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UR Medicine


Tracheostomy & Speaking Valve

What is a tracheostomy?

A tracheostomy is a surgical procedure to create a new, unrestricted and accessible airway. This procedure is done by a physician. An incision is created on the front of the neck at the level of the trachea (windpipe), below the vocal folds. This creates a direct airway as the trachea connects to the lungs. Once the tracheostomy is created, a tube is placed through the opening to establish a new, direct airway that can be attached to a ventilator or left open for the patient to breath without using the upper airway (larynx, vocal folds, pharynx (throat) and nasal and oral cavities).

Tracheostomy tubes can be different sizes depending on a patient’s size and respiratory needs. They also can be “cuffed” and “cuffless”. Cuffed trachs are used with patients on a ventilator and/or weaning from the ventilator or in patient’s that are having difficulty managing their secretions. A cuff keeps a seal between the trach tube and the upper airway so air passes only in and out of the trach tube. Without a trach, airflow can pass around the trach tube into the upper airway.  

What is a speaking valve?

A speaking valve is a small attachment that is placed at the opening of a trach tube. This valve acts as a one way valve that allows air in (to the lungs) but does not allow air out of the trach tube. Instead, it diverts air around the trach which can then be used to vibrate the vocal folds, make voice, and carry voice to the oral and nasal cavities to be made into speech. A speaking valve allows individuals with a trach to use their voice and communicate verbally. Speaking valves cannot be used when the tracheostomy cuff is inflated and evaluation with a specialist is important to ensure the upper airway is unrestricted to allow air to flow around the trach.

Your speaking valve will be ordered by your physician prior to your appointment.  Be sure to bring this speaking valve with you to your appointment.

Speech-Language Pathology Evaluation

Our Speech-Language Pathologists, have specialty training in the anatomy and physiology of the upper airway, in speech and voice production and in tracheostomies and speaking valves.  We work closely with the medical team to determine if and when a speaking valve may be appropriate to trial for an individual with a tracheostomy.