Total laryngectomy (TL) is an extensive surgical procedure, reserved for patients with advanced laryngeal carcinoma, staged as T3 and T4 by the TNM classification. The larynx, an anatomically complex organ by its structure, connects the upper and lower respiratory tract, and therefore it serves three important functions in humans: protection of the lower airways, facilitation of respiration and voice production. Following complete removal of the larynx and nearby structures, the patient has to adapt to new forms of living; breathing trough a stoma (permanent aperture in the neck), inhaling unprepared air directly into the trachea and lungs, loss of smell and taste, and most importantly, being voiceless. The loss of vocal communication severely disrupts interactions with others and leads to social withdrawal, psychological changes and a decrease in the quality of life. Since the first TL was described by Theodore Billroth in 1873, great effort has been put in finding the best option for voice resuscitation and improvement in the quality of life in laryngectomized patient. Successful voice restoration can be attained with one of three speech options: esophageal speech, electrolarynx, and, most recently, tracheoesophageal speech using an artificial valve. Esophageal speech is produced after the air has been drawn into the upper esophagus and then released in a controlled manner to vibrate the pharyngoesophageal segment (PES). An electrolarynx is an artificial, mechanical device which creates an external buzzing vibrations. By placing it on the neck, vibrations reach the throat and mouth of the user so he can convert this energy into the voice and speech. Tracheoesophageal speech with voice prosthesis is produced after expiratory air from the lungs has been drawn into the upper esophagus, directed through the voice prosthesis inserted into the fistula. The last method has become the most preferred speech method in the past decade in the world.