The upper esophageal sphincter: Role in alaryngeal speech acquisition

The developments of tracheoesophageal puncture and voice prosthesis for alaryngeal speech rehabilitation directed attention to the anatomy and physiology of the pharyngoesophageal segment. A reproducible tracheoesophageal shunt in a large number of patients permitted the largest study population for alaryngeal speech acquisition to date. The sustained tracheoesophageal airflow led to important observations on speech acquisition after laryngectomy. Surgical techniques to reduce the tension in the pharyngoesophageal segment have evolved and include pharyngeal constrictor myotomies or pharyngeal plexus neurectomies. These adjunctive procedures to total laryngectomy are key aspects for consistent and effective voice acquisition after laryngectomy.