[Phonation fistulas today].

Objective: To describe our experience with the use of trachea-oesophageal puncture (TEP) after total laryngectomy.

Material And Method: We have studied retrospectively 96 patients who received a voice prosthesis through tracheoesophageal puncture between October 2000 and December 2005.

Results: The punctures effected were 86 primary (89.6 %) and 10 secondary (10.4 %); of the prostheses, 81 (84.4 %) were Provox(R) type and 74 % of patients used it as their normal means of communication. Reasons for withdrawal included insufficiency and aspiration in 66.7 % (14/21), lack of use in 23.8 % (2/21), granulation tissue, and inflammation in 4.7 % (1/21).

Conclusions: Voice rehabilitation by TEP and prosthesis was successful in 74 % of our patients with acceptable complications and better results than those obtained by tracheaoesophageal speech. We recommend the use of TEP in those patients who have the motivation and a good oncological and physical assessment.