Techniques chirurgicales de réhabilitation vocale après laryngectomie totale

Total laryngectomy remains indicated in the treatment of extended invasive squamous cell carcinomas of the larynx; its major consequence is the loss of voice. For more than 20 years, numerous specialists work on voice rehabilitation following total laryngectomy. Rehabilitation techniques include oesophageal speech, artificial larynx, tracheo-oesophageal shunt operations and, more recently, surgical restoration of voice with prosthesis. Several techniques have been described for the restoration of voice, such as the surgical technique by button voice prosthesis and the tracheo-oesophageal fistula. Compared to button voice prosthesis the tracheo-oesophageal fistula induces more important technical requirements and complications but less cost. We associated the extended hemi-laryngectomy of Pearson nearest speech reconstruction than sub total laryngectomy.