Vibratory analysis of the neoglottis after surgical intervention of cricopharyngeal myotomy and implantation of tracheal cartilage.

OBJECTIVE To examine the effect of a new surgical intervention, consisting of cricopharyngeal myotomy and tracheal cartilaginous implantation on the anterior wall of the esophagus, for tracheoesophageal shunt and esophageal phonation. DESIGN We examined the vibration of the neoglottis of tracheoesophageal shunt and esophageal speakers after total laryngectomy using a high-speed video camera (frame rate, 1000 per second). PATIENTS Twenty-one alaryngeal patients were involved: 13 who had undergone the present procedure and 8 who had not. RESULTS The regularity of neoglottal vibration and the degree of neoglottal closure were significantly (P<.01) better in patients who had undergone the procedure than in those who had not. These effects on neoglottal vibration induced easier phonation. CONCLUSIONS Cricopharyngeal myotomy was useful for avoiding reconstructed esophageal spasm, and tracheal cartilaginous implantation was effective for maintaining a wide subneoglottal space. This combination of procedures is useful for obtaining optimal vibration of the neoglottis in tracheoesophageal shunt and esophageal speakers.