The air moves from outside the body through the tracheostoma directly to the lungs, without passing through the upper respiratory organs of the nose, mouth, and throat.
Esophageal speech is produced without an artificial larynx, and is achieved by pumping air from the mouth into the upper esophagus.
[citation needed] Because of the large, vibrating pharyngo-esophageal segment, the pitch of esophageal speech is very low—between 50 and 100 Hz.
In this simple surgical procedure, a small puncture is made between the trachea and the esophagus, and a one-way air valve is inserted.
The prosthesis is placed approximately 10–14 days post operation by a certified speech language pathologist (SLP) who specializes in ENT work.
This option has become increasingly popular in the past 10 years, as in many cases intelligible voicing may be achieved within minutes of placement of the prosthesis.
Some of the advantages to tracheoesophageal puncture are a higher success rate at about 95% of vocal rehabilitation and a much faster time frame compared to esophageal speech.