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Tracheo-oesophageal ‘Puncture Speech’

An assessment technique for failed oesohageal speakers

Published online by Cambridge University Press:  29 June 2007

A. D. Cheesman ,
J. Knjight ,
J. McIvor  and
A. Perry
A. D. Cheesman
Affiliation:
Departments of ENT Surgery
J. Knjight
Affiliation:
Departments of ENT Surgery
J. McIvor
Affiliation:
Departments of Radiology
A. Perry*
Affiliation:
Departments of Speech Therapy.
*
A. Perry, Speech Therapy Department, Charing Cross Hospital, Fulham Palace Road, London W6.
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Abstract

We describe the assessment procedures used at Charing-Cross Hospital to investigate laryngectomees who failed to develop oesophageal voice and give the results of assessment in 50 patients. Anatomical or physiological abnormalities in the reconstructed pharynx were found in all patients, and we feel these significantly contributed to the failure of achieving an oesophageal voice. The four cases of failure were due to hypotonicity of the pharyngo-oesophageal muscles, hypertonicity, frank spasm and stricture. This distinction can be used as a functional classification of failure as treatment for each group has to be different if successful surgical voice restoration is to be achieved. Patients with hypotonicity need to use external pressure; those with mild hypertonicity are able to use a low pressure tracheo-oesophageal voice prosthesis; those with spasm need a pharyngo-oesophageal myotomy prior to “puncture”, while those with stricture need surgical correction.

Type
Research Article
Information
The Journal of Laryngology & Otology , Volume 100 , Issue 2 , February 1986 , pp. 191 - 199
Copyright
Copyright © JLO (1984) Limited 1986

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