Long-term results of the Blom-Singer speech rehabilitation procedure.

We report a 64% long-term success rate in our series of 66 patients who have undergone the tracheoesophageal puncture (TEP) procedure with follow-up ranging from one to 3 1/2 years. Poor motivation and compliance were the most common factors noted in patients who failed to obtain or maintain tracheoesophageal speech. Other problems causing failure were technical problems relating to the TEP and medical problems. The success rate in the last 24 cases of our series has improved to 83%. The "collared" prosthesis, more careful patient selection, and emphasis on a team approach seem to be important factors for the higher success rate. The Blom-Singer TEP procedure is a safe, simple, and effective means of alaryngeal communication for selected patients.