title: Operative prevention and management of voice-limiting pharyngoesophageal spasm.
abstract: Voice-limiting pharyngoesophageal spasm presents a challenge to the surgeon who is trying to optimize functional voice outcomes in the laryngectomy patient. Modified closure techniques, adjunctive myotomy, and pharyngeal plexus neurectomy have the ability to improve or prevent pharyngoesophageal spasm. Attempts to maximize vocal outcome should be considered at the original time of laryngectomy and tracheoesophageal voice restoration because salvage treatment can be challenging.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Virginia Mason Medical Center, MS: X10-ON, 110 Ninth Avenue, P.O. Box 900, Seattle, WA 98111, USA.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Bayles
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Deschler
mesh_terms: D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D015155:Esophageal Spasm, Diffuse / Q000517:prevention & control* / Q000628:therapy; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects / Q000379:methods / Q000534:rehabilitation*; D009465:Neuromuscular Agents / Q000627:therapeutic use; D011677:Punctures / Q000379:methods
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A