With the in-depth research on the pathological mechanism of laryngeal cancer and the development and improvement of laryngeal cancer surgery and surgical skills, in addition to the classic laryngeal cancer surgical procedures, laryngeal vertical subtotal resection epiglottis repair (Tucker surgery), cricoid cartilage epiglottis anastomosis (CHEP) and cricoid cartilage epiglottis anastomosis (CHP) are gradually matured in clinical application, but some patients with T3 and T4 acoustic hilar laryngeal cancer However, some patients with T3 and T4 laryngeal cancer still have to undergo total laryngectomy. Intuitively, it sounds like the laryngectomy will result in the loss of articulatory function and the loss of normal speech and communication ability. In fact, this is not the case. As you know, the human articulatory organs consist of the following three parts: the power part of the lungs and trachea, the articulatory organ larynx, and the resonance/regulation organs nasopharynx, oropharynx and laryngopharynx. Therefore, if the laryngeal body is removed, only the articulatory organ larynx is lost, while the other two major components are still present. Therefore, in the preoperative conversation with the patient and the family, it should be explained that the larynx is lost after surgery, but not the articulation. Because, patients with total laryngectomy can restore the function of speech communication through the following methods: a. Esophageal pronunciation The comedian Li Wenhua, who is well known to the old generation, is a total laryngectomy patient, and he used esophageal pronunciation to greet his listeners on the radio program. When asked what motivated him to learn esophageal pronunciation and to speak so well, he said in continuous words, “In order to bring up my grandchildren, I have to speak. When he was asked what motivated him to learn esophageal pronunciation and speak so well, he said in a succession of resounding words, “To bring up my grandchildren, so I have to speak”. Another example is even more vivid. Once I took a cab from Tongji to Xiehe, I heard the driver speak with a special voice, so I took a sideways glance and asked him, but he was a laryngeal patient with esophageal articulation, which is really admirable. The basic principle is to use the esophagus to store a certain amount of air and force the air out from the esophagus with the help of intrathoracic pressure, just like burping, to impact the upper end of the esophagus or the mucous membrane of the pharynx and pronounce. Practice method: When inhaling, use the negative pressure in the esophagus and move the tongue to the back to press the air into the esophagus, then practice the abdominal muscle contraction to make the diaphragm rise, increase the intrathoracic pressure, compress the esophagus and expel the air from the upper mouth to pronounce. Practitioners must go through two to three weeks of training, and most patients can achieve more satisfactory results. At present, many places in China have laryngeal revoicing training courses, especially some large hospitals in the north, which can make laryngeal patients regain their new voice and return to the society. The main disadvantage of esophageal pronunciation is that the pronunciation time is more short and the coherence is poor. However, some people can still sing after practice, and the above two cases are clear evidence. Artificial electronic larynx is divided into transoral, transcervical and intraoral implants. It is a hand-held device with a plastic vibrating membrane. The end of the larynx is placed in the neck so that the plastic mold can replicate the movement of the vocal cords. Some patients need some time to train to place the electronic larynx in the right position in the neck and to achieve clear articulation also needs some training, although the sound coming from the electronic larynx is a mechanical sound. The advantages of the electronic larynx: 1. it can be used for long periods of time and can be easily understood; 2. no other care is required, as long as the electronic larynx is placed in the neck; 3. the electronic larynx can be adapted to basically anyone, although the method of neck surgery may be different, and some cannot be used due to wound scar formation. There is a promotional ad for the electronic larynx inside the back cover of the Journal of Clinical Otolaryngology Head and Neck Surgery, and there are some from other manufacturers, which can be found online. It should be noted that electronic larynx is a commodity after all, the quality and price varies, the specific patient to choose. Third, the pronunciation button pronunciation button for a tracheoesophageal when the need to use the valve type structure. In order to reroute the air into the esophagus, a fistula is made in the middle of the trachea and esophagus, and a one-way valve is placed on the fistula to stop the food in the esophagus from entering the trachea, and this device is generally called a sound prosthesis. The procedure can be performed either at the same time as or after a total laryngectomy. Currently, the more commonly used is the Blom CSinger voice prosthesis. During phonation, the tracheostomy port is blocked by the finger, and the airflow enters the esophagus through the pharyngeal tube. The airflow impacts the newly formed “vocal folds” in the pharynx and esophagus, and the voice is produced with the assistance of all the preserved speech organs. The voice prosthesis must be removed regularly for cleaning and care, especially when inserting the prosthesis, which requires some skill. There are also disadvantages such as air leakage, aging, low voice and low air flow, misaspiration, mispharyngeal and rejection of the body, etc. In addition, the prosthesis may come out, fall into the bronchus, choking and pneumonia. It is an articulation device that introduces the airflow in the tracheostomy opening directly into the mouth to pronounce. The advantages are obvious, no battery is needed, and the sound is natural because it is its own speech organ, and breathing and speech can be effectively coordinated. The disadvantage is that it requires hand support and the fistula must be closed well, and the range of sound variation is small and continuous speech is not possible.