声帯ポリープにおける二重声の臨床的並びに実験的研究

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概要

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• A considerable number of theories have accumulated on the mechanism causing diplophnia in recent years. The author made some clinical observations, With the following methods, on 48 patients with diplophonia accompanied by polyp of the vocal cords who visited the Oto-Rhino-Laryngologicat Clinic of University of Tokyo. 1) A stroboscopic observation of the vocal cords was made on each cases. 2) Vowels of the.patients were analysed by means of somagraph and oscillograph before and after the removal of polyp. on the other hand, experimental studies were carried out for the purpose of clarifying the mechanism causing diplophionia accompanied by polyp of the vocal cords. 1) The author deviced model vocal cords by using the femur muscles of Rana nigromaculata. In addition, model polyp was made on the model cord by knotching its medial free margin. A. forced vibration was induced with air current in the model cords in order to give a cord tone. By adjusting the pressure of air current and the tension of the model cords, a double sound was obtained during the vibratory movement of the model cords with model polyp. The double sound was analysed sonagraphically and, as a control, the cord tone of the same model was also analy- sed after removing model polyp. 2) The author sonagraphically compared a2-flageolet with double sound composedof simple a2 and a3-flageolet in chord tone of a violin. Results and Consideration: 1) An appreciable resemblance was found detween the double souhd of violin and diplophonia. That is to say, the author noticed on each sonagram the second fundamental tone with a freque- ncy approximate to harmonics of the proper one. 2)The tension of the model cords had a close connection with double sound. This fact: would indicate that the laryngeal muscles which adjust the tension of the vocal cords play an, important role in eliciting diplophnia. 3) pitch-level of eliciting diplophonia seemed to fluctuate according to the location, shape- and size of polyp. 4) Diplophonia was most likely elicited at the level of register change. From these observations it would be reasonable to consider that polyp itself has its proper fundamental tone with a frequency approximate to harmonics of the vocal cords, and that diplo- phonia is composed of these two fundamental tone and their harmonics.

• 社団法人 日本耳鼻咽喉科学会の論文

著者

• 米山 文明

  東京大学医学部耳鼻咽喉科学教室

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