Esophageal Speech

A learned method to restore verbal communication for people who have undergone LARYNGECTOMY (surgical removal of the larynx, or voice box). When the THROAT is intact, air coming out of the LUNGS passes through the VOCAL CORDS and other structures of the larynx, generating sound vibrations that travel to the MOUTH. The mouth then forms these vibrations into words. Laryngectomy removes the throat; air instead enters and leaves the TRACHEA through a surgically created opening, or stoma. For esophageal speech, the person takes air into the mouth and swallows it, which sends the air into the ESOPHAGUS (tube that carries food to the STOMACH). When the esophagus expels the air back into the mouth, the force of the moving air generates sound in the form of a burp or belch. The mouth then forms these bursts of air into words. The technique takes considerable practice; however, it is possible produce a fairly natural voice, although certain sounds may be difficult to form and understand.

Tracheoesophageal speech is a variation of esophageal speech in which the surgeon creates an opening between the trachea and the esophagus at the point of the stoma, called a tracheoesophageal puncture, and inserts a small shunt (connecting tube) with a one-way valve. The person then learns to force air from the trachea into the esophagus instead of taking air in through the mouth and forcing it into the esophagus. This is somewhat more natural and many people find it an easier technique to master.