Prevention of pharyngoesophageal spasm after laryngectomy with a half- muscle closure technique

Daniel G. Deschler, E. Thomas Doherty, Richard E. Hayden, Charles G. Reed, Mark I. Singer

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Because pharyngoesophageal spasm can limit successful voice restoration after total laryngectomy, 24 patients underwent a modified pharyngeal closure in an effort to avoid this problem. All patients underwent total laryngectomy with appropriate neck dissections and pharyngeal closure with a half-muscle closure technique in which only one side of the remnant constrictor muscles was used to reinforce the primary closure. Twenty-three patients underwent voice restoration. Twenty-two (96%) had a functional voice, and 1 patient (4%) had pharyngoesophageal spasm that required a secondary myotomy. One fistula (4%) occurred and resolved with conservative measures. Quantitative voice analysis demonstrated no significant differences between half-closure patients and control patients for fundamental frequency (96 Hz versus 101 Hz) or intensity (57 dB versus 64 dB). Extensive qualitative analysis by trained and naive listeners revealed no differences. This preliminary report indicates the half-muscle closure modification of the pharyngeal closure at primary laryngectomy may provide a simple and effective means of avoiding pharyngoesophageal spasm and maintaining an effective voice without increased complications.

Original languageEnglish (US)
Pages (from-to)514-518
Number of pages5
JournalAnnals of Otology, Rhinology and Laryngology
Volume109
Issue number5 I
DOIs
StatePublished - Jan 1 2000

Keywords

  • Half-muscle closure
  • Laryngectomy
  • Pharyngoesophageal spasm
  • Tracheoesophageal puncture

ASJC Scopus subject areas

  • Otorhinolaryngology

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