Between December 1985 and December 1988, 34 patients with total laryngectomy had their voice restored by creation of tracheoesophageal fistula. A shunt was created in 13 cases of total laryngectomy. In 21 others, the technique used was tracheosophageal puncture with placement of a Blom-Singer prosthesis. This puncture was carried out either at the time of the laryngectomy or a few weeks later, or when production of esophageal voice failed. Results were assessed on the basis of criteria such as quality of voice, its use and the patient's autonomy. Indications for both procedures, their respective limits and difficulties are exposed. Immediate results following voice recovery were satisfactory in 82% of cases.