A guide for patients and families
How to communicate after a laryngectomy
After a total laryngectomy, a person hears, thinks and feels just as before, but no longer has vocal cords. There are three ways to speak with a voice again, and while they are learned there are other ways to communicate. This guide summarizes the options. The decision is always made with the surgeon and the speech-language pathologist.
The first days: writing, pointing and apps that speak
Until the doctor approves starting voice therapy, people usually communicate in writing: a notepad, a whiteboard or a phone.
Text-to-speech apps also help at this stage. In a University of Michigan study of hospitalized patients who had lost their voice after a tracheostomy or laryngectomy, those reporting difficulty communicating dropped from 89% to 53% after using a tablet with such an app.
The three ways to speak with a voice again
Each has advantages and takes practice. Many people combine more than one.
- Tracheoesophageal voice prosthesisIt is placed in a small opening between the trachea and the esophagus, during surgery or later. A one-way valve lets air through to produce voice and keeps food and liquid out. For most patients it is the preferred option.
- ElectrolarynxA battery-powered device held against the neck that creates a vibration the mouth turns into words. Everyone with a total laryngectomy is advised to learn it, as a main or backup method. Practice can start in the hospital, and it even works on the phone.
- Esophageal speechNo device needed: you learn to bring air into the esophagus and release it to make sound. It is hard and usually takes months of practice; according to Weill Cornell Medicine, about 30% of patients achieve functional esophageal speech.
If surgery is scheduled: save your own voice
Before the operation, you can record your own voice to later create a personal synthetic voice (voice banking). A Charles University study of total laryngectomy patients concluded it should be offered to every eligible patient, although few used it in the first weeks. If you or your relative have surgery scheduled, ask the medical team early.
Tips for conversations at home
- Give timeWait until they finish; don't complete their sentences unless they ask.
- Yes-or-no questionsWhen they are tired, questions answered with a gesture help.
- Less noiseTurn off the TV and talk face to face, in good light.
- A backup planAlways keep a notepad or phone at hand, in case the prosthesis or device fails.
Where Tocavox helps
Tocavox does not replace voice rehabilitation. It is a support: on the days when speaking is not yet possible, as a backup when the voice tires or the device fails, and in noisy places. You tap a phrase and your phone says it out loud, in a natural voice. It is free and ad-free.
Frequently asked questions
Can a person speak again after a laryngectomy?
Yes. There are three ways to speak with a voice again: the tracheoesophageal voice prosthesis, the electrolarynx and esophageal speech. The medical team and the speech-language pathologist help choose the right one.
What is the best way to speak after a laryngectomy?
For most patients, the tracheoesophageal voice prosthesis is the preferred option. Even so, learning the electrolarynx as a backup is recommended. The decision is individual and made with the medical team.
How long does it take to learn esophageal speech?
It usually takes months of practice with a speech-language pathologist, and not everyone achieves it: about 30% reach functional esophageal speech, according to Weill Cornell Medicine.
How does someone communicate right after surgery?
In the first days, in writing, with gestures or with a text-to-speech app, until the doctor approves starting voice therapy.
Can you keep your own voice?
If surgery is scheduled, you can record your voice beforehand to later create a personal synthetic voice. Ask the medical team well in advance.
Sources
- ASHA · Communication After Total Laryngectomy
- Weill Cornell Medicine · Alaryngeal Voice Rehabilitation
- Cedars-Sinai · Learning to Speak Again After Laryngeal Surgery
- University of Michigan · Effect of Augmentative Technology on Communication and Quality of Life After Tracheostomy or Total Laryngectomy
- Biomedical Papers (2021) · Text-to-speech synthesis as an alternative communication means after total laryngectomy
- Revista de Investigación en Logopedia · Modelos de producción de voz después de una laringectomía total
This guide is for information only and does not replace care from your doctor or speech-language pathologist. · Updated October 10, 2026