A new one-stage surgical technique for postlaryngectomy speech.

A new one-stage surgical technique for the postlaryngectomy speech applied to the 17 patients and its results are described herein. The essential part of this technique consists of the construction of a tracheo-esophageal shunt using only the remainder of the trachea obtained at the time of laryngectomy to reestablish an air communication between the trachea and the gullet. Fourteen patients of the 17 patients thus operated upon developed conversational abilities equivalent to the normal subject, except that they use a finger during the speech for the occlusion of the tracheal opening. This technique can be applied to almost all candidates for total laryngectomy with or without neck dissection. The initial speech was developed in 25 days after operation in average. The inflow of the salivas and/or fluids into trachea is not problematic in these patients. It has been well known that an air communication reestablished between the natural air way and the gullet could reproduce a vocal function after total laryngectomy [5]. Despite very few surgical techniques for this purpose have been described and applied clinically, although a tremendous effort has been made for the complete removal of the malignancy and the avoidance of recurrence up to the present [1--4, 6]. A new surgical method for achieving a tracheo-esophageal shunt for the postoperative vocal function is described herein.