Transverse trachero-oesophagoplasty a new one-stage operation for construction of a 'Neo-Larynx'.

A new one-stage operation of constructing a 'Neo-Larynx' after total laryngectomy, transverse tracheo-oesophagoplasty, for a good alaryngeal ('Tracheo-Oesophageal') speech is described. A 'Neo-Epiglottis' is constructed from the posterior tracheal wall and a 'Pseudo-Glottis' in the tracheo-oesophagenal partition wall with a valvular mechanism for preventing aspiration into the trachea during deglutition. No extraneous tissue is used for the construction of the 'Neo-Larynx' and no practice is necessary on the part of the patient for developing alaryngeal 'Tracheo-Oesophageal' speech. The patient can phonate immediately after removal of the feeding tube and the silastic sheet and is ready for discharge five weeks after operation. Adequate surgical ablation is ensured and at the same time good functional rehabilitation is offered without jeopardizing the principles of cancer surgery, i.e. to be on the overdoing side rather than on the underdoing one in a futile attempt at retaining the function.