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

ObjectiveTo evaluate the utility of computerized manometry (CM) to identify pharyngoesophageal segment (PES) spasm during tracheoesophageal speech.Study DesignProspective clinical, controlled study.Subjects and MethodsIntraluminal 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.ResultsAll 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 as a threshold value for spasm was 100%.ConclusionCM 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.