People with tracheostomies can generally talk, although it may take some practice. Some people can use special speaking valves that attach to tracheostomy tubes, allowing for easier speech.

A tracheostomy is a surgical procedure that creates an opening, known as a stoma, in the front of the neck to provide an alternative airway route. Some people also refer to the opening itself as a tracheostomy or “trach.”

Doctors may insert one as a temporary life-saving measure in cases of severe airway obstruction or respiratory dysfunction. Alternatively, people may need permanent tracheostomies because of long-term medical conditions. These openings bypass the vocal cords in the larynx, affecting speech.

This article explores communicating with a tracheostomy and how a person may be able to restore or improve speaking abilities after the procedure.

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Generally, a person with a tracheostomy can talk. However, recovering speech can present challenges and is not possible for everyone.

Speaking with a tracheostomy may require adaptation and perseverance. The tracheostomy opening bypasses the vocal cords responsible for producing sound. As a result, there is a disruption to the usual process of vocal cord vibration and manipulation of speech.

This alteration can lead to changes in:

  • vocal quality
  • loudness
  • clarity

Despite this, people with a tracheostomy may be able to speak through various techniques and interventions, such as the following:

  • Reducing airflow: People may be able to cover the opening with a finger, so air flows through the vocal folds to the mouth. Additionally, assistive devices such as a speaking valve can support communication. The valve attaches to the tracheostomy tube to redirect airflow through the vocal cords, allowing for more natural speech production.
  • Speech therapy: Speech therapy can help with communication rehabilitation in combination with a speaking valve. Speech-language pathologists work closely with people to develop strategies and exercises that target breath control, vocal cord function, and articulation, helping with speech clarity and intelligibility.

Learn more about tracheostomies.

People may also wish to try using other forms of communication, such as augmentative and alternative communication systems.

These include:

  • Text-to-speech apps: These mobile phone apps can turn text into speech.
  • Communication boards: These may be handheld devices, computers, or tablets that include words, numbers, objects, drawings, pictures, and symbols to spell out speech.
  • Sign language: This is a visual type of communication using hand symbols and gestures.
  • Speech-generating devices: These are electronic devices that can replace speaking or text.

People may find the initial adjustment to speaking with a tracheostomy challenging. However, consistent practice and guidance from healthcare professionals can yield significant improvements in speech clarity and confidence.

In addition to formal speech therapy sessions, daily practice and self-monitoring can significantly affect progress.

Regular vocal exercises and repetitive speaking drills can help strengthen the muscles involved in speech production and promote vocal cord control. Engaging in conversation with family members, friends, or support groups can provide valuable opportunities to practice communication skills in real-life situations.

Although progress may take time, with support and assistive devices, if needed, individuals can reach their communication goals and regain any lost confidence in expressing themselves.

A tracheostomy primarily provides an alternative breathing pathway but also has other functions, including:

  • bypassing upper respiratory obstructions
  • allowing a continuous flow of oxygen to the lungs
  • facilitating efficient ventilation and oxygenation
  • enabling removal of airway secretions
  • simplifying medical procedures and ventilation management
  • allowing doctors to perform interventions more efficiently

Doctors perform tracheostomies for several reasons.

They may perform an emergency tracheostomy when an airway has a blockage or a health condition makes breathing impossible.

Some conditions that may require a tracheostomy include:

First, doctors thoroughly assess the individual’s respiratory condition to determine the necessity and suitability of a tracheostomy. Once they decide to proceed, they prepare the person for surgery, which requires general anesthesia.

During the surgery, the surgeon creates a small incision in the front of the neck, creating an opening into the trachea. They then insert a tracheostomy tube into the opening, securing it in place with sutures or a specialized holding device. The selected tube depends on the individual’s needs, considering factors such as size, material, and cuff design.

Doctors then closely monitor the individual for any complications. They ensure the tube is functioning correctly, providing a stable airway.

Fitting and help with speaking

While the tracheostomy bypasses the vocal cords, innovative techniques and devices exist to facilitate speech production. Not everyone will be able to recover their speech, however.

Speech-language pathologists can guide and support individuals with tracheostomies when it comes to speaking. They assess speech and communication abilities, considering factors such as vocal quality, intelligibility, and breath control. Based on the evaluation, the SLP develops a personalized treatment plan to address specific communication goals.

One method to restore speech is a speaking valve. These attach to the tracheostomy tube and allow airflow to pass through the vocal cords, simulating a more natural airflow pattern during speech.

Speaking valves promote vocal cord vibration, which is essential for generating sound and articulating words. They can significantly improve speech clarity and quality.

Adapting to life with a tracheostomy involves adjustments and ongoing care to ensure optimal well-being. However, with proper support and self-care, individuals with a tracheostomy can lead fulfilling lives.

Tracheostomy care includes regular maintenance. This includes daily cleaning of the stoma and tube to prevent infections and suction to remove excess mucus and maintain clear airways.

Individuals may also need to modify certain activities, such as swimming or contact sports, to ensure the protection and stability of the tracheostomy tube. Maintaining good hygiene practices, such as covering the stoma during showers or exposure to dust or dirt, is essential.

Living with a tracheostomy presents certain challenges, particularly with communication. However, some individuals can regain their speaking ability with support, speech therapy techniques, and practice.

Speech-language pathologists can play an important role in helping individuals develop and adapt communication strategies. This may include using speaking valves and other technologies.

Living with a tracheostomy requires care and lifestyle adjustments to ensure optimal well-being. Regular follow-up appointments with healthcare professionals are essential to monitor progress, assess respiratory function, and determine the appropriateness of tracheostomy removal or ongoing care needs.

Individuals can adapt to life with a tracheostomy with proper care and professional guidance.