The larynx, also known as the voice box, opens to help you to breathe. When you swallow, it keeps food out of the trachea, which is the windpipe. Air passing through the larynx causes the vocal cords to vibrate, producing sound. With the help of your mouth, teeth, tongue, and lips, that sound becomes your voice.

When the larynx is removed, the surgeon trims and turns the trachea to create an opening in the front of the neck. This opening, called a stoma, is the new passage for breathing. It bypasses the nose and mouth. During the operation, the surgeon inserts a tracheostomy tube in the stoma to hold it open. A few weeks later, the healthcare provider may replace the tube with a tracheostomy button, commonly called a stoma button. Some people without a larynx leave the trach tube in. Others, after some time, don't use either the tube or the button.

A speech-language pathologist (SLP) will meet with you before your surgery. The SLP will evaluate your speech and explain your communication options after surgery.

SLPs counsel patients before surgery to put them at ease and to let them know that they'll be able to communicate right after surgery.

You need to know that even if only a part of your larynx is removed, your voice won't sound the same as it did before the operation. It will have a lower pitch. Talking to be heard in loud situations may be difficult. You'll need to practice each type of speech, try to relax when speaking, and be patient. Remember, learning how to speak as a child wasn't easy, either. Your sense of smell and taste may also be affected.

For a few days after surgery, you won't be allowed to speak. This is because healthcare providers don't want you to move your tongue around and pull apart the sutures. To help you heal, you'll be fed through a feeding tube for a week or so. The type of feeding tube and length of time you'll need it depend on the type of surgery you've had. A humidifier in your hospital room will moisten the air to help keep the stoma from drying out. You may also be taught how to use a suction machine to remove excess mucus.

Before learning to speak again, you can communicate by writing. You might want to bring a laptop computer with you to the hospital so that you can write notes to caregivers and send emails to family and friends.

Speech therapy usually begins before you leave the hospital. Once the healthcare provider gives approval, the SLP will begin speech lessons with you. Learning to talk again may involve things like esophageal speech, an artificial larynx, or a transesophageal puncture (TEP). Each is described below.

When the larynx is removed, the usual method of producing voice is also lost. It's important to remember that laryngectomees (someone who has had cancer and laryngectomy surgery) can speak again. You just have to learn a new way to speak. 

A laryngectomee is sometimes called a "lary." You can find a lary to talk to through laryngectomee clubs, often called "Lost Cord" or "Nu-Voice" clubs. You'll find a list of clubs on the International Association of Laryngectomees website.