Alaryngeal Speech

1
Alaryngeal Speech

• Since the lungs can no longer expel air into the
  mouth, a person who has had a laryngectomy
  breathes through an opening in the lower neck
  called a stoma.
• The laryngectomee must also learn an entirely new
  method of speech without a larynx (alaryngeal).

2
Esophageal speech

• The patient is taught to take air into the mouth
  and swallow or force the
• air into the esophagus by locking the tongue to
  the roof of the mouth.
• When the air is forced back up into the mouth, it
  causes the walls of the
• esophagus and pharynx, as well as the returning
  air, to vibrate, causing
• a low-pitched sound. This sound is further
  changed in the mouth and
• becomes the laryngectomee's voice.
• The whole process is similar to a controlled
  belch or burp. The patient
• then forms this sound into words with the tongue,
  lips, teeth and palate,
• as do normal speakers.
• Esophageal speech costs less because
  laryngectomees don't need
• equipment to help them speak. Esophageal speech
  can also produce a
• more "normal" sounding voice but it can be
  sometimes harder to
• understand. A downside is that it is more
  difficult to learn than speech
• produced with special devices.

3
Esophageal speech
4
Injection methods

• Consonant injection rapid production of plosive
  consonants injects air into esophagus
• Glossopharyngeal press tongue presses air back
  towards esophagus
• Inhalation quick inhalation and release of air
• Swallowing same principle as glossopharyngeal
  press, during swallow

5
Tracheoesophageal Speech

• Tracheo-esophageal speech is similar to
  esophageal speech, but it uses a device to
  re-direct air from the trachea (windpipe) into
  the esophagus. This is often done through the use
  of a small shunt placed through an opening made
  between the trachea and esophagus called a
  tracheoesophageal puncture (TEP). TEP is done
  either at the time of the first surgery or at a
  later time.
• This procedure creates an opening between the
  windpipe and food pipe through a small puncture
  at the stoma site. A small one-way valve placed
  into this opening allows the patient to force air
  from their lungs into the mouth.

6
Tracheoesophageal
7
Electronic Speech

• If the laryngectomee is unable to be understood
  using esophageal speech, then an electronic
  larynx can be used to creates a clearer voice.
  The electronic amplifier is used to increase the
  volume of a person who uses esophageal speech.
• The extra-oral type of larynx looks like a
  flashlight with batteries in the handle and has a
  vibrating disc on the end. This is pressed
  against the outside of the upper neck. When a
  button is pressed, the disc vibrates, causing a
  sound to be made which travels through the soft
  tissues of the neck into the mouth. This sound
  becomes the laryngectomee's voice.
• The intra-oral type of larynx is a shirt pocket
  sized battery pack connected to a sound emitter
  by a small wire. The sound emitter is the size of
  a silver half dollar and about a half inch in
  thickness. It is held in the palm of the hand,
  and when a button is pressed, it makes a
  vibrating sound that is sent directly into the
  mouth through a small hollow plastic tube
  attached to the sound emitter. The sound becomes
  the laryngectomee's voice.

8
Electronic