Not being able to speak is a great loss for anyone who has had a laryngectomy. It can take a long time for you and your family and friends to adjust to this change. However, there are several methods to help people with a laryngectomy to produce sound and learn to speak again.

A speech and language therapist will usually visit you before your operation to discuss the different ways of communicating. You may be able to meet someone who has had similar surgery or watch videos of people talking after they have had a laryngectomy. Some people find this very helpful, while other people prefer to have written information. The method of speech you can use will depend on the type of surgery you have, your individual circumstances and what you prefer.

During the laryngectomy operation, a channel (tract) is made through the wall between the windpipe and the gullet (oesophagus). A valve (voice prosthesis) is inserted into the opening. When you breathe out and cover the tracheostomy with a thumb or finger, air from the lungs passes through the valve and vibrates in your gullet to produce a voice. As with normal speech, movements of your lips, cheeks and tongue shape the sound into words.

The valve also prevents food and fluids from passing into the windpipe. It may take a while to learn how to speak with a voice prosthesis. The voice can sound quite natural, although in women it’s usually a lower pitch than before the operation.

There are several types of valve. The most common examples are BlomSinger, Groningen and Provox valves. Some types are completely within the stoma and are known as in-dwelling valves. They need to be changed by a doctor, speech and language therapist or nurse. Others (ex-dwelling) have a strap outside the stoma and can be changed by you or your carer. There are benefits and disadvantages of each type and these should be discussed with you by a doctor, specialist nurse or speech and language therapist.

Another method is a technique known as oesophageal speech. As soon as you have recovered from a laryngectomy, you can be taught to use this technique. Air is squeezed into the gullet from the mouth. As the air moves up from the gullet, it vibrates and can be used to give a voice. Movements of the lips, cheeks and tongue shape the sound into words.

Some people find it easy to make oesophageal speech, or use a voice prosthesis, but other people find it more difficult. It’s usually best to practise little and often. A speech and language therapist will be able to help you have the best speech as comfortably as possible. They will also help you to use your new way of talking for social situations and on the telephone.

At least two-thirds of people with a laryngectomy are able to use a voice prosthesis or oesophageal speech. Some people can go back to jobs which involve a lot of talking: for example, telephone operators and salespeople.

Several types of electronic aids are available to help produce a voice. While you are in hospital you may be given one to use while you practice developing your new voice. You may choose to use it as your main way of communicating. The electronic devices are held next to the neck under the chin and make sound vibrations that can be formed into speech. Your speech and language therapist will help you to choose the type that suits you best. They will show you how to use it and look after it.

To use an aid properly or to have good oesophageal speech takes training from a speech and language therapist. You’ll need plenty of practice, but it’s well worth the effort.

Most people with laryngectomy can learn to speak effectively using one of the techniques described here. Some people also like to use electronic keyboards (like small typewriters) to communicate. Palm-tops or using your mobile phone to create a text message for other people to read can also be effective. Several different types of writing device are available. Your speech and language therapist will be able to show you these.