High-resolution ultrasound localisation of spasmodic pharyngo-oesophageal segment post total laryngectomy: technical report.

[OBJECTIVES] Pharyngo-oesophageal spasm is a common reason behind the failure of tracheo-oesophageal voice production. This study aims to describe the feasibility of high-resolution ultrasound for localisation of the spasmodic segment for botulinum toxin injection.

[METHODS] The pharyngo-oesophageal segment was localised using a 6-13 Hz linear probe. It was visualised as a concentric muscular area between the great vessels of the neck. The spasmodic segment was identified as the narrowest region when the patient was asked to attempt phonation and swallow.

[RESULTS] This technique was utilised in one patient who had pharyngo-oesophageal spasm following total laryngectomy. Following botulinum toxin injection, the patient was able to attempt phonation after one week.

[CONCLUSION] High-resolution ultrasound is an effective modality to guide botulinum toxin injection into the spasmodic pharyngo-oesophageal segment. It allows intervention to be performed at the bedside or outpatient setting without associated radiation exposure.