Primary vocal rehabilitation using the Blom-Singer and Panje voice prostheses

Vocal rehabilitation by means of tracheoesophageal puncture and placement of either the Blom-Singer or Panje silicone prosthesis has become a standard method of speech production following total laryngectomy. The same technique has been employed primarily at the time of the laryngectomy by the Department of Otolaryngology-Head and Neck Surgery, Indiana University Medical Center, and our experience with 11 patients undergoing this technique forms the basis for this report. Of the ten patients available for evaluation, all have developed satisfactory prosthetic speech 2-12 weeks following total laryngectomy. Advantages of this technique include the utilization of standard laryngectomy without compromise of oncologic principles, elimination of a second procedure to place the tracheoesophageal puncture, elimination of the nasogastric tube, care in the pharyngeal closure to afford the maximum success of prosthetic speech production, and finally, the psychological boost. Limitations of the technique have been few but relate to limited voicing with postoperative radiotherapy and unrealistic patient expectations.