Tracheostomies And Speech

Introduction

A tracheostomy is a “surgical opening in the windpipe (trachea) and is made by cutting the neck below the vocal cords.” A tube is then placed inside of the opening and air is able to move in and out, similar to how it moves through the nose and mouth. Tracheostomies are required to maintain an open, functional airway and are often used to bypass an airway obstruction. Patients with severe pulmonary disease or depression, poor cough effort, or who have experienced prolonged intubations often need a tracheostomy. A tracheostomy, depending on the individual’s situation, can be a short-term or permanent situation. Tracheostomies are not a perfect replica of the nose and mouth, they lack the structures that we use to filter debris, warm and moisten air, and help with swallowing. A tracheostomy tube must constantly be cleared through suctioning, if this is not done frequently food or other debris can enter the lungs and cause choking or pneumonia.

Impacts on Speech

After a tracheostomy is performed air is no longer able to pass through the vocal folds making it extremely difficult to produce sounds. Young children who require tracheostomies do not get the opportunity to explore sound making and they typically have limited social interaction which affects their ability to develop language skills. Both of these limitations have lasting effects on their speech. In order to communicate with a tracheostomy, the tube inserted into the opening for breathing can be covered with the fingers or hand so that air can enter the mouth and pass over the vocal folds to produce sound. This method is not successful for all tracheostomy cases so valves have been developed that can be attached to the tracheostomy tube which allow air to enter the tube but force it to leave through the mouth and nose. It has been found to be extremely beneficial in terms of speech development for individuals with tracheostomies to obtain speech-language pathology services following the surgery. This method of treatment has been successful in helping individuals improve their speech and maximize their communication abilities.

Footnotes:

1. American Speech-Language-Hearing Association. http://www.asha.org/public/speech/disorders/tracheostomies.htm. 2007.
2. Dixon, Lous. (2003). Tracheostomy: Postoperative Recovery. Perspective. 1(1) 1-8.

This page has been provided by Emily Greenlee