Tracheoesophageal voice restoration with total laryngectomy.

Tracheoesophageal voice restoration has gained worldwide acceptance over the past 24 years and is the preferred method of postlaryngectomy speech. Tracheoesophageal puncture is safe, reliable,and reproducible and should be considered in all patients undergoing total laryngectomy and in those who have failed to master other methods of alaryngeal speech. This article discusses patient selection, surgical technique and complications, quality of speech,and predictors of success. Improved prosthesis design has expanded the use of tracheoesophageal speech in laryngectomees.