The superior pharyngeal constrictor contract to narrow its lumen to assist with bolus transport as well as seal the nasopharynx to prevent food from going up - the middle and inferior pharyngeal constrictors contract to narrow its lumen to assist with bolus transport. These constrictor muscles originate from bones and cartilage anteriorly and insert posteriorly to a tendinous seam called the pharyngeal raphe. The outer circular layer consists of the superior, middle, and inferior pharyngeal constrictor muscles. The pharynx extends from the posterior nasal and oral cavity to the cricoid cartilage before blending into the esophagus. The inner longitudinal layer consists of the palatopharyngeus, salpingopharyngeus, and stylopharyngeus muscles. The pharyngeal muscles receive innervation from the vagus and glossopharyngeal nerve to work in sync to propel food from the oral cavity into the esophagus. A group of muscles called the pharyngeal muscles, which consist of the outer circular layer and the inner longitudinal layer, forms the lumen of the pharynx. However, the efficacy and safety of this surgical procedure should be explored in further multicenter studies.The pharynx is the digestive system posterior to the nasal cavity, oral cavity, and larynx and divides into the oropharynx, nasopharynx, and laryngopharynx. The study suggests that the tree-layer non-muscular pharyngeal closure with inferior pharyngeal constrictor unsutured is the preferable method to prevent pharyngo-esophageal spasm after total laryngectomy. The average pharyngo-esophageal pressure was significantly lower (p < 0.01) among patients after the tree-layer non-muscular closure. After the two-layer non-muscular pharyngeal closure mean pressure was 35 (min.-17, max.-40) mmHg, and after the tree-layer non-muscular pharyngeal closure the average pressure was 22,42 (min. The average pharyngo-esophageal pressure in the group after the pharyngo-esophageal plastic surgery was 32 (min.-5, max. To evaluate the pharyngo-esophageal pressures manometric tests were performed, and to asses the pharynx morphology videopharyngoscopy was used. One hundred eighty two subjects after total laryngectomy were enrolled in this study, and included 108 patients subjected to the pharyngo-esophageal plastic surgery, 44 patients who underwent the two-layer pharyngeal closure, and 30 patients with the tree-layer closure. The aim of this study was to compare the pharyngo-esophageal pressure between patients after pharyngo-esophageal plastic surgery and following the non-muscular pharyngeal closure. To prevent pharyngo-esophageal spasm in Department of Otolaryngology in Szczecin are used: pharyngoesophageal plastic surgery with interposition of vascular thyroid flap, two-layer (only mucosa) non-muscular pharyngeal closure and tree-layer closure (mucosa and muscle layer leaving inferior pharyngeal constrictor unsutured). High pressure of pharyngo-esophageal segment is the most important factor of impaired development of alaryngeal speech (esophageal speech, tracheoesophageal speech) after total laryngectomy.
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