Pressão intra-esofágica durante a produção da voz esofágica em pacientes laringectomizados com e sem recuperação da capacidade de comunicação oral

Abstract

Background - After laryngectomy for treatment of pharyngeal/laryngeal carcinomas the patients may be rehabilitated, for oral communication, with the esophageal speech. Aim - To study the intra-esophageal pressure during the esophageal speech. Patients and Methods - It was measured the intra-esophageal pressure in 25 laryngectomized patients aged 40 to 70 years (median 57 years), 10 rehabilitated with esophageal speech and 15 unable to do so. The manometric method with continuous perfusion was used. The esophageal pressures was measured 3 to 5 cm below the upper esophageal sphincter when the patients tryed to speek the vowel "a". Sometimes the air swallowed went to the stomach, with a peristaltic or simultaneous contraction in the esophageal body. Results - During the attempt of esophageal speech the intra-esophageal pressure was higher in patients able to have esophageal speech (26,4 ± 10.1 mm Hg, mean ± SD) than in patients unable to do so (13.7 ± 7.2 mm Hg). The esophageal contraction after a swallow of air was also higher in patients with esophageal speech (45.3 ± 8.6 mm Hg) than in patients unable to do so (33.8 ± 13.1 mm Hg). Conclusion - Laryngectomized patients rehabilitated with esophageal speech has a higher intra-esophageal pressure during speech than patients unable to do so, what may be consequence of the capacity to retain air inside the esophagus.