Ultrasonography of the process of esophageal speech in three laryngectomy cases.

Abstract

Aims: To visualize the process of esophageal speech in patients who underwent laryngectomy using diagnostic ultrasound.

Material and methods: Three patients with different surgical reconstructions (total laryngectomy, pharyngo-laryngo-esophagectomy with gastric tube reconstruction, and pharyngo-laryngo-cervical-esophagectomy with free jejunal reconstruction) were studied. Ultrasound with a linear probe observed organ vibration and dimensions at the 5th-7th cervical vertebrae during rest, air swallowing, and phonation. Cross-sectional lateral and anteroposterior diameters were measured.

Results: Lateral diameters (mm) during rest, air swallowing, and sound production were 15, 18, and 15 for the esophagus; 24, 27, and 23 for the gastric tube; and 19, 32, and 20 for the jejunal graft, respectively. Longitudinal motion of the esophagus and gastric tube lumen coincided with artifact, while jejunal villi movements were noted. Air swallowing induced an oval organ shape, and lateral diameters shortened during sound production.

Conclusions: Vibratory activity spanning over 4 cm was observed at the 5th-7th cervical vertebrae. Each organ displayed distinct vibration patterns, with luminal shape changes during sound production. These findings offer new insights into the biomechanics of esophageal speech and understanding of postoperative rehabilitation.