Twenty laryngectomees underwent voice rehabilitation using the Blom-Singer voice prosthesis. A Duckbill prosthesis was utilized in 11 patients, while a Trapdoor prosthesis was in 9 patients. Five of the 20 cases inadvertently lost their prostheses prior to speech training. Eleven of the remaining 15 achieved fluent speech. The airway resistance value, success rate, fluency of speech and phonatory functions were compared between the two groups using the different types of prostheses. The Trapdoor prosthesis exhibited a lower resistance and produced more fluent speech. However, there were no differences in success rate and phonatory functions between the two groups. Fluency of speech correlated closely with the expiratory pressure during phonation, so that the handling of the inferior pharyngeal constrictor, which controls expiratory pressure, seemed to be the most important factor in the success of voice restoration using the Blom-Singer voice prosthesis.
