Esophageal Determinants of Alaryngeal Speech

Techniques of intraluminal manometry were applied to the study of the esophagus and its sphincters in 20 patients following laryngectomy and in 20 control subjects. Resting cricopharyngeal sphincter pressure was found to be significantly lower in laryngectomees with fluent esophageal speech (13 mm Hg) than in those unable to develop esophageal speech after laryngectomy (30 mm Hg) and controls (39 mm Hg). The function of the lower esophageal sphincter and the body of the esophagus was similar in all groups. Whereas the cricopharyngeal sphincter normally prevents entry of unwanted air into the digestive tract, following laryngectomy this function may be detrimental and hinder the development of useful esophageal speech.