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 breathe without using the upper airway (larynx, vocal folds, pharynx (throat) and nasal and oral cavities). A tracheostomy may be used in patients who require long-term ventilator support, or for patients who have an upper airway restriction that makes it difficult to breathe through their nose and mouth.

Tracheostomy tubes can be different sizes depending on a patient’s size and respiratory needs. They may also have a cuff, which is a donut-shaped balloon around the end of tube which is inside the trachea. Cuffed tubes are typically used with patients who require a ventilator or in patients who are having difficulty managing their secretions. When the cuff is inflated, it creates a seal between the trach tube and the upper airway so that air passes only in and out of the trach tube. With the cuff deflated, airflow can pass around the trach tube into the upper airway. Cuffless tubes are typically used with patients who do not require a ventilator.

What is a speaking valve?

A speaking valve is a one-way valve which can be placed on the end of a tracheostomy tube. The valve allows air to pass in through the trach tube when the patient inhales. As the patient exhales, the one-way valve closes, blocking the tube and diverting the air around the tube, up to the nose and mouth, simulating a more normal airway. Speaking valves can be used to help patients use their voice to communicate. Additional benefits can include: improved swallowing function, better secretion management and reduced need for suctioning, stronger and more effective cough, restored sense of taste and smell, and more efficient weaning from the tracheostomy tube.

Because a speaking valve blocks the exhalation of air through the tracheostomy tube, it can only be used with a cuffless tube or, for individuals with cuffed tracheostomy tubes, when the tracheostomy cuff is fully deflated. Evaluation with a specialist is crucial to ensure the upper airway is unrestricted to allow air to flow around the trach tube safely and comfortably.

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.