Abstract
This study aims to measure the pressure of the pharynx and the pharyngoesophageal segment (PES) at rest and during phonation in total laryngectomized patients, with different levels of voice production. four total laryngectomized individuals participated in the study, All patients underwent High Resolution Manometry (MAR) at rest and during phonation. After this process, a descriptive analysis of the results was performed. we observed that during rest the patients had PES pressure below normal and this data may be related to changes in the muscular connections at the level of the upper esophageal sphincter (UES) especially the interruption of the cricopharyngeal plexus. During phonation, two patients presented higher UES pressure values during phonation, when compared to the values found at rest, suggesting that introduction of air into the esophagus is followed by pharyngoesophageal contraction and that during phonation the patients with good esophageal speech may develop more pressure in this region. Studies with a greater number of participants may help define, for example, subjects who may benefit from procedures such as cricopharyngeal myotomy or other medical conduct in order to facilitate the acquisition of esophageal voice in these patients.
Highlights
Cancer is one of the most serious diseases that affect the larynx
We found that the four patients had low upper esophageal sphincter (UES) pressure at rest
Understanding the mechanisms that act on the esophageal voice is fundamental due to the low rate of patients who can develop this means of communication after total laryngectomy
Summary
Cancer is one of the most serious diseases that affect the larynx. One of the treatments for curing laryngeal cancer in the main rehabilitation centers for patients undergoing head and neck surgery is total laryngectomy.In some cases, the impact of the disease can be devastating for the patient, leading to difficulty in speech and swallowing. Cancer is one of the most serious diseases that affect the larynx. One of the treatments for curing laryngeal cancer in the main rehabilitation centers for patients undergoing head and neck surgery is total laryngectomy. The impact of the disease can be devastating for the patient, leading to difficulty in speech and swallowing. The speech of the patient will have to develop a sound source different from the vocal folds. The new sound source for these patients is the vibration of the Pharyngo-Esophageal Segment (PES). The authors hypothesize that the excessive pressure in the PES, or the exaggerated reduction of that same pressure, can make this process difficult. The treatment for laryngeal cancer depends on the clinical stage, the extent and location of the tumor (supraglottic, glottic, and subglottic)
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