Speaking after a laryngectomy

Most people are able to speak again after a laryngectomy. Learning to speak can be difficult at first but ways of communicating have improved. A speech and language therapist will talk with you about these before you have your operation.

Ways to help you communicate include:

  • A voice prosthesis valve. The surgeon makes a small channel between your windpipe and gullet (oesophagus) and places a small valve in it. When you cover the stoma with your finger and breathe out, air from your lungs goes through the valve, making it vibrate to produce a sound.
  • Oesophageal speech. This is used less often nowadays. It is a way of drawing air into your gullet to help you speak. As the air moves, it vibrates to produce a voice.
  • An electrolarynx. This is an electronic aid that you hold under your chin. It makes sound vibrations that can be turned into speech.
  • Electronic keyboards. Some people prefer to type messages, whether on a keyboard, tablet or phone. Your speech and language therapist (SALT) can tell you about other writing devices as well.

Ways to speak after a laryngectomy

Most people who have had a laryngectomy are able to speak afterwards, but in a different way to before their surgery.

Learning to speak again is likely to feel distressing to start with and can be difficult to cope with, but alternative ways of communicating have improved. The type of communication you use will depend on your individual situation, your type of surgery and what you would prefer to use.

A speech and language therapist will visit you before your operation to discuss different ways of communicating. You may be able to watch videos of people talking after a laryngectomy or meet someone who has had similar surgery. Some people find this very helpful, while others prefer to have written information or to meet someone after they have had the surgery.

We have a video of a speech and language therapist and someone who has had a laryngectomy. They discuss different ways to communicate, including using a voice prosthesis valve.

Your surgeon and speech and language therapist will talk to you about putting in a small valve, called a voice prosthesis valve, at the time of your operation. This will allow you to develop a new voice after your operation.

There are other ways to help you communicate if you don’t have a valve. These include:

  • an oesophageal voice
  • an electrolarynx
  • a combination of the two methods.

Speech therapy after a laryngectomy

A speech and language therapist explains methods for speech restoration after a laryngectomy.

About our cancer information videos

Speech therapy after a laryngectomy

A speech and language therapist explains methods for speech restoration after a laryngectomy.

About our cancer information videos


Voice prosthesis valve

The surgeon makes a channel between the windpipe and the gullet (oesophagus). This is called a trachea-oesophageal puncture (TOP). During the laryngectomy operation or at a later stage, a small valve (voice prosthesis) is put into the channel. This connects the windpipe to the gullet. The valve is one-way, which prevents food and fluids from passing into the windpipe.

The position of the voice prosthesis valve between the trachea and the oesophagus
The position of the voice prosthesis valve between the trachea and the oesophagus

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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.


Oesophageal speech

Sometimes, people choose 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 use your new way of talking for social situations and on the telephone.

This technique is used less often nowadays.


Electrolarynx

There are different types of electronic aids available to help you produce a voice. You may be given one to use while you practise developing your new voice. You hold them next to your neck under the chin and they make sound vibrations that can be formed into speech. 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.


Electronic keyboards

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. There are different types of writing device available, too. Your speech and language therapist can tell you about these.

I depend on my phone and tablet to communicate, for example texting, emails, and an app that speaks what you type in. This is my main way of talking now.

Chris

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