Use of computerized manometry for the detection of pharyngoesophageal spasm in tracheoesophageal speech.
OBJECTIVE
To evaluate the utility of computerized manometry (CM) to identify pharyngoesophageal segment (PES) spasm during tracheoesophageal speech.


METHODS
Prospective clinical, controlled study.


METHODS
Intraluminal pressures of the PES were collected in 12 tracheoesophageal speakers without spasm and 8 tracheoesophageal speakers with PES spasm before and after localized injection of botulinum toxin to the PES. All subjects underwent voice analysis and videofluoroscopy in addition to CM before and after treatment.


RESULTS
All tracheoesophageal speakers with PES spasm presented with mean intraluminal pressures greater than 16 mmHg (mean, 25.36 mmHg). In contrast, mean intraluminal pressures of subjects without spasm was 11.76 mmHg (P<0.05). The negative predictive value associated with the use of 16 mmHg as a threshold value for spasm was 100%.


CONCLUSIONS
CM is a clinically useful tool to aid in speech rehabilitation for tracheoesophageal speakers. Intraluminal pressures of greater than 16 mmHg was highly predictive for PES spasm.
Chone
Carlos Takahiro
CT
Department of Otolaryngology-Head and Neck, State University of Campinas, Unicamp, Campinas, Brazil. carloschone@uol.com.br
Seixas
Vinicius O
VO
Paes
Lucia A
LA
Gripp
Flavio M
FM
Teixeira
Cristiane
C
Andreollo
Nelson A
NA
Spina
Ana L
AL
Quagliato
Elizabeth
E
Barcelos
Irene K H
IK
Crespo
Agricio N
AN
D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D015155:Esophageal Spasm, Diffuse / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D008365:Manometry / Q000379:methods*; D009465:Neuromuscular Agents / Q000627:therapeutic use; D011312:Pressure; D012680:Sensitivity and Specificity; D013072:Speech, Esophageal
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A