History of the Artificial Larynx
by Jack Henslee

Through the years the artificial larynx has gone through many transformations and continues to do so today. From the time of the first recorded laryngectomy an artificial larynx was used to create speech, and even before that a laryngeal prosthesis was used on a young tracheostomized girl whose larynx was closed. This was accomplished by using a reed device that directed air from her lungs via a small tube to her mouth.

In 1873 Theodore Billroth performed the first successful laryngectomee and as a part of the procedure he implanted an artificial larynx. This device, as with most of the early devices, was fitted in the trachea via the stoma with a cannula that had a branch in it that entered the oral cavity. This branch of the cannula enclosed a reed that produced sound with air from the lungs (see the illustration). When these early laryngectomies were performed the opening from the pharynx to the trachea wasn’t closed off as it is today. While this method allowed for what appears to be an easy way to transmit sound to the oral cavity without the use of an external device, it had some major drawbacks. The most significant being that food and liquid leaked into the trachea and caused infections, i.e., pneumonia. In fact that was one of the leading causes of death for early laryngectomees.

In 1892 Julius Hochenegg designed an artificial larynx that was powered by a bellows that was held under the armpit. A nasal tube with a reed inside it was used to transmit the sound to the pharynx. Through the years there have been several adaptations of this device, one of which has been demonstrated by Robert Keith on a video tape at the IAL Annual Meetings. For the next fifty years there were many different types of external pneumatic devices developed with a wide variance in success and methods. Most of them consisted of a cannula that fit in the stoma, a cylinder that housed a reed or rubber band for producing sound, and a tube to transfer the sound to the oral cavity.

The first electro-larynx was introduced by Wright in 1942. It consisted of a device similar to those used today which was held against the neck. Unlike today’s instruments however, it had a separate battery pack that was connected via an electrical cord. In 1945 the Aurex Corporation of Chicago, started producing Wright’s instrument and it evolved into the Aurex Neovox , one of the first cordless electric instruments we see today. In 1957 Dr. Herbert Cooper and the Rand Development Corporation introduced the first electric inter-oral instrument, the Cooper-Rand. The features used in the early Cooper-Rand led to the development of independent controls for pitch and loudness that is taken for granted today. After almost 40 years the Cooper-Rand continues to be a favorite device for many laryngectomees, especially women.

There have been many interesting concepts and differing approaches during these last 120 years or so. A lot of pneumatic devices with different sources of air were used, i.e., a bellows, a car horn bulb, and the good old lungs. There have been many electric devices ranging from neck types with portable battery packs connected by electric cords, devices embedded into dentures and either connected by cord or a built in battery, and of course the so called modern instruments with their various adapters and battery chargers.

The quest continues for the perfect device. In the last few years we have seen the introduction of the SPKR, Denrik, and NuVos. The Servox continues to be the consensus favorite, at least in the opinion of most people I’ve talked to, and the old Cooper-Rand is still going strong with some improvements made this year. Then there is the new Ultra Voice. A sound source that’s embedded in a denture and controlled via a remote control device that fits in your hand. Makes you wonder, "What will they think of next ?”

Return to Laryngectomee Articles