Speech After a Total Laryngectomy
As stated in the web page describing a total laryngectomy, this operation involves a complete removal of the larynx (voice box) and with it the vocal folds that normally produce speech sounds. Instead of breathing through the mouth, an individual with a laryngectomy will breathe through a permanent opening in the neck called a stoma. In order to communicate, an entire new type of speech will need to be learned.
At the current time there are three main types of alaryngeal ("without a larynx") speech: electrolarynx, esophageal speech, and tracheoesophageal speech. Each is described in the pages below.
It is important to remember that speech requires not only a larynx, but also fine control of the vocal tract. In some operations for laryngeal cancer, portions of the vocal tract must also be removed. For example, some large laryngeal cancers extend into the tongue. Loss of the tongue or other parts of the vocal tract can severely affect our ability to enunciate certain sounds. The devices below will not help this part of a speech problem, but instead only attempt to recreate the sound production that previously came from the larynx.
Examples of two different types of alaryngeal speech are given here. In this segment (a .WAV format file, about 360k in length) a woman who has had a laryngectomy first speaks using her electrolarynx, and then uses tracheo-esopagheal speech.
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