Objective To explore the effect of Passy-Muir speaking valve(PMV)on swallowing biomechanics of dysphagia by us-ing high resolution manomety(HRM)in stroke patients after tracheotomy,and to evaluate the application value of pressure parameters of pharynx and upper esophageal sphincter(UES)in PMV therapy. Methods From January,2020 to January,2024,100 patients in People's Hospital of Xinjiang Uygur Autonomous Region were randomly divided into control group(n = 50)and PMV group(n = 50).The control group accepted routine swallowing therapy,and PMV group accepted PMV additionally,for two weeks.Before and after treatment,the clinical swallowing function was evaluated with modified Mann Assessment of Swallowing Ability(MMASA);and then they were observed with HRM,and the velopharynx maximal pressure,velopharynx time,UES residual pressure and duration of UES relaxation were collected.The correlation of the scores of MMASA and pressure parameters of pharynx and UES was analyzed. Results Four cases dropped down in each group.After treatment,UES residual pressure significantly decreased(t>47.403,P<0.001),and the score of MMASA,the velopharynx maximal pressure,the velopharynx time and the duration of UES relaxation significantly increased(t>19.621,P<0.001);and all the indexes were better in PMV group than in the control group(t>2.050,P<0.05).The scores of MMASA were significantly positively correlated with velopharynx maximal pressure(r = 0.924,P<0.001),velopharynx time(r = 0.948,P<0.001)and duration of UES relaxation(r = 0.954,P<0.001),negatively correlated with UES residual pressure(r =-0.939,P<0.001). Conclusion PMV could improve the swallow function and biomechanics of pharynx and UES in stroke patients with tra-cheotomy.The pressure parameters of pharynx and UES may predict the effect of swallow function by using PMV.