A downward facing tissue flap from the posterior wall of trachea and the anterior wall of esophagus was made after total laryngectomy, then inserted into the esophageal cavity to form a fistula. In order to cover the fistular opening and also to avoid food aspiration, 2-3 mm of the valvular tip must be kept. Of 11 cases undergoing this operation, 5 patients obtained a good vocalization, a comparative dysphonia occurred in 3 patients and another 3 patients got a esophageal voice due to shut of their fistulae. We consider this method a rather simple one, vocalization can recover easily without any special training, and also there were few complications will emerge.