Changes to speech

The ability to talk can be affected following surgery and radiation therapy, either by the treatment itself or by side effects such as a tracheostomy or swelling after surgery. You may lose the ability to speak clearly (dysarthria) or the ability to produce sound (dysphonia). The degree and duration of any change will vary depending on the location of the tumour and treatment.

Talking will take time and practice – it’s natural to feel distressed, frustrated and angry at times. You will need to get used to the way your new voice sounds. Use the National Relay Service to make phone calls,

Managing changes in speech

  • Try non-verbal ways to communicate – gesture, point, nod, smile, mouth words or ring a bell to call people.
  • Use a notepad or technology (computer, tablet, mobile phone) to write notes.
  • Ask people to speak louder or confirm the message to check what you heard was correct.
  • Encourage family and friends to be honest if they don’t understand you and to learn new ways to communicate with you.
  • Work with a speech pathologist to improve your speech and learn strategies for communicating with your family and friends (see Restoring speech after a laryngectomy).
  • Speak to a counsellor or psychologist about any problems or frustrations.

Restoring speech after a laryngectomy

If changes to your voice are long-term, such as after a total laryngectomy, a speech pathologist may use a variety of methods to help you use your voice again.

Mechanical speech – A battery-powered device called an electrolarynx is used to create a mechanical voice. The device is held against the neck or cheek or placed inside the mouth. You press a button on the device to make a vibrating sound.

Tracheoesophageal puncture (TEP) speech – Your surgeon creates a puncture between your trachea and oesophagus. A small voice prosthesis (or valve) is inserted to direct air from your trachea into the oesophagus. This creates a low-pitch, “throaty” voice. TEP is usually done during the laryngectomy or later.

Oesophageal speech – You swallow air and force it up through your oesophagus to produce a low-pitched burp. This technique can be difficult and requires training.

This information was last reviewed in May 2017
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