The current report describes a 40-month experience with 129 patients undergoing voice restoration by endoscopic tracheoesophageal puncture and use of a removable silicone valve. Successful acquisition of voice was achieved in 88% of patients with minimal complications. Observations of this group of laryngectomy patients suggest that esophageal voice is profoundly affected by the residual function of the pharyngeal constrictor musculature. Selective division of these muscles will enhance voice acquisition in a large number of failed esophageal speakers.
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