Published online by Cambridge University Press: 29 June 2007
Successful communication following laryngectomy usually involves an electrolarynx or oesophageal speech. Only within the past decade has tracheoesophageal puncture been advocated for alaryngeal speech and evolved into the procedure of choice. Successful production of speech after total laryngectomy using tracheoesophageal speech may be impaired secondary to anatomical and functional difficulties. The primary limitation of tracheoesophageal speech is pharyngoesophageal spasm occurring in the upper oesophageal sphincter impeding airflow through this segment. Our report presents four patients who underwent a pharyngeal myotomy with the potassium-titanyl-phosphate (KTP) laser. Post-operatively, each patient was able to communicate with functional alaryngeal speech. A transmucosal pharyngeal myotomy may represent an alternative for patients with speech failure after tracheoesophageal puncture.