Seiichi Ryu

A Newly Devised Speech Accumulator

Voice therapy is often most effective for treating patients with vocal cord polyp, polypoid degeneration and singers nodule. However, little is known about the total speaking times in 1 day, the ratio of speech per hour and the sound level during speech, in individual patients. If these parameters can be readily detected, it could be clarified as to how speaking times or patterns are related to a particular voice disorder and/or what instruction a doctor had given a patient. We devised a speech accumulator which records the vibration time of the vocal cords by a small contact microphone attached to the neck, but does not record the actual speech, thus monitoring the privacy of the individual. The time of speech, at any sound level can be read digitally, at any time. This system was clinically used for 11 patients and proved to be most useful. The longest speaking time in 1 day was 182 min, for a bus guide, and the shortest time was 33 min for an office clerk.

Biofeedback therapy for spastic dysphonia.

Spastic dysphonia is a disorder of phonation which is characterized by a strained, creaking, and choked vocal attack, a tense and squeezed voice sound. Spastic dysphonia in a functional voice disorder can be classified into two types from the viewpoint of activities of the extrinsic and intrinsic laryngeal muscle groups. A functional voice disorder pertaining to abnormal activities of the intrinsic and extrinsic laryngeal muscles results in spastic dysphonia. The adductor spastic dysphonia may be due to abnormal actions of the intrinsic laryngeal muscles as such is relieved by sectioning of the recurrent nerve, while spastic dysphonia mainly dealing with the extrinsic laryngeal muscles is relieved by relaxation on monitoring an electromyographic feedback system. Within 3 months we encountered two patients whose extrinsic laryngeal muscles were hyperactive on phonation. A trial on injection of lidocaine into extrinsic laryngeal muscles made their muscles relax. So, biofeedback therapy of relaxation was began using a monitoring system of EMG burst regarding to hypertonicity of the extrinsic laryngeal muscles. Normal vocal abilities were recovered using a biotrainer as a monitoring device of electromyographic feedback.

A newly designed teaching scope.

Otorhinolaryngologists find it difficult simultaneously to conduct physical examinations and to show students local findings in patients. A flat mirror attached to a headband is generally used, but only one student at a time can observe the findings, and the position of observation is restricted. Sometimes students cannot see the eardrum because of the parallax of the mirror. Although the endoscope is a relatively simple device for student demonstrations, it is expensive to prepare different endoscopes for observation of the ear, nose, pharynx, and larynx. Moreover, their handling, disinfection, and storage are tedious. We designed a parallax-free scope that can be used like the conventional head mirror. The scope is composed of four portions, the supporting, the image-transporting, the illuminating, and the guide-marking parts (Figs. I and 2). For the supporting part, we use a conventional headband, and other parts are equipped as one viewing assembly on the headband by means of a universal joint (Fig. 2). The scope weighs only SOO gm. The image-transporting part is the most important. The image that the teacher observes is reflected 4S degrees upward by a half mirror and is sent into an image guide cable. The metal-coated half mirror, set at 45 degrees to the natural line of vision, acts as a beam splitter, so that the image is seen by both the teacher and the student (Fig. 3). The reflection rate is SO%. There are no parallax errors between the image the