Over the past 20 years, tracheoesophageal (TE) fistulization has been being performed for voice reconstruction after total laryngectomy in Kobe University Hospital. The essential part of this technique consists of the construction of TE fistula using the membranous part of the trachea, and currently the esophageal muscular loop production arround the esophagus and TE fistula has been added to the original method for preventing aspiration.
Out of a total number of 307 patients, 262 (80%) succeeded in the postoperative TE speech. The rate of the aspiration was clearly improved from 59% in the original technique to 89% in the current one. Main reasons for restoration failure were the obstruction, the destruction of the TE fis-tula and lack of passion in patients.
The pitfall of this technique was precisely discussed.
