Using an Artificial Larynx - Advice Sheet | Hull University Teaching Hospitals NHS Trust

This leaflet has been produced to give you general information. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and the healthcare team but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What is an artificial larynx/electrolarynx?

An artificial larynx/electrolarynx is a handheld device that can be used by individuals who have had surgery to remove their voice box (laryngectomy). The head of the artificial larynx vibrates and can be placed against your neck or face. The vibration against your tissue creates a sound. The sound can then be shaped using the tongue and lips to create speech.

There are two types of artificial larynx (electrolarynx) available:

Intra-oral: Has a tube attachment that is placed in the mouth
Neck: Placed on the neck or cheek

Using an artificial larynx/electrolarynx

It is important to consider the following points when using these aids:

Placement: Correct placement of the intra-oral aid in the mouth or the device on the neck/cheek is essential for success.

When using an intra-oral aid, the tube should be inserted about 1-2 inches inside the mouth. Make sure the tongue and teeth does not block the sound coming through the tube.

When using the device on the neck or cheek, a soft, pliable area of skin is required, large enough to place the head of the aid comfortably. Place the device flat against your neck/ cheek. Do not place on a swollen area of tissue or on a spot that triggers coughing or discomfort.

On/Off timing: This is essential in order to avoid unnecessary noise. Switch on only as you speak and lift the button/ switch off as soon as you have stopped speaking.

Breathing: You do not need air from your lungs when speaking with an artificial larynx. Avoid forced breathing whilst speaking e.g. huffing. This will reduce loud rushes of air known as “stoma blast”.

Speaking rate: Speak slightly slower than you usually speak. This will help your speech sound clearer.

Articulation: You may need to emphasize speech sounds to improve clarity. Please refer to the practice items.

Phrasing: Try to use a natural speaking rhythm with pauses, as in normal conversation. Remember to lift your finger off the button/ switch when pausing.

Loudness: You will not be able to shout or raise your voice. You will need to adjust the volume for quiet and noisy situations. Reduce the volume when on the telephone (see further tips for using the telephone below).

Intonation (rise and fall) of the voice: If your device allows you to change the intonation try practicing this function on the device. It may help to practise telling a joke, where changes in tone are required.

Speaking to new people: If meeting new people or for example, ordering a drink, try starting with a short introductory phrase first, so that they can tune into your speech e.g. “It’s windy out there! Please could I order a coffee?”

Using the phone: Keep your phone microphone away from the noise of the artificial larynx. If the phone microphone is near to the artificial larynx, there will be more noise heard by the listener, making speech sounds harder to hear.

If you use the device on your neck, keep the phone microphone in front of your nose, (rather than down by your chin).

If you use the device on your cheek, keep the phone microphone by your chin.

If you use the intra-oral device, keep the phone microphone by your chin.

Practice: Try gradually using your electrolarynx in different situations to build your confidence and skill.

Exercises

Exercises to aid clearer speech when using an artificial larynx:

Open your mouth as if saying “ah”
Repeat “mah”, “mah”
Count 1-10
Recite the days of the week
Recite the months of the year
Practise the lists of similar sounding words
Practise short social phrases eg:

Hello, how are you?
Fine thanks
That’s nice
See you soon

Practise this list of similar sounding words, emphasizing the difference between them:

am/an all/ or on /ale aim /aid

eye /isle owe /ore we /wear wore / why

low / lay law /lee lame / lane lone / load

me /may more / my knee / know nor / name

pie/buy too/do tuck/duck cut/gut

fan/van fine/vine file/vile few/view

see/she sip/ship sock/shock Sue/shoe

chill/Jill chess/Jess chain/Jane chin/gin

lie/rye late/rate lack/rack lamp/ramp

pay/play bite/bright tick/trick core/claw

gate/grate four/floor sell/spell sick/stick

sip/skip

Practising intonation:

Using the device controls for intonation, practice saying these sentences putting emphasis on the highlighted word.

‘He won the lottery!’ ‘He won the lottery!’

‘I got paid yesterday!’ ‘I got paid yesterday!’

‘It’s going to be sunny tomorrow!’ ‘It’s going to be sunny tomorrow!’

‘When’s your birthday?’ ‘When’s your birthday?’

‘It cost me £10!’ ‘It cost me £10!’

‘I went into town!’ ‘I went into town!’

‘How much was it?’ ‘How much was it?’

Looking after the machine

Please return the aid if it develops any faults. Please do not attempt any home repairs, as this may invalidate the warranty. Avoid over-tightening the top or base as this will lead to cracking. To prevent the unit hitting a hard surface, please use the neck cord or carry case.

If you have any further questions, please do not hesitate to contact the Speech and Language Therapy Department on telephone number: (01482) 463155.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

you must be able to give your consent

you must be given enough information to enable you to make a decision

you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.