In recent years, various techniques have been introduced for construction of an epithelium-lined shunt between the trachea and the esophagus or hypopharynx. We described a rigid neoglottis in a preliminary report of 12 cases in which the upper tracheal rings were used to construct the epithelium-lined tract. This study reports the cases of 22 additional patients and offers an in-depth analysis of additional demographics, complications, and long-term speech results that quantify the vocal characteristics of neoglottic speakers. Results indicate rapid postoperative speech rehabilitation in nearly all patients, good long-term speech results (mean followup, 52 months), and low morbidity. There was a low incidence of local recurrence and stenosis, and 26 of 34 patients had either no aspiration or occasional asymptomatic aspiration of small amounts of liquid. This modified neoglottis procedure should be considered for patients who need voice restoration after laryngectomy.
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