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The Hyodo scoring system during the endoscopic procedure has been proposed as a new tool for evaluating oral intake feasibility. However, the effectiveness of the information obtained from this procedure in predicting aspiration is not fully elucidated. The aim of this study was to assess the significance of clinical factors, including Hyodo scores, for predicting the risk of aspiration.Five hundred and twenty-eight endoscopic swallowing examinations were performed. Clinical factors, including age, sex, disease type, history of aspiration pneumonia, cognitive function, presence of tracheostomy, presence of vocal cord paralysis, consciousness level on the Japan Coma Scale, ECOG Performance Status, serum albumin level and Hyodo score, were obtained for each examination. The relationship between each of these factors and the presence of aspiration during endoscopic procedure was evaluated.Three hundred and thirty-two patients (62.9%) were scored less than 5, 153 (29.0%) were scored between 5 and 8, and 43 (8.1%) were scored above 8. The number of patients with aspiration was 133 (25.2%). ROC analysis revealed that a cut-off point of 6 for Hyodo score was effective for predicting aspiration, with a sensitivity of 0.65 and a specificity of 0.86. History of aspiration pneumonia (OR 1.87, P0.001), vocal cord paralysis (OR 2.23, P0.001), PS≥3 (OR 2.47, P0.001) and Hyodo score6 (OR 9.08, P0.001) were found to be independent predictive factors for aspiration.The Hyodo scoring method was easy for otolaryngologists to perform and the scores were useful for predicting aspiration with moderate sensitivity and high specificity. Hyodo score6, history of aspiration pneumonia, vocal cord paralysis, and PS≥3 were independent predictive factors for aspiration and that a Hyodo score above 6 was the statistically strongest predictor for aspiration.

Summary Background The precise comparison of the voice characteristics of Parkinson disease (PD) patients with age-matched normal subjects is still one of the important research projects. The present study aimed at comparing the voice characteristics in sustained phonations of PD patients with an age-matched control group. Methods The subjects were 30 Japanese PD patients (15 males and 15 females). The control group consisted of 30 age-matched normal Japanese subjects (15 males and 15 females). Each subject was required to phonate into a mouthpiece attached to Vocal Function Analyzer (PS-77E; Nagashima Medical Instrumental Corporation, Tokyo, Japan) with the airway interruption system, and expiratory lung pressure, mean flow rate, fundamental frequency and intensity of voice, and pitch range were measured. Maximum phonation time was also assessed. Results The highest pitch level was significantly lower in the PD group than that of the control group in both sexes, whereas the lowest pitch level was significantly higher in the PD group only in males. In both sexes, the pitch range was significantly narrower in the PD group than in the control group. There was no significant difference in intensity, mean flow rate, expiratory pressure, or maximum phonation time between the two groups, for both males and females. Conclusion Only remarkable difference in the voice characteristics between PD patients and age-matched normal elderlies was limited to the narrowing of the pitch range in PD patients. The restriction in pitch regulation in PD patients was considered to be because of difficulty in reciprocal control of the laryngeal muscles secondary to latent rigidity.

Background: In English- and German-speaking countries, ataxic speech is often described as showing scanning based on acoustic impressions. Although the term ‘scanning’ is generally considered to represent abnormal speech features including prosodic excess or insufficiency, any precise acoustic analysis of ataxic speech has not been performed in Japanese-speaking patients. This raises the question of what is the most dominant acoustic characteristic of ataxic speech in Japanese subjects, particularly related to the perceptual impression of ‘scanning’. Aims: The study was designed to investigate the nature of speech characteristics of Japanese ataxic subjects, particularly ‘scanning’, by means of acoustic analysis. Methods & Procedures: The study comprised 20 Japanese cases with spinocerebellar degeneration diagnosed to have a perceptual impression of scanning by neurologists (ataxic group) and 20 age-matched normal healthy subjects (control group). Recordings of speech samples of Japanese test sentences were obtained from each subject. The recorded and digitized acoustic samples were analysed using ‘Acoustic Core-8’ (Arcadia Inc.). Outcomes & Results: Sentence duration was significantly longer in the ataxic group as compared with the control group, indicating that the speaking rate was slower in the ataxic subjects. Segment duration remained consistent in both vowels and consonants in the control group as compared with the ataxic group. In particular, the duration of vowel segments, i.e. the nucleus of Japanese mora, was significantly invariable in the control group regardless of differences between subjects as well as in segments compared with the ataxic group. In addition, the duration of phonemically long Japanese vowels was significantly shorter in the ataxic group. Conclusions & Implications: The results indicate that the perceptual impression of ‘scanning’ in Japanese ataxic cases derives mainly from the breakdown of isochrony in terms of difficulty in keeping the length of vowel segments of Japanese invariable during speech production. In addition, the tendency toward irregular shortening of the length of phonemically long Japanese vowels is thought to reinforce the impression of ‘scanning’ in ataxic speech in Japanese cases.

喉頭・下咽頭癌症例に対するconcurrent chemoradiotherapy (CCRT) により温存された喉頭の機能評価を行った。1998年10月から2003年9月までの期間に切除可能な喉頭・下咽頭扁平上皮癌病期II～IV期で一次治療としてCCRTを施行した32症例を対象とした。この32例中，すべての調査・検査に参加可能であったのは20例であった。喉頭機能の評価方法としては，アンケート調査，GRBAS尺度，最長発声持続時間，声域・話声位の測定，嚥下機能評価基準の栄養摂取方法，および気管切開孔の有無に関して検討した。喉頭・下咽頭癌のCCRT後は，大多数の症例で種々の程度の嗄声が認められ，また声域が狭まる症例があるが最長発声持続時間は75％の症例で正常範囲内であった。一方，1例を除くすべての症例 (97％) で，誤嚥性肺炎の既往なく経口摂取が可能となっていた。喉頭癌症例中2例で気管切開孔が閉鎖できなかったが，大多数の症例で喉頭の呼吸機能は温存されていると考えられた。

Ataxic dysarthria often refers to disturbance of coordinated articulatory movements in SCD subjects. In our recent study of acoustic analysis of selected speech samples obtained from normal and ataxic subjects, it was revealed that the ataxic speech diagnosed as having "scanning" was characterized by slower speaking rate, inconsistent segment duration of both vowels and consonants, and significant shortening of phonemically long Japanese vowels, as compared to the normal speech. The findings are apparently different from those reported in the study of ataxic speech characteristics of the subjects speaking Germanic languages. Thus, the impression of "scanning" in Japanese ataxic subjects derives mainly from the breakdown of isochrony in terms of difficulty in keeping the length of segments (morae) of Japanese invariable during speech production. The acoustic analysis of selected Japanese sentences is considered to be one of the appropriate methods for objective evaluation of ataxic symptoms.

In English- and German-speaking countries, ataxic speech is often described as showing scanning based on acoustic impressions. Although the term 'scanning' is generally considered to represent abnormal speech features including prosodic excess or insufficiency, any precise acoustic analysis of ataxic speech has not been performed in Japanese-speaking patients. This raises the question of what is the most dominant acoustic characteristic of ataxic speech in Japanese subjects, particularly related to the perceptual impression of 'scanning'.The study was designed to investigate the nature of speech characteristics of Japanese ataxic subjects, particularly 'scanning', by means of acoustic analysis.The study comprised 20 Japanese cases with spinocerebellar degeneration diagnosed to have a perceptual impression of scanning by neurologists (ataxic group) and 20 age-matched normal healthy subjects (control group). Recordings of speech samples of Japanese test sentences were obtained from each subject. The recorded and digitized acoustic samples were analysed using 'Acoustic Core-8' (Arcadia Inc.).Sentence duration was significantly longer in the ataxic group as compared with the control group, indicating that the speaking rate was slower in the ataxic subjects. Segment duration remained consistent in both vowels and consonants in the control group as compared with the ataxic group. In particular, the duration of vowel segments, i.e. the nucleus of Japanese mora, was significantly invariable in the control group regardless of differences between subjects as well as in segments compared with the ataxic group. In addition, the duration of phonemically long Japanese vowels was significantly shorter in the ataxic group.The results indicate that the perceptual impression of 'scanning' in Japanese ataxic cases derives mainly from the breakdown of isochrony in terms of difficulty in keeping the length of vowel segments of Japanese invariable during speech production. In addition, the tendency toward irregular shortening of the length of phonemically long Japanese vowels is thought to reinforce the impression of 'scanning' in ataxic speech in Japanese cases.