esophageal speech A learned method to restore
verbal communication for people who have
undergone LARYNGECTOMY(surgical removal of the
larynx, or voice box). When the THROATis intact,
air coming out of theLUNGSpasses through the
VOCAL CORDSand other structures of the larynx,
generating sound vibrations that travel to the
MOUTH. The mouth then forms these vibrations
into words. Laryngectomy removes the throat; air
instead enters and leaves the TRACHEAthrough a
surgically created opening, or stoma. For
esophageal speech, the person takes air into the
mouth and swallows it, which sends the air into
the ESOPHAGUS(tube that carries food to the STOM-
ACH). When the esophagus expels the air back into
the mouth, the force of the moving air generates
sound in the form of a burp or belch. The mouth
then forms these bursts of air into words. The
technique takes considerable practice; however, it
is possible produce a fairly natural voice, although
certain sounds may be difficult to form and under-
stand.
Tracheoesophageal speech is a variation of
esophageal speech in which the surgeon creates
an opening between the trachea and the esopha-
gus at the point of the stoma, called a tracheo-
esophageal puncture, and inserts a small shunt
(connecting tube) with a one-way valve. The per-
son then learns to force air from the trachea into
the esophagus instead of taking air in through the
mouth and forcing it into the esophagus. This is
somewhat more natural and many people find it
an easier technique to master.
See also ELECTROLARYNX.eustachian tube An elongated, valvelike chan-
nel of tissue that connects the middle EARand the
THROAT. The eustachian tube relaxes or constricts
to equalize the pressure between the middle ear
and the external environment. The sensation of
the ears “popping” indicates air moving through
the eustachian tube. Congestion easily blocks the
eustachian tube, particularly in children because
their small, compact facial structure causes the
eustachian tubes to be nearly horizontal. In adults,
the eustachian tubes angle downward from the
ear to the throat, thwarting progression of fluid
from the throat to the middle ear. Blocked
eustachian tubes result in a feeling of fullness in
the ears and can set the stage for OTITISmedia
(INFECTIONof the middle ear).
For further discussion of the eustachian tubes
within the context of otolaryngologic structure
and function, please see the overview section “The
Ear, Nose, Mouth, and Throat.”
See also PHARYNGITIS.eustachian tube 23