Oesophageal function in tracheoesophageal fistula speakers after laryngectomy.
OBJECTIVE
Patients who have undergone tracheoesophageal puncture for surgical voice restoration often use unnaturally high oesophageal air pressures during speech. This study examined the effect of high oesophageal air pressure on oesophageal body motility, lower oesophageal sphincter function and dyspeptic symptoms.


METHODS
Cross-sectional study using several investigative tests of oesophageal function.


METHODS
Sixteen patients who used tracheoesophageal fistula speech underwent several investigations, including: oesophageal manometry, videofluoroscopy, barium swallow, and tracheal pressure measurements during speech. The patients were also asked to complete a dyspepsia questionnaire.


RESULTS
We demonstrated that more than 50 per cent of these patients had subjective or objective disordered oesophageal function. Videofluoroscopy and manometry identified oesophageal dysmotility in the same patients.


CONCLUSIONS
Oesophageal function appears to be altered by tracheoesophageal fistula speech. However, our study showed that there is no contraindication to proceeding with tracheoesophageal fistula voicing even in patients with a history of oesophageal dysfunction.
Department of Regional Medical Physics, Sunderland Royal Hospital, UK.
W
W
Allan
L
L
Burgess
A
A
Hurren
R
R
Marsh
P R
PR
Samuel
P K
PK
Small
D000368:Aged; D000369:Aged, 80 and over; D000399:Air Pressure; D003430:Cross-Sectional Studies; D004415:Dyspepsia; D015154:Esophageal Motility Disorders / Q000209:etiology*; D004947:Esophagus / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D001239:Inhalation; D007825:Laryngectomy / Q000534:rehabilitation*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011677:Punctures; D013072:Speech, Esophageal; D014132:Trachea / Q000601:surgery*