Losing your voice if you have had your larynx completely removed (a total laryngectomy) is likely to be a shock in the beginning. But members of your healthcare team will support you during this time. Without your larynx, you can’t make sounds the same way. Any individual who’s had this form of surgery can learn to communicate.
The main aim is to keep your life as normal as possible. This means helping you to feel confident speaking with people in everyday situations, including using the telephone. Some options are likely to be better suited to your work and home situation than others.
There are several different methods for communicating.
Nonverbal communication includes gestures, facial expressions, and picture boards, or mouthing words without using your voice.
You might find it useful to carry a small notebook and pen after your surgery so that you can write notes to people if you need to. Other ways to communicate are:
- laptop computers
- electronic notebooks
Several small portable machines are available. Your speech and language therapist can advise you on which might suit you best.
You can also speak to someone who uses the same type of communication that you have chosen. The National Association of Laryngectomee Clubs (NALC) is an organisation that offers support. They can give advice before and after surgery to remove the larynx.
Every laryngectomy patient must use nonverbal communication at some point during the physical recovery process.
Some people learn “oesophageal speech.” In this form of speech, a person uses air from the mouth and traps it in the throat and upper oesophagus. The controlled release of air produces vibrations and speech can be performed using the mouth, tongue, and lips. Oesophageal speech can be difficult to learn, but it’s effective. The person speaks Spanish but the video has subtitles in English.
This type of speech can be used as soon as 3-5 days after surgery. You place the device against your neck or use an adapter for your mouth. It enhances your speech when you talk. The voice produced will sound automated and robotic but it is easy to learn and use. It can serve as a good short-term solution for some people and can remain a long-term solution as well. Please watch the video for very helpful information
TEP speech uses the surgically created tracheoesophageal puncture (TEP). A one-way valve is inserted through the TEP. This valve allows for air from the trachea to enter the esophagus, but material from the esophagus, like food and liquids, can’t enter the lungs. Often these devices are attached to a voice prosthesis, which helps you to speak. The prosthesis sits over the stoma.
With training, by covering the hole from the outside, people can learn to direct air from the lungs into the esophagus so that the vibrations can be heard as speech. “Hands free” voice prostheses have been developed which work based on varying amounts of air pressure to form speech. If interested, ask your doctor to see if a voice prosthesis is right for you.