機能性開鼻声の1治験例

　緒言

　諸種の音節障碍の中で，最も多く見られ且つ吃と共に患者及其の家族の気に病むのは，開鼻声である．

　開鼻声の原因には機能性と器質性とあり，器質的開鼻声に先天性口蓋破裂，或は後天的に黴毒や悪性踵瘍や結核等による口蓋破裂によるもの，扁摘或はアデノトミーの際の副捐傷により軟口蓋或は口蓋垂に瘢痕収縮を来せるために生ずるもの，中枢性器質性疾患たる小児麻痺，延髄球麻痺，仮性延骼球麻痺，脳溢血，多発性硬化症，震顫麻痺，舞踏病，頭蓋底腫瘍，脳膜炎，脳炎，脊髄癆，フリードライヒ氏病，脊髄灰白質炎，脊髄空洞症，筋萎縮性側索硬化症等によるもの，末梢性器質性原因として咽頭ヂフテリー，或はインフルエンザ，猩紅熱，腸チフスの際の咽頭炎に併発せるもの等があり，機能性開鼻声にはヒステリー性のもの，或は白痴虚弱者等の音節筋の先天的脆弱によるもの等がある．

KAWANO AND SENTO report a case in whom the complaint was nasal voice which deve-loped after the recovery from meningitis of de-ntal origin. Various treatments were tried such as injections of normal saline solution into the soft palate locally, parenteral use of vitamin B-and vagostigmin and massage of the palate but, without effect. However, a reief was finally brought about by a counterpressure treatment with caloric stimulation to the soft palate and posterior pharyngeal wall. Examination revealed no pathological changes in the nasal cavity, pha-rynx or the palate to warrant the presence of the symptoms. But, there were some evidence that the patient might be hysterically affected and the manifestation of the nasal voice was purely funetional in type.