Vocal rehabilitation by a tracheopharyngeal shunt.

Vocal rehabilitation by a new one-stage tracheopharyngeal (TP) shunt procedure was done in eight laryngectomies. The procedure is summarized as follows. The horizontal parallel and a vertical lateral skin incision are made in the anterior part of the neck, and the medially and laterally based flaps are made. After laryngectomy, the TP tunnel is created with the medially based flap, and a functioning sphnicter is created by the thyropharyngeus muscle at the pharyngeal opening of the TP tunnel. The cervical defect is closed by the laterally based flap. Two patients experienced minor aspiration, and two had stenosis of the TP tunnel. The quality of the voice is hoarse and similar in quality to that produced by the Asai laryngoplasty.