Loss of speech and voice restoration after a laryngectomy
These days, almost everyone who has a laryngectomy is able to speak afterwards. Most people are given a voice prosthesis valve. There are other ways to help you communicate if you don’t have a valve.
A speech and language therapist will visit you before your operation to discuss different ways of communicating. You may be able to meet someone who has had similar surgery, or watch videos of people talking after a laryngectomy. Some people find this very helpful, while others prefer to have written information.
We have a video of a speech and language therapist and someone affected by cancer. They discuss different ways to communicate, including using a voice prosthesis valve.
The different ways you can communicate again after having a laryngectomy are by using:
- a voice prosthesis valve
- an oesophageal voice
- an electrolarynx
- a combination of the above methods.
During the laryngectomy operation, the surgeon makes a channel between the windpipe and the gullet (oesophagus). This is called a TOP (trachea-oesophageal puncture). During the operation or a few days later, a small one-way valve (voice prosthesis) is put into the channel to connect the windpipe to the gullet.
The valve is one-way, which prevents food and fluids from passing into the windpipe.
When you breathe out and cover your stoma with a thumb or finger, air from the lungs passes through the valve. This vibrates in your throat to produce a sound. As with normal speech, the movements of your lips, cheeks and tongue can shape the sound into words. It may take a while to learn how to speak with a voice prosthesis. The voice can sound quite natural. In women, it’s usually a lower pitch than before the operation.
Some people may have an external ‘hands-free’ valve that allows them to speak without covering the stoma with a finger. These aren’t suitable for everyone, but you can ask your cancer specialist or speech and language therapist about using one.
Some people chose to learn a technique called oesophageal speech. You can be taught this as you recover from your laryngectomy.
Air is squeezed into the oesophagus (gullet) from the mouth.
As the air moves up from the oesophagus, it vibrates and can be used to produce a voice. Movements of the lips, cheeks and tongue shape the sound into words.
Oesophageal speech has the advantage of not needing any equipment. Some people find it easy to do but others find it more difficult. It’s usually best to practise little and often. A speech and language therapist can help you develop the best speech possible. They will also help you to use your new way of talking for social situations and on the telephone.
There are different types of electronic aids available to help you produce a voice. You hold them next to your neck under the chin and they make sound vibrations that can be formed into speech. While you’re in hospital, you may be given one to use while you practise developing your new voice. Your speech and language therapist will help you choose the type that suits you best.
They’ll show you how to use it and look after it.
Some people like to use electronic keyboards (like small typewriters) to communicate. Mini-laptops, tablets or text messaging on your mobile phone can also be good methods. There are different types of writing device available, too.
Your speech and language therapist can tell you about these.