A TEP is a method of communicating following a total laryngectomy surgery to remove the voice box to treat cancer. Your surgeon will create a fistula (hole) between your breathing pipe and your swallowing pipe, and implant a one-way valve with flanges on either side to hold it in your throat. When you cover your stoma and exhale, you can re-direct air through the valve into your throat. This allows vibration of the tissue in your throat to create a voice. 

Tracheoesophageal Voice Prosthesis (TEP)

You can have a TEP placed at the time of your laryngectomy surgery, or months or years afterwards as a minor secondary procedure. Your speech-language pathologist (SLP) will help you decide if and when a TEP is right for you. A TEP is a great way to get back to communicating after surgery, but there are different pros and cons. 


  • Most natural sounding voice quality
  • Easy to use
  • Option to speak “hands free” with special attachments


  • Higher level of daily maintenance than other options
  • Need for return visits to have TEP changed
  • Potential for complications that require additional visits to manage

Your SLP will teach you how to take care of your TEP and manage potential complications. To care for your TEP, you will need to clean it with a special brush every day. Over time, the valve of your TEP will wear out, and your device will leak. This means that when you eat and drink, liquids will leak through your device into your airway. When this starts, you will need to come to clinic to have your TEP changed. This is an outpatient procedure performed by your SLP that that does not require anesthesia and is usually quick and straightforward. You will likely need your TEP changed every 2-3 months.