Modified asai procedure

To develop a method of establishing speech in the patient who could not develop esophageal speech after laryngectomy, a modification of the Asai procedure with a specially designed Silastic prosthesis was used in three female patients. All three patients had immediate return of voice and were pleased initially. Eventually, however, because of complicating factors, all three operations were revised back to the original state and the new method considered as a failure. The reason for this presentation is to stimulate other surgeons to consider the problem further and perhaps to glean from this technique some useful considerations.