Objective To study the changes of morphology and mucosa functions of nasal cavity after total laryngectomy in patients suffering from laryngeal carcinoma. Methods 20 patients suffering from laryngeal carcinoma and treated with total laryngectomy from Jul. 2009 to Jul. 2000 were enrolled. Before and after total laryngectomy, all patients received saccharin test and electron nasopharyngoscope examination, meanwhile 15 of them received scanning electron microscopy of the nasal mucosa. Results ① Electron nasopharyngoscope examination demonstrated relative wide nasal cavity with unchanged general structures 3 months after surgery, atrophic structures, thin, rigid and pale mucosa with watery secretion 18 months postoperatively. ② The saccharin test showed that the ciliary transmission time at 3 months after surgery was slightly shorter than that of preoperation without statistically significant difference, while that at 18 months after surgery was much longer than the preoperative one (P<0.05). ③ The examination of electron microscope demonstrated that the ultrastructures of nasal mucosa and cilia kept undamaged at 3 months after surgery; and at 18 months after operation, the ultrastructure of nasal mucosa was impaired, characterized by sparseness and loss of cilia, disordered cilia array with different and inverse orientation, cilia dumping and clustering. Conclusion In patients after total laryngectomy, the general structure, ultrastructure and mucociliary clearance function of nasal cavity keep normal within 3 months after surgery. With the prolongation of postoperative duration, atrophic change of the general structure, ultrastructure impairment and prominent decline of mucociliary clearance function will occur.