数

9

被引用文献数

1 1

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We successfully developed the Taguchi method as the short version of Vocal Function Exercise (VFE). The Taguchi method involves only the following training contents included in VFE: Extension of phonation time, and phonation exercise with a certain voice pitch. We applied this method to a series of voice disorder cases. Patients treated with the short version of VFE were typically in their 60s and 70s, often with vocal cord atrophy and sulcus. The number of training sessions and the training period duration were ≤6 times and ≤3 months, respectively, so treatment was completed in a shorter period of time than with the original VFE method. We also noted an improvement in the auditory impression, maximum phonation time, and Voice Handicap Index (VHI) in most cases with the short version of VFE compared to before therapy. The short version of VFE can be accomplished with a simple procedure and is expected to shorten the treatment period.

著者

宮本 真 宮田 恵里 岩井 大 友田 幸一

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.29, no.2, pp.90-93, 2017-12-01 (Released:2018-06-08)

参考文献数

17

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The vagus nerve is one of the 12 cranial nerves, which is considered as the 10th nerve. The vagus nerve extended from the medulla oblongata to the second segment of the transverse colon. This nerve innervates the majority of the muscle of the pharynx, soft palate and larynx. In cases of vagus nerve paralysis, palatal arch movement is restricted. The arches cannot move up and back in order to close off the nasopharynx. This causes hoarseness, nasal speech, aspiration and regurgitation of liquid through the nose. In this article, we report 10 cases of the vagus nerve paralysis. The patient’ mean age is 59.4 (range 34-83). There were 5 male and 5 female patients, among which there were 6 cases of right and 4 cases of left side paralysis. In six cases the chief complaint was vocal disorders. The causes included 5 cases of Varicella-Zoster virus infection (all confirmed) and 4 cases of central paralysis. In 9 cases of the 10 patients, nasopharyngeal incompetence, elevation or constriction of the paralyzed side and saliva pooling in the pyriform sinus were observed. In 4 cases of the 10 cases, the vagus nerve paralysis improved after treatment within 6 months. In cases of vagus nerve paralysis immediate and accurate diagnosis and treatment are crucial. It is important to observe the palatal arches as they contract and the soft palatal as it swings up and back in order to close off the nasopharynx.

著者

松永 敦

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.20, no.2, pp.104-106, 2008-12-01 (Released:2012-09-24)

参考文献数

3

著者

岩橋 利彦

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.28, no.2, pp.53, 2016-12-01 (Released:2017-06-13)

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【目的】大声発声および頻回の咳払いは声の衛生における問題行動とされている.その理由として,大声発声や咳払い時の声帯間の強い衝突が喉頭組織へ障害を与えることが考えられている.しかしながら,通常のビデオ画像(30frame/秒)では,急速な声帯の内転を断続的にしか捉えることができないため,実際にその衝突の速さを実測することは困難であった.今回我々は,高速度撮影装置を用いて,声の衛生上の問題行動である咳払いおよび大声発声に加えて,音声訓練に用いられるハミング発声時における声帯間角度・角速度の変化を連続的に解析し,通常発声時の変化と比較検討した.【対象と方法】健常成人20例を対象として,高速度撮影装置を接続した喉頭ファイバースコープを挿入した状態で,強弱の咳払い,持続母音/e:/の通常発声・大声発声およびハミング発声の5 つのタスクを指示し,喉頭の高速度動画(4000frame/秒)を記録した.動画解析ソフトDipp-Motion Proを用いて,高速度動画において前交連および左右の声帯突起上の計3点の定点を自動追尾させ,声帯内転時の声帯間角度・角速度の連続的変化を解析した.その後,声帯運動範囲の100–80%,80–20%,20–0%の各区間における平均角速度を算出した. 【結果】咳払いおよび大声発声時には声帯間角度の変化は多次関数曲線を描き,角速度の変化は加速し続けたが,通常発声およびハミング時には角度の変化はS字曲線を描き,角速度の変化は一旦加速した後に減速した.強い咳払いにおける平均角速度は通常発声と比較して全区間で有意に大きく,特に20–0%区間の平均角速度は2倍以上となった.ハミングにおける平均角速度は通常発声と比較して全区間で有意に小さく,特に20–0%区間の平均角速度は1/2以下であった. 【結論】高速度撮影装置の使用により声帯の内転角速度の連続的解析が可能となった.咳払い・大声発声における声帯内転速度は通常発声より速く,ハミングでは遅くなることが証明された.

著者

杉山 庸一郎

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.33, no.01, pp.16-20, 2021-06-01 (Released:2021-09-17)

参考文献数

22

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Bilateral vocal fold immobility influences not only vocal function but also the airway tract, possibly resulting in dyspnea. Pathophysiological diagnosis using electromyography of laryngeal muscles is also critical for patients with bilateral vocal fold immobility to optimize the surgical procedures. Vocal fold lateralization, transverse cordotomy, and arytenoidectomy can be utilized for bilateral vocal fold paralysis and posterior glottic stenosis depending on the severity of stenosis and mobility of cricoarytenoid joints. A unilateral approach should be recommended for the initial surgery to reduce the risks of aspiration and hoarseness. Laryngofissure with cartilage grafting and T-tube stenting may be performed for severe posterior glottic stenosis, often coinciding with subglottic stenosis. Laryngeal stenosis due to the bilateral vocal fold immobility should be carefully evaluated and treated with appropriate surgical technique, thereby keeping adequate airway space with preventing severe postoperative swallowing and phonatory dysfunction.

著者

土師 知行 寺田 香菜子

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.32, no.02, pp.195-206, 2020-12-01 (Released:2021-05-11)

参考文献数

19

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The validity of the application of the Cepstral/Spectral Index of Dysphonia (CSID) to Japanese dysphonic speech was examined by analyzing normal and breathy voice samples both produced by healthy Japanese volunteers with no vocal problems. Four Japanese sentences which had phonological similarities to the English test sentences were prepared for the application of the CSID. The voice samples included sustained vowel /a/ and the four sentences.The CSID was applied for analyzing both the sustained vowel and the four sentences. Established indices based on pitch synchronous analyses, such as period perturbation quotient (PPQ), amplitude perturbation quotient (APQ) and noise to harmonic ratio (NHR) were applied to the samples of the sustained vowel.For the grade of the hoarseness and the breathiness, auditory perceptual evaluations of Japanese speech sentences and the sustained vowel were performed using a visual analog scale (VAS). GRBAS scale was used for evaluations of the sustained vowel only.Strong statistical relationships were found between the CSID and the three indices with pitch synchronous analyses. Furthermore, the CSID had strong statistical relationships with the two auditory perceptual evaluations as well, which was equal to relationships between the auditory perceptual evaluations and the indices with pitch synchronous analyses. Given that the CSID can be used to analyze speech samples whereas the indices with pitch synchronous analysis have certain technical problems to analyze speech samples, this index is considered to be applicable as a useful measure for evaluating vocal dysfunction of Japanese speech and should be used actively in clinical settings.

著者

井口 郁雄

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.29, no.2, pp.30-36, 2017-12-02 (Released:2018-06-08)

参考文献数

10

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Regional branches of the Japan Medical Association take the initiative to establish the comprehensive system of care which provides medical and nursing care recently. Otolaryngologists are expected to join in this system to exercise their expertise because of the burgeoning of needs for evaluation and rehabilitation of deglutition disorders. Without the system, practicing otolaryngologists who are interested in the care of deglutition disorders may be faced with difficulties of medical collaboration. Also, if the collaboration itself requires considerable effort, some medical providers would avoid the clinical practice of dysphagia. It is therefore imperative to build an easy-to-join system for otolaryngologists to exert their expertise in the regional community. Division of Hiroshima Prefecture, The Oto-Rhino-Laryngological Society of Japan has set up the committee of home care in November 2015. We describe regarding the launch of the committee, activities such as “dysphagia case conference” for the members and actions against public administration and the Japan Medical Association in this article.

著者

塩谷 彰浩 大久保 啓介 福田 宏之 小川 郁

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.14, no.2, pp.69-73, 2002-12-01 (Released:2012-09-24)

参考文献数

16

被引用文献数

1 1

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Juvenile laryngeal papillomatosis develops between the ages of 6 months and 4-5 years and runs a multiple and recurrent clinical course. There were 61 patients with laryngeal papillomatosis treated at Keio university hospital during the 20-year period between May 1981 and May 2001, of whom 20 patients were under the age of 15 at onset. The average number of repeated operations they received was 18.1, showing the pronounced multiple, recurrent trend of this disease. Treatment is basically laryngomicrosurgery using a CO2 laser, and attempts should be made to conserve normal mucosa as much as is practicable as well as to improve phonation and respiratory function, in addition to targeting the total resection of the tumor. As the human papilloma virus, which is etiologically responsible for the formation of papillomas, grows in the mucosal epithelium, it is in principle, sufficient to vapolize the epithelial layer alone, avoiding a deeper intervention than is required. Tracheostomy should be avoided wherever feasible because it may cause tumor dissemination. Development of effective adjuvant therapy, besides surgery, is also generally anticipated. Efficacy of interferon-α in this disease has been demonstrated and indole 3 carbinol (I3C), a major component of cabbage, and the antiviral agent cidofovir are also currently used. Independently, we focused on Chinese medicines, prescribing this type of herbal medicines in anticipation of their effects for contraction of residual tumor and preventive effects against recurrence. It is worth noting that favorable results have been observed in 6 of the 10 patients receiving Chinese medicines whose therapeutic responses could be evaluated.

著者

海野 徳二 野中 聡

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.1, no.1, pp.26-30, 1989-06-01 (Released:2012-09-24)

参考文献数

12

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This paper describes an aerodynamic and electromyographic study of the sneeze. A sneeze is characterized by a deep inspiration followed by an abrupt expulsive expiration. The sneeze consists of three phases; inspiratory (preparatory), compressive (minimum flow) and expiratory. In the compressive phase the airway is temporarily obstructed while the intrathoracic pressure is elevated by contractions of the expiratory muscles. The study attempted to determine if the point of obstruction was at the level of the glottis similar to that observed in the cough. Aerodynamic studies using the body plethysmograph show that intrathoracic compression is greatest during the compressive phase, and that expiratory air, when present, is expelled only through the mouth. Electromyographic data show that the diaphragm (DIA) and posterior circoarytenoid (PCA) muscles are activated during the inspiratory phase and then the rectus abdominis (RA), thyroarytenoid (TA) and levator veli palatini (LP) muscles are activated during the compressive and expiratory phases. The interrelationship among these muscle groups appears to be extremely delicate as seen in the transition between the compressive and expiratory phase where an abrupt change in TA and PCA activity is observed while the RA and LP continue to be active. In cases where delayed activation of the PCA is observed the subglottic pressure created was not sufficiently high to perform an effective sneeze. From these aerodynamic and electromyographic data the authors conclude that in the sneeze the glottis is the occlusive point necessary for the elevation of the intrathoracic pressure.

著者

田口 亜紀 兵頭 政光 城本 修

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.20, no.2, pp.99-103, 2008-12-01 (Released:2012-09-24)

参考文献数

4

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It has become recently well known that voice therapy is an effective method to treat voice disorders conservatively. We introduced voice therapy for various kinds of voice disorders. 224 cases (73 males and 151 females) with voice disorders were treated at Ehime University Hospital 1998 and 2008. The wide range of maladies consisted of vocal nodules, laryngeal granulomas, sulcus vocalis and atrophies, vocal fold paralyses, and functional voice disorders. Methods of treatment included vocal hygiene education, laryngeal relaxation maneuvering, abdominal breathing, pitch adjustment, resonant voice therapy and the accent method. In performing a structured therapeutic program, the needs of each patient should be considered. Close cooperation between otolaryngologists and speech therapists is mandatory. Surgical management should be considered in cases where insufficient improvement has resulted from voice therapy.

著者

鹿野 真人 桑畑 直史 佐久間 仁 大谷 巌

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.11, no.2, pp.62-67, 1999-12-01 (Released:2012-09-24)

参考文献数

7

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A survey regarding post-laryngectomy olfaction was conducted on 17 patients. 12 patients expressed the ability to smell after laryngectomy. All of five patients who had esophageal voice and five of 10 patients who had electrolaryngeal voice stated that they could smell. The post-operative period before patients indicated that they could smell ranged from 0 to 5 years. These patients who claimed the ability to smell could not do so with complete function. 11 patients (65%) hoped to regain normal olfaction.In order to achieve this goal, we manufactured a tool to restore the capability of smelling. Utilization of this tool is projected to restore normal nasal airflow and to improve the olfactory threshold. This tool offers an invaluable improvement of the quality of life of patients that have undergone laryngectomy.

著者

本多 清志

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.8, no.2, pp.109-115, 1996-12-01 (Released:2012-09-24)

参考文献数

38

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Voluntary use of voice in human speech and song is supported by uniquely human mechanisms of peripheral apparatus and neural adaptation to their forms. This paper examines various mechanisms of voice fundamental frequency (F0) control by laryngeal muscles based on previous reports by the author and others. Besides the well-known function of the cricothyroid, other intrinsic muscles potentially contribute to voice control by their own unique manners. Extrinsic laryngeal muscles apply horizontal and vertical forces to the laryngeal framework to enhance F0 control. The horizontal component interacts with supra-laryngeal articulators and provides causal explanation of the intrinsic vowel F0. The vertical component produces a rotation of the cricoid cartilage by means of vertical laryngeal movement along the curvature of the carvical spine. Thus, F0 is tuned by overall force balance among a number of laryngeal muscles, and our capacity of its voluntary use reflects morphological characteristics of the human larynx.