A deep neck abscess and cervical osteomyelitis developed in a 37-year-old laryngectomy patient 6 weeks after TE puncture and insertion of a voice button prosthesis. This complication resulted in voice prosthesis failure, multiple surgical procedures, 83 days of hospitalization while receiving parenteral antibiotics, and exposure to potentially fatal complications. Some factors contributing to this problem may include an improperly fitting prosthesis, rough insertion of the prosthesis, and altered tissue response to infection from radiation therapy and surgery.