Dr. Bruce Pearson described near-total laryngectomy (NTL) in 1981¹ a procedure which creates a biological shunt between the airway and the neopharynx to restore speech. Unlike other biological shunts, this is a dynamic myomucosal shunt which has universal applicability as seen by various series published from around the world.^2-11 We feel that the NTL procedure is oncologically safe and can provide a serviceable, prosthesis free voice and should be considered as a sound treatment option in advanced but lateralized cancers of the laryngopharynx. NTL has been described extensively in literature but we would like to highlight in this technical note a few modifications which we have found to be suitable and easily applicable by surgeons who regularly perform a total laryngectomy. We feel strongly that each and every surgeon who intends to treat laryngopharyngeal cancer should be well versed in this technique. A NTL shunt performed in a suitable patient gives the ability to phonate at will and makes the patient independent of a medical professional since the shunt is permanent and maintenance free.