Computerized manometry use to evaluate spasm in pharyngoesophageal segment in patients with poor tracheoesophageal speech before and after treatment with botulinum toxin.
Tracheoesophageal voice (TEV) with voice prosthesis (VP) is an efficient and reproducible method used in vocal rehabilitation after total laryngectomy (TL), prevented by spasms in the pharyngoesophageal segment (PES). Computerized Manometry (CM) is a new, direct and objective method used to assess the PES.


OBJECTIVE
to carry out an objective analysis of the PES, with CM, before and after the injection of botulinum toxin (BT).


METHODS
Clinical-prospective.


METHODS
Analysis of eight patients consecutively submitted to TL with TEV and VP, without vocal emission, with PES spasms seen through videofluoroscopy, considered the gold standard for spasm detection. All had their spasms treated with the injection of 100 units of BT in the PES. The assessment was based on PES videofluoroscopy and CM, before and after BT injection.


RESULTS
There was a PES pressure reduction according to the CM after BT injection in all patients. The average pressure in the PES seen through the CM in eight patients before BT injection was 25.36 mmHg, and afterwards it dropped to 14.31 mmHg (p=0.004). There was vocal emission without stress and PES spasm improvement seen through the videolaryngoscopy after BT injection.


CONCLUSIONS
We observed a reduction in PES pressure after BT injection, seen through CM in all the patients, with spasms improvement seen through videofluoroscopy.
Chone
Carlos T
CT
Head and Neck Department - Otorhinolaryngology Program - Unicamp.
Seixas
Vinícius Oliveira
VO
Andreollo
Nelson A
NA
Quagliato
Elizabeth
E
Barcelos
Irene H K
IH
Spina
Ana L
AL
Crespo
Agrício N
AN
D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D003680:Deglutition Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D007825:Laryngectomy; D007831:Larynx, Artificial; D008365:Manometry / Q000379:methods; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D010609:Pharyngeal Muscles / Q000000981:diagnostic imaging / Q000503:physiopathology; D011312:Pressure; D011446:Prospective Studies; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*; D013035:Spasm / Q000000981:diagnostic imaging / Q000188:drug therapy*; D013061:Speech Acoustics; D013072:Speech, Esophageal
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A