Hearing Your Voice as a Laryngectomee
by Lisa Zee, MS, CCC, Speech and Language Pathologist
When we hear sounds through our ears, the sound travels down the ear canal and vibrates against the ear drum. On the other side of the eardrum are the three smallest bones in the body, commonly known as the hammer, anvil and stirrup, due to the shape of these three small bones. The medical terms for these bones are the incus, the malleus, and the stapes. The end of the stapes vibrates in turn against the fluid in the middle ear, so when we hear sound from the outside world, the sound passes through to the auditory nerve in this manner.
When we hear our own voices speaking, we hear the sound vibrations that come either from vocal cords or in case of a laryngectomee, an esophageal or synthetic vibration, we hear the sound waves coming from our own mouths through the ear canal like we hear sound from the environment. However, when we are speaking we also set up the bones of our body, particularly the neck and head, into vibration due to the act of speaking itself. The bones in the skull are set into vibration due to the vibratory nature of speech. Again, this is the same phenomenon whether it is with a larynx and vibration of the vocal cords, or due to esophageal vibration or artificially induced vibration. When this happens, there is a phenomenon known as bone conduction that happens to the sound of the voice. The little bones discussed in the previous paragraph are set into vibrations by the two sources. One source is the outside sound and the second source is the actual vibrations of the bones in the skull, which cause the little bones to vibrate in a different manner.
So this is why your own voice when you are speaking will sound different to you than it does to others. There is no way to get around this phenomenon. Therefore, it is especially important for someone working on their speech or voice, be it for laryngectomee or whatever reason, it is important to work with a take recorder to hear the actual sound of your voice as it affects others. A high quality tape recorder will give you the best recording of your voice. Your own auditory interpretation of your voice is simply not accurate. This is also why a person may listen to their voice on a tape recorder and not believe it is them speaking, or that the voice may sound very different from what they had expected.
I always recommend that laryngectomee work with a tape recorder when trying esophageal speech or for increasing their clarity of speech using an artificial larynx and also for trachesophageal puncture speech. It may be challenging for a laryngectomee, especially in the area of beginning esophageal speech to listen to the sound of their new voice on a tape recorder. I like to practice this however, even at the single syllable level.
(Submitted by Clark Eldridge, Chatterbox Club, Santa Cruz County, California)