Change in the force-summed pressure measurements of the upper esophageal sphincter prelaryngectomy and postlaryngectomy.
The pharyngoesophageal high pressure zone (PE-HPZ) was measured prelaryngectomy and postlaryngectomy with a new force-summing probe that accounts for sphincter pressure asymmetry. A total of 31 patients were studied six times each. Postoperatively, pressures dropped from 130+/-24 mm Hg to 66+/-9 mm Hg. After a standardized, intensive laryngectomy rehabilitation program, 12 of 19 postoperative patients acquired acceptable esophageal speech and 7 did not. Speakers and nonspeakers were found to have nearly identical PE-HPZ pressures (speakers = 70+/-10 mm Hg, nonspeakers = 59+/-18 mm Hg). Differences in sphincter length or relaxation likewise did not discriminate between these two groups. We conclude that PE-HPZ pressure is not a critical determinant of the acquisition of esophageal speech.
D000368:Aged; D004947:Esophagus / Q000503:physiopathology; D006801:Humans; D007822:Laryngeal Neoplasms / Q000503:physiopathology* / Q000601:surgery; D007825:Laryngectomy / Q000534:rehabilitation; D007830:Larynx / Q000503:physiopathology; D008365:Manometry; D008875:Middle Aged; D011184:Postoperative Period; D011300:Preoperative Care; D011312:Pressure; D013070:Speech Therapy; D013072:Speech, Esophageal