Hiroto Saito

Anxiety and depression in patients after surgery for head and neck cancer in Japan

OBJECTIVE The present study sought to examine the impact of physical symptoms, facial disfigurement, adequacy of preoperative information, and social support on anxiety and depression in Japanese patients with head and neck cancer (HNC) who had undergone surgery. METHOD A cross-sectional study with 194 patients was conducted using a self-administered questionnaire. This instruments included the Hospital Anxiety and Depression Scale (HADS), the European Organization for Research and Treatment of Cancer (EORTC) Head and Neck cancer module (QLQ-H&N35), and a Social Support Scale developed by Okabayashi et al. (1997). RESULTS The majority (56.7%) had surgery two or more years before completing the questionnaire. More than 25% of respondents showed anxiety or depression. Higher levels of perceived social support were associated with lower rates of anxiety and depression (p < 0.01). Sensory problems were associated with anxiety, and reduced sexuality was associated with depression (p < 0.01). Perceived disfigurement and adequacy of preoperative information were not associated with anxiety or depression. SIGNIFICANCE OF RESULTS Survivors of HNC experience anxiety and depression for an extended period of time. Social support may alleviate the severity of these disorders. More research is needed to confirm the impact of facial disfigurement and that of the preoperative information provided by surgeons on psychological distress in HNC patients.

Perception of Lateral Misarticulation and Its Physical Correlates

In order to clarify the relationship between perceptual diagnosis of lateral misarticulation (LM) by sophisticated listeners and the physical correlates of LM, three experiments using sustained speech /∫/ were conducted. Experiment 1 was designed to compare the spectral envelopes of normal speech (NS) /∫/ with those of LM /∫/. Experiment 2 was designed to collect the auditory impressions of sophisticated listeners listening to LM and NS /∫/ with specific spectral envelope bands replaced by LM. These two experiments showed that: (1) the spectral envelopes of LM are flat or decrease along the frequency axis in the frequency band above approximately 4 kHz, and there is a substantial peak at around 3.2 kHz in LM, which varies peculiarly with time; (2) the replacement of the spectral envelope between 2.5 and 4.5 kHz of NS with that of LM resulted in a remarkable increase in auditory impressions of LM. The facts suggest that the spectral envelope characteristic of LM has a peculiar variation at around 3.2 kHz. Additionally, experiment 3 estimated the spectrum of sustained speech /∫/ using vocal tract area functions. The results suggest that typical peaks of LM are related to the length and position of the vocal tract constriction region.

FEM analyses of three‐dimensional vocal tract models after tongue and mouth floor resection

The accuracy of vocal tract transfer functions estimated by Finite Element Method (FEM) analyses was evaluated to find relationships between structural characteristics of vocal tracts and their acoustical characteristics. Three‐dimensional vocal tract models were constructed from MR Images of four speakers (two normal persons and two patients after tongue and mouth floor resection), uttering the Japanese vowel /i/. Vocal tract transfer functions of the models were estimated by FEM and one‐dimensional models, and peak positions of these functions were compared with formant frequencies of these speaker’s speech waves. The patient speech waves had a peculiar formant at around 1500 Hz. The peak positions of the patients estimated by FEM were similar to the formant frequencies of the patients, especially the formant at 1500 Hz. However, the transfer functions by the one‐dimensional models had no peak at around 1500 Hz and the number of peaks was fewer than that by FEM. Since the patient vocal tract shapes were...