Abstract
The technique of tracheo-esophageal shunt which Amatsu introduced in 1977 is simple. The voice produced is usually fluent and intelligible, but because of the continuity with the esophagus, aspiration seems to be unavoidable. To eliminate aspiration, we folded the membranous portion of the trachea above the anastomosis and created a valve-like slit. We have used this technique in 15 patients.In 13 of the 15 patients, aspiration is almost negligible. Two patients had mild aspiration, but no clinical problem. The speech is as good as in the original technique except in one case.
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