Speech requires a source of sound waves (vibrations) and a means of shaping those vibrations into words. The vocal cords normally provide the vibrations, which are then shaped into words by the tongue, palate, and lips. People whose vocal cords have been removed can regain their voice if a new source of sound vibrations can be provided because their tongue, palate, and lips remain able to shape these new vibrations into words.
There are three ways that people with no larynx can produce sound vibrations. In all three techniques, sound changes into speech through the throat (pharynx), palate, tongue, teeth, and lips.
Esophageal speech
No surgery or mechanical accessories required
Person taught to swallow air into the esophagus (pathway from the throat to the stomach) and expel the air (as in a belch) to produce a sound
Difficult to learn and may be hard for other people to understand
Tracheoesophageal puncture
One-way valve inserted in surgically created hole between the windpipe (trachea) and the esophagus
Air enters the windpipe (trachea) through an opening in the front of the neck (stoma)
Speech produced with air diverted into the esophagus through the valve while the person exhales
Requires significant practice and training
Often eventually produces easy and fluent speech
Valve requires daily cleaning and needs to be replaced after many months
With some valves, person must block the opening in the windpipe with a finger to speak
Risk of fluids or food accidentally entering the windpipe if the valve malfunctions
Electrolarynx
Battery-powered vibrating device that acts as a sound source when held against the neck
Produces an artificial, mechanical sound
Easier to use and understand than esophageal speech
Requires batteries and must be carried with the person
Requires little or no training
Can carry a great deal of social stigma for many people
