In 1979 Singer and Blom described an endoscopic technique of vocal rehabilitation of the total laryngectomy patient. We have used this technique in 26 patients. Fluent speech developed in 24 patients. Four patients inadvertently had the devices used in this technique fall out of the fistula with subsequent closure. They will need repuncture. Two patients who had excellent speech voluntarily removed their devices. One transient case of aspiration responded to silver nitrate cautery of the fistula and placement of a new device. We believe that at the present time this is the surgical procedure of choice to vocally rehabilitate the total laryngectomy patient.
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