Speech rehabilitation after laryngectomy with the amatsu tracheoesophageal shunt

The Amatsu vocal rehabilitation technique is a tracheoesophageal shunt using a posterior tracheal flap associated with a sphincter made of esophageal muscular wall. Since march 1991 the procedure was done in 33 men and 2 women, ages ranging from 30 to 78 years. Previous radiotherapy, hypopharynx lesions, need for postoperative radiotherapy or use of myocutaneous flap were not considered contraindications. Vocalization was achieved in 76% of our patients and the quality was considered superior than that obtained by the esophageal voice. In only one case the shunt had to be closed surgically because of aspiration. In conclusion, the Amatsu tracheoesophageal shunt is an inexpensive technique that obtain a good quality of vocal rehabilitation in a high percentage of patients, it has few complications and it should be considered for all candidates to a laryngectomy, mainly for those with a good prognosis and a desire to return to their social environment.