In the 13 years from 2005 to 2018, we have performed tracheoesophageal puncture （TEP） surgery along with Provox voice prosthesis insertion for 266 patients after total laryngectomy or total laryngo-pharyngectomy due to larynx or hypopharynx cancer, and conducted pre/post-operative instructions for those patients. During the pre-operative period, we observe and assess the patient’s adherence to our instructions as well as their self-management capability for daily maintenance after TEP. During the post-operative instruction, it is important to teach the patient how to use a voice prosthesis cleaning brush to make sure they do not break the one-way valve of the Provox, which can easily happen. A clear and thorough explanation is also considered very important.