Vocal Rehabilitation With a Tracheo-Esophageal Shunt

Abstract

Since July 1971 we have used the tracheo-esophageal (T-E) shunt technique described by Calcaterra and Jafek (Arch Otolaryngol 94:124, 1971) to provide vocal rehabilitation in nine laryngectomy patients. The T-E shunt was created at the time of laryngectomy, and six of the nine patients developed speech 14 to 21 days after surgery. The speech produced by these patients seems superior to conventional esophageal speech and occurred without extensive training by a speech pathologist. Two patients developed a postoperative wound infection, three patients stenosed the shunt while receiving postoperative radiation, and three patients had difficulty with aspiration. The reasons for these problems and their management and possible prevention are discussed.