Tracheoesophageal puncture

A surgical procedure that creates a small opening (fistula) between the trachea and esophagus to restore voice production after total laryngectomy. A one-way valve is inserted that allows exhaled air to pass into the esophagus, where vibrations in the pharyngoesophageal segment produce sound that can be shaped into speech. TEP is considered the gold standard for voice restoration after laryngectomy, producing more natural-sounding speech than electrolarynx devices, though it requires ongoing maintenance and may not be suitable for all patients.