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Electrolarynx: Artificial speech aid after Total Laryngectomy

Marie Cadotte posted this on Apr 23, 2020

A total laryngectomy is a surgical process to exclude the voice box to treat the advanced stage of laryngeal and hypopharyngeal cancers. It is indeed a life-saving procedure that leaves little to no vocal ability. The ability to speak and communicate is fundamental to your existence and losing it can adversely impact the quality of life.

However, more than 100,000 people worldwide have had this surgery done and got back to leading normal lives. Over the past fifty years, thanks to scientific breakthroughs, there has been immense work on voice restoration. At present, there are three successful techniques, among which, electrolarynx is the most popular one.

What is an Electrolarynx?

An electrolarynx is also referred to as a ‘throat back’. It is a handheld external medical equipment which when placed on the neck produces vibrations. The vibration so generated is then shaped by the lips and tongue to form coherent speech. Muscles of the lips and tongue remain intact after a total laryngectomy which helps in shaping the vibration.

The sound produced can appear robotic compared to normal human speech.

How to use an Electrolarynx?

The machine is the size of an electric razor and must be placed against the neck or face skin. When turned on, the machine makes a sound. An individual would be able to make words out of these sounds using the mouth or tongue.

Some electrolarynx machines have extra features to change pitch and tone. This creates variations in the sounds produced.

Advantages of an Electrolarynx:

• Using an electrolarynx device does not require surgery.

• It is quicker and easier to learn compared to other methods.

• The other forms of methods can be anatomically challenging, especially for respiratory issues.

A speech therapist is recommended to make the usage easier to understand. They properly train an individual to talk using this device. One can even sing with proper training.

Disadvantages of and Electrolarynx:

• One has to remember charging the device.

• It is high-priced.

• The mechanical voice output can appear unattractive.

• To be able to speak, one must continuously hold the device.

Electrolarynx VS other forms of vocal restoration

As already mentioned, there are presently three kinds of voice restoration methods available:

• Electrolarynx device

• Esophageal voice

• TEP (Tracheoesophageal puncture)

Esophageal voice involves the intelligible use of swallowed air. It is similar to talking with the help of a belch (burp). However, due to limited air storage of the esophagus, the voice quality differs. Moreover, it is critical to generate an esophageal voice in the first place compared to using the electrolarynx device.

TEP uses voice prosthesis to direct air through a puncture in the tracheal wall. This can be done during the laryngectomy or later. The prosthetic require replacement from time to time which adds additional cost. Several laryngectomees avoid TEP mainly for the surgical procedure.

The future of Electrolarynx voice aid:

Two of the major drawbacks are the magnet fitted over the pole piece and the weight because of it. If accidentally dropped, the magnet can get dislodged damaging the device. Also, the magnet adds weight to it making it difficult for the user to handle for a longer duration.

To overcome these problems, an innovative design was introduced by making the device in the form of a neckband instead of the handheld one. Though experiments are on for better voice results and The National Institute of Deafness and Other Communications Grant support the work.

At present, electrolarynx holders are available to place the device and keep it hands-free. Some laryngectomees find these holders useful while some others do not. However, more techniques are being explored to better the quality of speech for laryngectomy patients.

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