Total laryngectomy is a major surgical procedure with life-changing consequences. As a result of the surgery, the upper and lower airways are disconnected, the natural voice is lost, and patients breathe through a tracheostoma in the neck. Tracheoesophageal speech is the most common speech rehabilitation technique. Due to the lack of air volume, and the amount of muscle tension in the esophagus, some patients may suffer from a hyper- or hypo-tonic voice, resulting in less intelligible speech. To communicate as intelligibly as possible, patients likely adapt their verbal and nonverbal communication to their physical disabilities. The current study aimed to explore the compensation techniques in verbal and nonverbal communication after total laryngectomy focusing on the complexity of grammar and the use of co-speech gestures. We analyzed previously obtained interviews of eight laryngectomized women on the syntactic complexity in speech and the use and type of co-speech gestures. Results were compared with analyses of productions by healthy controls. We found that laryngectomized women reduce the syntactic complexity of their speech, and use nonverbal gestures in their communication. Further research is needed with systematically obtained data and more suitable match-groups. Index Terms: total laryngectomy, communication, speech, co-speech gestures, grammar, compensation