Introduction The human voice is an extraordinary instrument as the voice is the unique identification work of each individual. A speaker can evoke a wide range of emotions and mental images through subtle changes in vocal timbre, volume, or subtle nuances in inflections. A person's voice is also a sensitive barometer of physical and emotional health. Any damage and injury to the larynx will also hinder the voice. For example, laryngeal cancer which may require surgery to save people's lives and in some cases requires removal of the entire voice box, an operation known as a total laryngectomy. Before undergoing surgery, pre-laryngectomy counseling by a speech pathologist plays a significant role. This will provide the option of rehabilitation after surgery and will help the client and their family prepare mentally, physically and emotionally for surgery and after surgery. Total laryngectomy results in physical and functional changes that can affect emotional well-being and some of the most basic functions of life, including breathing, swallowing and communication. Patients undergoing total laryngectomy experience decreased quality of life compared to patients undergoing partial laryngectomy or healthy individuals. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an original essay Therefore, vocal rehabilitation is one of the most difficult challenges these patients have to overcome. The speech-language pathologist should explain to the client and his or her family the most appropriate method of voice rehabilitation, which can help the client maintain realistic expectations from the device. If the client fails to maintain realistic expectations or has excessive expectations, this may demotivate them to use the rehabilitation method and will have a negative impact on their quality of life. Need of the Study: In our experience most of the clients get demotivated to use voice rehabilitation method after total laryngectomy due to many problems. Since many studies have reported that artificial larynx is one of the best and easiest rehabilitation options after total laryngectomy, yet many patients refuse to use it, so there is a lack of studies to explore the various factors that lead to rejecting artificial larynx as a vocal tool . rehabilitation option. The AIMpresent study aims to explore the level of acceptance of the artificial larynx between two cases of total laryngectomy. Methods: In this article we present two laryngectomy cases who underwent total laryngectomy but refused to use the artificial larynx as a voice rehabilitation option. To assess their self-perception and quality of life we ​​conducted a detailed client history and medical outcome study questionnaire (McHorney et al., 1994). The client was also provided with a questionnaire consisting of 10 questions relating to pre-operative and post-operative consultation. This questionnaire was developed by the authors and validated by 2 speech therapists who have worked in the same area for the last 10 years. The clinician also interviewed the client's family member to assess the emotional and psychological impact of the client's problem on the family. The same was also discussed with the surgeon to assess the surgeons' perception. Case Studies: Case A: Geriatric male client aged 63 years reported to client that he was unable to speak due to total laryngectomy. The client was diagnosed in 2016 with carcinoma of the.