It is well established that if a vibrating column of air is introduced into the esophagus or pharynx, understandable speech can be formed by the oral cavity. Several methods of creating a tracheo-esophageal fistula have been attempted in the laryngectomized patient; however all have been beset by stenosis, aspiration, or both. An esophageal tube anastomosed to an opening in the trachea has been constructed in dogs to provide an air shunt. Stenosis is avoided by using a full-thickness esophageal flap, and aspiration is prevented by using a narrow lumen tube which runs upward from the esophageal opening. There has been no evidence of aspiration or shunt closure for one year.
Calcaterra TC, Jafek BW. Tracheo-Esophageal Shunt for Speech Rehabilitation After Total Laryngectomy. Arch Otolaryngol. 1971;94(2):124–128. doi:10.1001/archotol.1971.00770070360007
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