How a Total Laryngectomy Affects Speech

A total laryngectomy involves the 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.

Currently, there are three main types of alaryngeal (without a larynx) speech: electrolarynx, esophageal speech, and tracheoesophageal speech. 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, as when 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. Electrolaryngeal, esophageal and tracheo-esophageal speech will not help this part of a speech problem, but instead attempt to recreate the sound production that previously came from the larynx.