[Finger-free speech following total laryngectomy. Instrumentation and technic of surgical voice rehabilitation].

Surgical voice restoration during and after total laryngectomy using Blom-Singer puncture and the glottoplasty techniques provide good results. There is no doubt that the proportion of patients with a good voice is higher after surgical voice restoration than with the use of the esophageal speech or electronic speaking aids. Nevertheless there are problems due to the shunt or the necessary daily changing of the prosthesis with its risks, and failures due to the tracheostomy, the prosthesis and the pharynx. In order to reduce these surgical problems we developed new instruments, a personal surgical procedure for restoration during and after laryngectomy using this set of instruments, a new type of prosthesis and a tracheostoma valve. This technique allows the patient to speak fluently without using his hands, to breathe and to swallow without aspirating.