Preoperative assessment of tracheoesophageal speech

Air insufflation testing of tracheoesophageal (TE) puncture candidates as currently practiced lacks objectivity and relies on subjective evaluation of the sound produced. Intraesophageal pressure measurements were obtained from 21 consecutive laryngectomized patients during air insufflation by either experienced examiners or a compressed air source at 1 liter or 3 liters per minute. Postoperatively, three levels of TE speech fluency were identified. Preoperative intraesophageal pressure measurements were associated with a specific post-TE puncture speech fluency result. Intraesophageal pressure measurements may offer a reliable objective preoperative assessment of post-TE puncture speech fluency and identify patients who would benefit from pharyngeal myotomy at the time of TE puncture.