ESOPHAGEAL PRESSURE IN TOTAL LARYNGECTOMEE PATIENTS

• Grant number: 17/20876-9
• Support Opportunities: Scholarships abroad - Research
• Start date: January 01, 2018
• End date: June 30, 2018
• Field of knowledge: Health Sciences - Speech Therapy
• Principal Investigator: Renata Rangel Azevedo
• Grantee: Renata Rangel Azevedo
• Host Investigator: Peter C. Belafsky
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil
• Institution abroad: University of California, Davis (UC Davis), United States

Abstract

ABSTRACTPharyngoesophageal segment pressure in total laryngectomees:esophageal voice and tracheoesophageal prosthesisCommunication alternatives for total laryngectomized patients are very restricted, and the best option is the use of a tracheoesophageal prosthesis. However, this possibility is not available in the Brazilian public health system and few patients in this population can aford its acquisition. For many, esophageal voice is the only oral communication option. There are many causes of failure to acquire esophageal voice, and there are few studies that seek to clarify the reasons and to define new behaviors to facilitate the development of the esophageal voice. Differences in pressure of the pharyngoesophageal segment (PES) have been described in a study with conventional manometry and were associated with voice quality. Therefore, the objective of this study is to compare differences in PES pressures in three groups: tracheoesophageal voice speakers, and good and poor esophageal voice speakers. All patients will undergo high resolution manometry, considered an innovative and cutting edge test, with high sensitivity for detecting esophageal pressure differences. Pressure levels will be measured at rest, during swallowing and during the emission of a sustained vowel. The examination includes an initial period of adjustment for the individual to adjust to the presence of the transnasal catheter, followed by 10 swallows (5 ml of water) spaced at 30-second intervals. After 10 minutes for adaptation to the probe, patients will be asked to produce the vowel / a / twice, with a 50 second interval between each emission. Manometry will evaluate esophageal pressure at rest and phonation, considering amplitude measurements (mmHg). The results will be correlated to each other