The resting pressure and pressure change during swallowing in the pharyngoesophageal high pressure zone (PHPZ) were examined in 35 alaryngeal patients and 8 normal subjects. Twenty five of 35 patients had undergone simple total laryngectomy (TL) because of cancer of the larynx, and the other 10 patients had undergone pharyngolaryngoesophagectomy combined with free jejunal transplants (JT) because of cancer of the hypopharynx. As for the resting pressure, some previous reports describe that the lower resting pressure is more advantageous for the acquisition of esophageal speech. However, in this study, the resting pressure in the PHPZ of a good esophageal speech group was higher than that of a poor esophageal speech group. Seven of 10 JT group showed remarkable low resting pressure in the region of PHPZ. One patient of JT group acquired good esophageal speech who showed relatively high resting pressure. As for the pressure change during swallowing, the author obtained interesting information through the analysis of the swallowing wave. The duration of swallowing wave was more prolonged in the poor esophageal speech group. The pattern of swallowing wave form was classified into four groups, which were the normal pattern, the pattern without relaxation, the spasmodic pattern and the no critical wave pattern. Most of the patients who showed the normal pattern acquired good esophageal speech. On the other hand, all the patients who showed the spasmodic pattern or the no critical wave pattern could not acquire esophageal speech.
