For patients requiring a laryngectomy, the prospect of losing the voice may be the most disturbing element of the operation. The patient often fears the psychological, social and economic impact upon himself or herself and family. Rapid, effective rehabilitation, particularly of speech, can greatly lessen this impact by restoring the patient to his or her full capacity. A laryngectomy is the surgical removal of the larynx. The larynx, also called the voice box, is the organ in the throat that creates speech and, in conjunction with the epiglottis, prevents food from entering the airway during swallowing. It lies between the trachea (windpipe) and the upper part of the airway known as the pharynx, forming part of the tube in the throat that carries air to and from the lungs to create speech, air from the lungs is expelled over the vocal cords in the larynx, resulting in vibrations, which are modified by the tongue, palate and lips. When the larynx is removed, the top of the trachea immediately below the larynx is attached to a permanent opening made in the throat called a stoma. It is through this opening that the laryngectomee breathes.

Understanding Voice Restoration
With persistence, a laryngectomee can learn from a speech pathologist new ways of speaking. One option, called Esophageal Speech, involves the patient learning to breathe in a manner that injects air into the pharynx, expelling it in a controlled way to form voicing. Another option, known as an Artificial Larynx, uses a speaking aid device that emits a vibrating noise and is held against the throat. By mouthing words, a laryngectomee converts the vibrations into speech. A third option, called Tracheoesophageal Puncture (TEP), is described below.

Blom-Singer® Voice Prostheses and Tracheoesophageal Puncture (TEP)
Today, advances in medical technology enable speech production by means of voice prosthesis. By creating a small surgical passage (TEP) just inside the stoma, from the back wall of the trachea into the esophageal wall, a small one-inch valved tube (voice prosthesis) can be placed into this passage to enable tracheoesophageal speech. Voice is produced by temporarily blocking the stoma, either with a finger or an adjustable tracheostoma valve, so that exhaled air from the lungs can be directed from the trachea through the prosthesis into the esophagus (where vibrations are produced) and then out through the mouth. Fluent, conversational speech may be acquired within a few days. Blom-Singer voice prostheses have set the standard in post-laryngectomy voice restoration since 1979. Drs. Blom and Singer continue to introduce innovative procedures and medical devices allowing thousands of patients worldwide to regain their ability to speak.