Oesophageal voice

The most common surgery used for the treatment of throat cancer is a total laryngectomy. In this operation, the larynx (and with it the vocal chords etc.) is removed completely. After this, the end of the trachea is sewn onto the edge of an opening cut out at the lower part of the neck, creating a breathing hole similar to that used by a whale. This hole is called tracheostoma and permits the patient to breathe through it after the operation.

The air goes from outside through the tracheostoma directly to the lungs without passing the upper respiratory organs of nose, mouth and throat. Because of that, speech is seriously impaired and the development of an oesophageal voice is thereby necessary.

The oesophageal voice is thus produced without an artificial larynx and achieved by learning to pump air from the mouth into the upper oesophagus. The oesophagus is slightly expanded. Then the air is released in a regulated manner and goes back to the mouth with simultaneous articulation of words.

The oesophageal speech is quieter and more strenuous than ‘normal speech’. Not so many words can be produced successively. Good oesophageal speakers can produce an average of 5 words per breath and 120 words per minute.

Because of the large, vibrating pharyngo-oesophageal segment, the pitch of oesophageal speech is very low; between 50 and 100 Hz. In oesophageal speech, pitch and intensity correlate: a low-pitched voice is produced with low intensity and a high-pitched voice is produced with high intensity. The production of the latter is more exhausting.

The voice of a speaker without a larynx sounds as if he or she has a cold.

Another option for restoring speech to the laryngectomy is the tracheoesophageal puncture or TEP. In this simple surgical procedure, a small puncture is made between the trachea and the esophagus, and a one-way air valve is inserted. This air supply can be used to cause vibrations in a similar manner to oesophageal speech.

An electrolarynx is a handheld device which is held against the throat, and provides vibrations to allow speech.

Related Links:

WebWhispers laryngectomee support group (http://www.webwhispers.org)