@article{oai:asahi-u.repo.nii.ac.jp:02000084,
 author = {小嶋, 千栄子 and KOJIMA , CHIEKO and 山村, 理 and YAMAMURA, OSAMU and 藤原, 周 and FUJIWARA, SHUU},
 issue = {2},
 journal = {岐阜歯科学会雑誌},
 month = {Oct},
 note = {【目的】高齢者の口腔機能の維持やリハビリテーションが歯科分野において課題となっており、嚥下機能や治療効果の評価を行う機会が増えている。今回、全部床義歯床口蓋部の厚みに注目し、頸部聴診法における術者の感覚である「きこえ」を定量化し、簡便で客観性に富んだ嚥下音の評価を試みた。【被験者および方法】被験者は、健常有歯顎者10名とした。各被検者ごとに、厚さが1.0mm（P1）と3.0mm（P2）の2種類の実験的口蓋床を製作した。無響音室にて、被験者に口蓋床未装着（N）で聴診器をあて、水10ccの嚥下音の記録を行った。同様に、実験的口蓋床を各々装着した時（P1、P2）の嚥下音を記録した。音質評価ソフトを用いて、ラウドネス、シャープネス、ラフネスの解析を行った。また、音声分析ソフトにて、嚥下音持続時間、Ⅰ音、Ⅱ音、Ⅲ音およびⅠ音とⅡ音合計の嚥下音持続時間、嚥下音開始時から波形が最大値に達するまでの時間およびピッチ曲線高低差を計測した。得られたデータをもとに統計処理を行なった。
【結果】ラウドネスは、口蓋床装着時に値が大きくなる傾向を示し、対照（N）とP2との間に有意な差が認められた。 嚥下音持続時間は、口蓋床装着時に延長する傾向が認められ、対照（N）とP2との間、P1とP2との間にそれぞれ有意に大きな値を示した。Ⅰ音とⅡ音合計嚥下音持続時間は、口蓋床装着時、P1においてわずかに短縮される傾向を示したが、有意差はなかった。
【考察】ラウドネスの増大は咽頭挙上筋や咽頭収縮筋などの運動変化によるものであると考えられる。また、嚥下音持続時間の延長、Ⅰ音とⅡ音合計嚥下音持続時間のわずかな短縮は、嚥下終了後の喉頭の開放に時間を要したと考えられる。
【結論】義歯口蓋部の厚さの決定にラウドネスの考察は有用であり、嚥下音から厚みを決定できる可能性がある。また、嚥下音持続時間の計測、分析が頚部聴診法の確立の一助となる可能性が示された。, [Purpose] Maintenance and rehabilitation of oral function in the elderly have brought about some problems in the dental fi eld, and opportunities to evaluate swallowing function and therapeutic effects are increasing. This study focused on palate thickness of the complete denture base, and attempted to quantify how swallowing is “heard”. “heard” is usually a sensation of the operator in neck auscultation, but we also tried to evaluate swallowing sounds simply and objectively. [Subjects and methods] Subjects comprised 10 healthy, edentulous individuals. Two experimental palatal floors with thicknesses of 1.0mm (P1) and 3.0mm (P2) were producted for each subject. In an anechoic room, a stethoscope was applied to the subject without a palate floor (N), and the swallowing sound of water 10 cc was recorded. Similarly, swallowing sounds were recorded when each experimental palatal floor (P1, P2) was attached. The loudness, sharpness and roughness of the sounds were analyzed using audio software. In addition, speech analysis software was used to analyze the duration of the swallowing sound, durations of the first, second, third, and total swallowing sounds, time from the start of the swallowing sound until the waveform reached maximal value, and pitch. Curve height differences were also measured. Statistical processing was performed based on the obtained data.
[Results] When the palate floor was attached, loudness tended to be increased. There was a significant difference between the control (N) and P2. Other significant differences were also observed between control (N) and P2, and between P1 and P2. Total duration of the first and second swallowing sounds tended to be slightly shortened at P1 when the palate floor was attached, but there was no significant differese in these parameters.
[Discussion] It is possible that the increase in loudness is due to changes in movements of the pharyngeal lifter and pharyngeal constrictor muscles. The extension of the durations of swallowing sounds and the slight shortening of the total duration of swallowing sounds on the first and second sounds may depend on longer time to open the larynx after swallowing.
[Conclusion] Loudness is useful for determining the thickness of the denture palate. It is possible that thickness of palatal plate may be able to be determined by swallowing sounds. Measurement and analysis of the duration of swallowing sounds may help establish establishment of cervical auscultation.},
 pages = {67--80},
 title = {口蓋床の厚さが嚥下音に及ぼす影響},
 volume = {50},
 year = {2023}
}