Use of computerized manometry for the detection of pharyngoesophageal spasm in tracheoesophageal speech

OBJECTIVE: To evaluate the utility Of Computerized manometry (CM) to identify pharyngoesophageal segment (PES) spasm during tracheoesophageal speech. STUDY DESIGN: Prospective clinical, controlled study. SUBJECTS AND METHODS: Intraluminal pressures of the PES were collected in 12 tracheoesophageal speakers without spasm and 8 tracheoesophageal speakers with PES spasm before and after localized injection of botulinum toxin to the PES. All subjects underwent voice analysis and videofluoroscopy in addition to CM before and after treatment. RESULTS: All tracheoesphageal speakers with PES spasm presented with mean intraluminal pressures greater than 16 mmHg (mean, 25.36 mmHg). In contrast, mean intraluminal pressures of subjects without spasm was 11.76 mmHg (P < 0.05). The negative predictive value associated with the use of 16 mmHg its a threshold value for spasm was 100%. CONCLUSION: CM is a clinically useful tool to aid in speech rehabilitation for tracheoesophageal speakers. Intraluminal pressures of greater than 16 mmHg was highly predictive for PES spasm. (c) 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.139344945