The Hypopharyngeal Puncture
By constructing a tracheohypopharyngeal shunt in a patient who has undergone a laryngectomy, intelligible speech can be developed. In order to prevent aspiration, the use of prostheses dates back to the time of the first cancer laryngectomy performed by Billroth in 1873. The device created by Gussenbauer (1874) not only prevented aspiration, but restored the patients voice. 100 years later Mozolewski (this volume, p. 7) developed a miniature valved prosthesis that allowed rapid voice rehabilitation with minimal complications. In 1979 Blom and Singer presented an endoscopic procedure in which a midline tracheoesophageal puncture is performed. They constructed an inexpensive commercially available prosthesis which projects through the upper part of the tracheostoma and is taped to the neck. Furthermore, Herrmann and Kley (1981) as well as Panje (1981) developed silicon valves which could be inserted through the previously formed fistula tract and which are self-contained within the tracheostoma.
KeywordsIntelligible Speech Voice Prosthesis Contrast Radiography Shunt Technique Dialect Pattern
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