Summary
The tracheo-esophageal shunt has not to be created too wide because of the danger of aspiration; but narrow shunts require high intrathoracical pressure for phonation. In seven patients a pulmonary function test was done and then the mean air flow and the esophageal pressure during phonation were measured. In four of these patients we obtained sufficient data: one patient showed a shunt resistance of 35 cm H2O/l/s which is comparable to the phonatory resistance of a normal glottis. In the three other patients resistances were found being 10–80 times higher than the normal glottal resistance. In those two patients having the lowest and the highest shunt resistance, respectively, the change of blood pressure in the pulmonary artery during phonation was recorded by cardiac catheterisation. In the patient with low resistance the mean arterial pressure increased twofold, whereas the other one showed a sixfold increase. From these observations it is concluded that phonation with a Staffieri-shunt often does not only mean a considerable respiratory load, but also a cardiovascular stress in the sense of the Valsalva-maneuver. Therefore, chronic lung and heart diseases should be regarded as contraindications against a Staffieri-shunt.
Similar content being viewed by others
Literatur
Isshiki N (1964) Regulatory mechanism of voice intensity variation. J Speech Hear Res 7: 17–29
Staffieri M (1973) Funktionelle totale Laryngektomie. Monatschr Ohrenheilkd 107: 77–89
Swan HJ, Ganz W, Forrester J et al. (1970) Catheterization of the heart in man with use of a flow-directed balloon-tipped catheter. N Engl J Med 283: 447–451
Author information
Authors and Affiliations
Additional information
Wird im vollen Wortlaut in Laryngol Rhinol publiziert
Rights and permissions
About this article
Cite this article
Schultz-Coulon, H.J., Sybrecht, G.W. & Pilavakis, P. Die kardio-respiratorische Belastung beim tracheo-ösophagealen Shunt nach Staffieri. Arch Otorhinolaryngol 227, 467–469 (1980). https://doi.org/10.1007/BF00467565
Issue Date:
DOI: https://doi.org/10.1007/BF00467565