A group of 122 patients that underwent a total laryngectomy and phonatory prosthesis surgery are evaluated after five years follow up. We compared three different techniques. 1) Herrmann technique; 2) total laryngectomy and inferior pharyngeal constrictor myotomy, and 3) classic total laryngectomy. Failures and complications are analyzed. A functional evaluation of the patients is made by means of oesophageal manometry and pharyngo-oesopyhageal isotopic transport. Voice quality is assessed in each group. As a conclusion inferior pharyngeal constrictor myotomy is very positively evaluated.