| The role of the upper oesophageal sphincter in voice rehabilitation after laryngectomy and Staffieri's procedure. | |
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MedLine Citation:
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PMID: 3944505 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The Staffieri method was used for voice rehabilitation after total laryngectomy in our patients. Leakage of saliva has been a problem in some. It has been suggested that aspiration could be due to specific pressure relations in the pharynx, upper oesophageal sphincter and cervical oesophagus during deglutition (Mann et al., 1980). Regarding voice production, the upper oesophageal sphincter is probably the main sound source, functioning in essentially the same way as in oesophageal speech. Intraluminal pressure recordings at rest and during swallowing were used in 16 Staffieri speakers and 9 oesophageal speakers. Upper oesophageal sphincter dysfunction was seen more often in Staffieri speakers with aspiration problems than in Staffieri speakers without aspiration problems, but the relation is not clearly understood. A definite relation could be established between upper oesophageal sphincter function in terms of relaxation and coordination and aerodynamic pressure measured in the tracheostoma, necessary to sustain phonation. After dilatation of the oesophagus, produced by the inflow of air, a reflex rise in the upper oesophageal sphincter pressure is thought to occur. The pressure necessary to sustain phonation probably depends on the extent to which this reflex mechanism occurs and on the ability of the patient to induce a relaxation of the upper oesophageal sphincter before air expulsion. Selective myotomy will possibly lower the necessary pressure and enhance vocal rehabilitation. Whether this will solve a part of the aspiration problems in Staffieri speakers is completely unpredictable, as the relation of the motor function of the upper oesophageal sphincter and the aspiration problems is not well understood. |
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Authors:
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H D Vuyk; E Klinkenberg-Knol; R M Tiwari |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of laryngology and otology Volume: 100 ISSN: 0022-2151 ISO Abbreviation: J Laryngol Otol Publication Date: 1986 Jan |
Date Detail:
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Created Date: 1986-03-06 Completed Date: 1986-03-06 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8706896 Medline TA: J Laryngol Otol Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 59-68 Citation Subset: AIM; IM |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Esophagogastric Junction / physiopathology* Esophagus Female Humans Hypopharynx / physiopathology Inhalation Laryngeal Neoplasms / surgery* Laryngectomy* Male Manometry Middle Aged Pressure Speech, Alaryngeal* |
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