Abstract
The esophageal voice can be scarcely uttered after laryngopharyngoesophagectomy, because the reconstructed dermal pharyngoesophagus is usually wide opened without any constriction as the pseudoglottis. It has been a general concept. Unexpectedly, one male patient got the esophageal speech 2 months after the surgery. His esophagus was reconstructed with D-P flap. After clinical examinations of this case, the following requirements were found to be able to speak after laryngopharyngoesophagectomy.
1) A dermal tube should not be cicatricial, not adhesive and easily movable to the surrounding tissue. Therefore, the pharyngoeophagus is preferably reconstructed on one stage with D-P flap attaching excessive subcutaneous fat tissue, and the infection should be prevented as much as possible.
2) The pharyngoesophagus should be reconstructed flat in its middle portion so that the anterior and the posterior walls are attached together. This portion plays a role of the pseudoglottis. For this reason, the dermal tube is created rather longer than the size enough to substitute the excised pharyngoesophagus.
3) In training of the esophageal speech, the patient may slightly press the middle portion of the new pharyngoesophagus with his finger during phonation.
