Tracheo-oesophageal puncture for voice restoration is now established as a common procedure in the postlaryngectomy patient. We present what we believe to be the first recorded case of osteomyelitic cervical cord compression following this technique. This is a potentially fatal complication, but diagnosis and active surgical intervention can result in recovery of full neurological function.

Certain problems have been encountered using a rigid endoscopic technique for tracheo-oesophageal puncture in voice restoration following laryngectomy. An alternative method is described using a modified curved abdominal forceps which allows quicker and more predictable access to the puncture site.

Tracheo-oesophageal puncture now has a well established role and in several units is now the principal means of speech rehabilitation following laryngectomy. Although not a difficult procedure, there are a number of problems and complications that may be encountered. With proper management these can usually be overcome and a useful voice achieved.

This study looks at those problems in a series of 119 patients and discusses their management.