The electrolarynx has been used for decades by laryngectomees for speech communication following the loss of the larynx. More recent advancements in laryngectomy rehabilitation, however, have resulted in the evolution of tracheoesophageal speech, which is now the most common form of voice restoration in this practice.
Why Use an Electrolarynx?
In this practice, the vast majority of patients will undergo tracheoesophageal voice restoration, utilizing a TEP to restore speech communication. Despite this, it is important that every laryngectomee learn to use an electrolarynx as an alternate means of communication. Although never anticipated, there may be times when TE speech is not possible. Being able to use an electrolarynx ensures your continued ability to communicate orally. This is particularly important in urgent or emergency situations.
Since the state of Texas has the STAP voucher system, every patient is able to acquire an electrolarynx at no cost to them. For this reason, regardless of the means of oral communication you plan to use regularly, the SLP staff will assist you in the process of acquiring the electrolarynx as well as ensuring you are able to use it properly.
There are also very specific instances where TE speech is not/may not be possible:
• Post-Operative Recovery
Even if you are provided with a tracheoesophageal puncture at the time of your laryngectomy surgery, it will be necessary for a certain amount of healing and recovery to take place before you are able to use your TEP. Additionally, it may take some time and/or practice for this to be an effective and reliable means of oral communication.
• Flap Reconstruction
In some cases, a laryngectomy patient may require more extensive reconstruction, including a “donor” flap or graft that is used to replace/reconstruct a portion of the throat. If this is the case, a tracheoesophageal puncture will not be made during the laryngectomy surgery. It is most important that the new donor flap heal properly before a puncture is placed. Flap reconstruction does not mean you will not be able to undergo tracheoesophageal voice restoration, but puncture/prosthesis placement will be post-poned for several weeks until your doctor is sure the flap reconstruction has healed well.
In this case, the electrolarynx will typically be the only means of oral communication for the weeks prior to receiving the TE puncture.
Tips for Using an Electrolarynx
When learning to use this device, there are some tips that you may find helpful in remembering as you develop your new speech:
• “Head” Placement
The head of the electrolarynx must be in full contact with neck tissue. If a portion of the head is exposed to air (not in contact with the neck), less tone will be transmitted into the throat and a “buzz” will be emitted into the air. This will not allow for audible or understandable speech. If the device seems to be buzzing too much, check to ensure the head is completely contacting the skins surface. Even beard whiskers can interfere with proper contact so its best to keep the neck/beard shaved.
• Proper Positioning
For every laryngectomy, there will be areas of more/less resonance in the throat. This is determined mostly by the density or thickness of the neck tissues as well as the “space” in the throat region where the device is placed. The most ideal placement is generally in a place where the neck tissues are thinner and somewhat soft, at a level where there is space in the throat to resonate. In general, the more dense or “tough” the neck tissues are, the harder it will be to achieve a nice tone.
• The “Sweet Spot”
In golf, tennis and other sports, the “sweet spot” refers to the perfect point of contact between the ball and the club or racket. At this point, there is the best potential for the perfect shot. With an electrolarynx, there will also be a “sweet spot” or position where the EL produces the best resonant tone. The SLP staff will try various positions around your neck, under the chin and even on the cheek to find your own personal “sweet spot.” This spot is rarely the same from person to person so it is important to find your own unique spot and do NOT model after another person.
• The Big Mouth Effect
Although you are able to speak in the same manner as before, the typical EL user will need to change their speech pattern somewhat in order to be well understood. It is important to remember that the human ear is designed to listen and understand natural speech. A mechanical tone to the speech present a challenge for the listener, especially those with a hearing impairment. As a result, it is often helpful to articulate more precisely when using an electrolarynx. The SLP staff refers to this as the “big mouth” approach. In a general sense, these are the basic principles:
1. SLOW DOWN: You will need to speak slower when using an EL. This allows your listener to better adjust to hearing/understanding a mechanical tone. This does not mean you need to speak in an unnaturally slow way or staccato fashion (short and choppy). Rather simply slow your speech down slightly. This is also helpful in assisting allowing you time for more precise articulation.
2. SPEAK CLEARLY and OVER-ARTICULATE: Very often, people are accustomed to speaking in a comfortable manner that also includes slurring words together or rushing between sounds. When using an EL, it is important to pronounce your words clearly and concisely. Take your time to articulate each sound. At first, this may seem tedious but the more you practice, this will soon feel very natural!
3. OPEN YOUR MOUTH: Very often, especially in certain regional dialects (including Texas), the local speech pattern results in speaking with a rather closed mouth. Texas men are notorious for not moving there lips too much when they speak!! That is how the Texas drawl came to be! But when learning to speak with an electrolarynx, it is very important to use a nice open mouth when pronouncing your words. This will ensure the clearest speech pattern possible.
GZK101 – Griffin Laboratories Trutone Electrolarynx,
Servox Digital Electronic Speech Device
NuVois I Electronic Larynx
SolaTone Plus Electrolarynx Speech Aid
Romet Model R120 Electronic Larynx
TruTone Electronic Artificial Larynx
TruTone Plus Electronic Artificial Larynx
Romet Model R310 Electronic Larynx
Romet Electronic Larynx Model R210
IHEL1000 – Blom-Singer Electrolarynx Digital Speech Aid
Hands Free Holder for Trutone Electrolarynx
NuVois Electronic Larynx Spare