The Pharyngoesophageal Segment After Total Laryngectomy

Area of Science:

• Otolaryngology
• Speech-Language Pathology
• Physiology

Background:

• Total laryngectomy necessitates alternative speech methods, often tracheoesophageal voice (TEV).
• The pharyngoesophageal segment (PES) is crucial for TEV function.
• Understanding PES anatomy and function in functional TEV speakers is vital for optimizing voice outcomes.

Purpose of the Study:

• To characterize the pharyngoesophageal segment in laryngectomees who self-report as functional tracheoesophageal speakers.
• To correlate perceptual voice assessments with objective physiological measures of the PES.

Main Methods:

• High-resolution videomanometry (HRVM) of swallowing and phonation.
• High-speed camera (HSC) recording during phonation.
• Perceptual voice assessment (PVA).

Main Results:

• Significant correlations found between voice roughness and poor voice quality, hyperfunction and poor intelligibility, and voice quality with time since operation and age.
• HRVM revealed decreased pressures from the distal esophagus to the pharynx, low resting PES pressures, and reduced esophageal peristaltic pressures compared to controls.
• HSC showed a predominantly circular neoglottis shape with a strong mucosal wave in most participants.

Conclusions:

• PVA and HSC provide essential baseline data on voice characteristics and neoglottis vibration regularity.
• Quantitative HRVM data may serve as valuable reference data for clinical voice rehabilitation post-total laryngectomy.