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Oesophageal function in tracheoesophageal fistula speakers after laryngectomy

Published online by Cambridge University Press:  10 October 2008

W Allan ,
L Burgess ,
A Hurren ,
R Marsh ,
P R Samuel  and
P K Small
W Allan
Affiliation:
Department of Regional Medical Physics, Sunderland Royal Hospital, UK
L Burgess
Affiliation:
Department of Gastro-intestinal Physiology, Sunderland Royal Hospital, UK
A Hurren
Affiliation:
Department of Speech and Language Therapy, Sunderland Royal Hospital, UK
R Marsh
Affiliation:
Department of Radiology, Sunderland Royal Hospital, UK
P R Samuel*
Affiliation:
Department of ENT, Sunderland Royal Hospital, UK
P K Small
Affiliation:
Directorate of General Surgery, Sunderland Royal Hospital, UK
*
Address for correspondence: Mr P R Samuel, ENT Department, Sunderland Royal Hospital, Kayll Road, Sunderland SR4 7TP, UK. Fax: 01915699202 E-mail: peter.samuel@chs.northy.nhs.uk
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Abstract

Objectives:

Patients who have undergone tracheoesophageal puncture for surgical voice restoration often use unnaturally high oesophageal air pressures during speech. This study examined the effect of high oesophageal air pressure on oesophageal body motility, lower oesophageal sphincter function and dyspeptic symptoms.

Design:

Cross-sectional study using several investigative tests of oesophageal function.

Materials and methods:

Sixteen patients who used tracheoesophageal fistula speech underwent several investigations, including: oesophageal manometry, videofluoroscopy, barium swallow, and tracheal pressure measurements during speech. The patients were also asked to complete a dyspepsia questionnaire.

Results:

We demonstrated that more than 50 per cent of these patients had subjective or objective disordered oesophageal function. Videofluoroscopy and manometry identified oesophageal dysmotility in the same patients.

Conclusion:

Oesophageal function appears to be altered by tracheoesophageal fistula speech. However, our study showed that there is no contraindication to proceeding with tracheoesophageal fistula voicing even in patients with a history of oesophageal dysfunction.

Keywords

SwallowingLaryngectomyOesophagus
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 6 , June 2009 , pp. 666 - 672
Copyright
Copyright © JLO (1984) Limited 2008

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