Surgical speech rehabilitation after total laryngectomy by the three procedures of Prof. Staffieri is based on the principle of establishing a short fistula lined by pharyngeal mucosa between trachea and hypopharynx. It permits voluntary air pressure control for voice production while preventing aspiration during deglutition. In a single-stage procedure the "neoglottis phonatoria" is established on the occasion of the laryngectomy at the top of the trachea. In cases of prevoius laryngectomy a shunt is established between the trachea dorsal wall and the oesophagus, either cranially (direct internal shunt) or more caudally (retrograde internal shunt). The three methods are described, and the one-way function of the different fistulas are demonstrated. The percentage of successful voice restorations that remain free from swallowing difficulties in 700 patients, subjected to these techniques in Europe and Overseas is between 60 and 90%. The main advantage of this operation, which is easy to perform and without risk for the patient, is the wide oncologic spectrum of indications.