“…12 One prospective study examined the role of external approach cricopharyngeal myotomy in those undergoing surgical management of tongue-base and supraglottic laryngeal cancer. 13 The authors concluded that the procedure failed to provide any benefit and criticised purported widespread reporting of its application for dysphagia in the literature despite a lack of evidence.…”
Endoscopic carbon dioxide laser cricopharyngeal myotomy remains a viable option in treatment-related cricopharyngeal dysfunction; its targeted role requires further prospective study. Objective analysis of the technique can be reported using the validated Modified Barium Swallow Impairment Profile.
“…12 One prospective study examined the role of external approach cricopharyngeal myotomy in those undergoing surgical management of tongue-base and supraglottic laryngeal cancer. 13 The authors concluded that the procedure failed to provide any benefit and criticised purported widespread reporting of its application for dysphagia in the literature despite a lack of evidence.…”
Endoscopic carbon dioxide laser cricopharyngeal myotomy remains a viable option in treatment-related cricopharyngeal dysfunction; its targeted role requires further prospective study. Objective analysis of the technique can be reported using the validated Modified Barium Swallow Impairment Profile.
“…Speech failure after total laryngectomy is most frequently caused by so‐called spasm or hypertonicity of the PE‐segment. 3 , 4 , 8 , 18 , 25 , 26 , 28–32 Other causes are scarring, fibrosis, residual tumour or radiation fibrosis. Blom et al .…”
Section: Discussionmentioning
confidence: 99%
“…In a study by Horowitz et al . 30 pharyngeal pressure peaks were recorded in patients who underwent total laryngectomy with and without cricopharyngeal muscle myotomy. It appeared that in patients without myotomy, peak pharyngeal pressures were all greater than 60 mm Hg.…”
Section: Treatment Of Hypertonicity Of the Pe‐segmentmentioning
confidence: 99%
“…Speech failure is most frequently attributed to spasm of the PE‐segment. 3 , 4 , 8 , 18 , 25–32 Other causes are scarring, fibrosis, persistent tumour or radiation fibrosis of the PE‐segment muscles. The degree of tonicity of the PE‐segment appears to be an important factor in predicting successful acquisition of alaryngeal speech.…”
“…Surgical alterations of the upper aerodigestive tract are particularly interesting to investigate with pharyngoesophageal manometry. For example, manometry has demonstrated a postlaryngectomy pharyngoesophageal high pressure zone [15±20], which was reduced by cricopharyngeal myotomy performed concurrently with total laryngectomy [21]. No study has used manometry to investigate the eect of tracheotomy tube occlusion on UES and pharyngeal pressure generation during swallowing.…”
The biomechanics of the pharyngeal swallow in patients with a tracheotomy tube were investigated with manometry. Upper esophageal sphincter (UES) and pharyngeal pressure recordings were made with and without occlusion of the tracheotomy tube. Criteria for selection were ability to tolerate tracheotomy tube occlusion for both 5 minutes prior to and during the first manometric analysis, absence of surgery to the upper aerodigestive tract other than tracheotomy, and no history of oropharyngeal cancer or stroke. Aspiration was determined objectively by fiberoptic endoscopic evaluation of swallowing (FEES) immediately prior to manometric recording. Eleven adult individuals with tracheotomy participated; 7 swallowed successfully and 4 exhibited aspiration on FEES. The results indicated no significant effect of tracheotomy tube occlusion on UES or pharngeal pressures in either aspirating or nonaspirating patients. It was concluded that the biomechanics of the swallow as determined by UES and pharyngeal manometric pressure measurements were not changed significantly by tracheotomy tube occlusion in aspirating or nonaspirating patients. These results support previous observations that subjects either aspirated or swallowed successfully regardless of tracheotomy tube occlusion status.
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