Functional tracheoesophageal shunt for vocal rehabilitation after laryngectomy

A new one-stage surgical technique for postlaryngectomy vocal rehabilitation was applied to 19 patients with advanced carcinoma of the larynx. The technique consists mainly of the construction of a tracheoesophageal shunt and the creation of a tracheoesophageal flap to cover the shunt preventing entry of food into the trachea. Fifteen of the 19 patients developed useful speech. Slight leakage of liquids into the trachea occurred in four patients. This is avoided by having the patient bend his head down during deglutition. This technique can be performed in a wide variety of clinical situations and restores effortless speech without any special training.