title: The role of videofluoroscopy and ultrasound in assessing pharyngoesophageal muscle tone after laryngectomy.
abstract: The aim of this study was to compare the respective value of videofluoroscopy and ultrasound for assessment of the tonicity of the neoglottis and determination of the exact neolaryngeal segment of hypertonicity. We examined twelve patients who had developed inadequate tracheoesophageal voice following total laryngectomy and installation of tracheoesophageal prosthesis. We assumed that the cause of the unsatisfactory voice quality in our patients was neolaryngeal muscle spasm. After determining the exact hypertonic segment, we administered lidocaine intramuscularly and tried to act on the hypertonic segment. By means of videofluoroscopy as gold standard for comparison with ultrasound examination, we followed the passage of contrast through the neo-larynx and watched for dilatation of the segment during swallowing, phonation and at rest to determine whether there were any tonus disturbances or differences before and after lidocaine injection. In conclusion, a combination of the two methods could yield better results in voice restoration. Videofluoroscopy is the method of choice for initial assessment and determination of the hypertonic segment, while ultrasound is the method to apply to facilitate administering the drug more precisely.
authors: University of Rijeka, Rijeka University Hospital Center, Department of Otorhinolaryngology, Rijeka, Croatia.
authors: Robert
authors: R
authors: Tićac
authors: Barbara
authors: B
authors: Candrlić
authors: Jurica
authors: J
authors: Juranić
authors: Goran
authors: G
authors: Pavelić
authors: Dijana
authors: D
authors: Pedisić
authors: Marin
authors: M
authors: Pusić
authors: Marko
authors: M
authors: Velepic
authors: Radan
authors: R
authors: Starcević
authors: Damir
authors: D
authors: Miletić
mesh_terms: D004947:Esophagus / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D007825:Laryngectomy; D009129:Muscle Tonus; D009130:Muscle, Smooth / Q000000981:diagnostic imaging / Q000503:physiopathology*; D010614:Pharynx / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014463:Ultrasonography