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Cineradiography of the pharyngoesophageal segment in postlaryngectomy patients.

Abstract
The use of tracheoesophageal voice prostheses has gained wide acceptance in the field of vocal rehabilitation after total laryngectomy. In a randomized study with 3 arms, alaryngeal speech proficiency was assessed in 60 postlaryngectomy patients: 20 patients underwent primary unilateral pharyngeal myotomy, 21 patients underwent neurectomy of the pharyngeal plexus in addition to pharyngeal myotomy, and 19 patients did not undergo an additional surgical procedure. Pharyngoesophageal (PE) dynamics were examined during esophageal and tracheoesophageal speech. A single vibrating PE segment was seen in good alaryngeal speakers. Hypertonicity, spasm, strictures, and hypotonicity of the PE segment were correlated significantly with poor or moderate alaryngeal speech. Unilateral myotomy with or without unilateral neurectomy prevented hypertonicity or spasm of the PE segment. The acquisition of alaryngeal speech did not differ significantly between the 2 groups who had undergone an additional surgical procedure. Evaluation of anatomic and physiological factors may be helpful in subsequent clinical management to achieve effective alaryngeal speech.
AuthorsR van Weissenbruch, M Kunnen, F W Albers, P B van Cauwenberge, A M Sulter
JournalThe Annals of otology, rhinology, and laryngology (Ann Otol Rhinol Laryngol) Vol. 109 Issue 3 Pg. 311-9 (Mar 2000) ISSN: 0003-4894 [Print] United States
PMID10737317 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
Topics
  • Adult
  • Aged
  • Cineradiography (methods)
  • Esophageal Spasm, Diffuse (diagnostic imaging, physiopathology, surgery)
  • Female
  • Humans
  • Laryngectomy (rehabilitation)
  • Larynx, Artificial
  • Male
  • Middle Aged
  • Pharyngeal Diseases (diagnostic imaging, physiopathology, surgery)
  • Prospective Studies
  • Spasm (diagnostic imaging, physiopathology, surgery)
  • Speech, Alaryngeal
  • Treatment Outcome

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