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Tracheo-esophageal Speech

Tracheo esophageal puncture (TEP) is the most common way to restore speech after laryngectomy. The procedure is usually done as part of the laryngectomy operation, or you can go back for a minor operation to have it done later.

A small hole is created which extends from the back wall of the trachea into the front wall of the esophagus, then a TEP prostehesis is inserted into the opening. The TEP prosthesis has a one-way valve that allows air to go from the trachea through the prosthesis into the esophagus, but it prevents liquids and food from moving from the esophagus through the prosthesis into the trachea.

TEP speech is created by taking a breath into your lungs as you normally would through your neck via your stoma, then, when you breathe out and want to speak, you simply cover the tracheostomy opening in your neck, and all the air passes through the TEP prosthesis. Air is forced into the esophagus, up your throat and out your mouth. Mucosa of the esophagus and pharynx vibrate as the air passes through, creating sound.


  • Speech created by a TEP device can be very clear
  • Speech develops faster than esophageal speech
  • High success rate
  • With practice, can be performed with special valve over stoma, freeing up hands
  • Will have full lung power behind your prosthesis, allowing for longer sentences than esophageal speech



  • It can be expensive and requires changing every three months
  • Using a voice prosthesis takes practice
  • It requires regular care and maintenance to prevent infection and other complications
  • Patient needs to cover the stoma to speak
  • There may be complications