The loss of voice following total laryngectomy is a severe blow to the patient's functional and psychological well-being. Numerous attempts have been made to restore the voice with only limited success. The tracheoesophageal puncture with insertion of the voice prosthesis is a major development in neoglottic reconstruction. In authors' experience in the tracheoesophageal puncture, the success rate for fluent and intelligible speech was 62.5% and for willingness and ability to maintain the voice prosthesis was 41.7%. Our results have not been satisfactory. However, psychological gain and neoglottis from the tracheoesophageal puncture may be helpful for voice restoration by esophageal speech.