In a group of 22 patients where during 1996 - 1999 total laryngectomy was performed the results of trials with substitution phonation mechanism are tested. The vocal rehabilitation involved at first training of oesophageal voice, possibly use of a vocal prosthesis Provox I. in unsuccessfully rehabilitated patients finally the use of an electrolarynx. The quality of the voice was evaluate according to Robe’s scale. A very good oesophageal voice was recorded in 10 patients (F. G. according to Robe’s scale), i.e. in 45.4% of the patients, incl. six patients (27.3%) without an oesophageal prosthesis Provox I and four (18.2%) with a vocal prosthesis. Seven patients (31.8%) speak only partly with an oesophageal voice (C, D. according to Robe), incl. six without a prosthesis (27.3%) and one with a vocal prosthesis (4.5%). From the total number of patients two use an electrolarynx and three do not use any substitution phonation mechanism. During vocal rehabilitation after total laryngectomy the following procedure is optimal: to start training of oesophageal voice, in case of failure, introduction of a vocal prosthesis and as the last resort an electrolarynx.

        Key words: laryngectomy, oesophageal voice, vocal prosthesis.