Restorative procedures in cases of impaired voice function following complete laryngectomy.

Surgical voice restoration with a tracheo-oesophageal fistula using an alloplastic voice prosthesis is the current standard in Germany for patients with laryngectomy. With the increasing widespread use of this type of rehabilitation new duties emerge, not only for ones colleagues in the hospital but also for those in general practice. Care of these patients close to their home must be the aim of us all. With the use of voice prostheses on the increase any problems arising for the clinician are few and easily treatable; for these a therapy concept should be borne in mind. Surgical voice restoration is indicated only in individual cases due, among other reasons, to the high operational costs involved. If surgical voice restoration is impossible or unsuccessful, oesophageal voice replacement and electronic voice support are realistic alternatives. Improvements can be expected as regards the durability of voice prostheses, methods of replacing them, and speech procedure with finger-free tracheostomy closure. Greater use of the artificial larynx without tracheostomy is the objective for the distant future.