If a patient undergoes surgical removal of the voice box (laryngectomy), they lose the ability to speak in the traditional way because the larynx is responsible for producing sound. However, there are alternative methods for communication that can be used after a laryngectomy. Here are some common options:

1. **Speech Rehabilitation:**
- **Esophageal Speech:** This technique involves using the muscles of the esophagus to produce speech sounds. The patient learns to swallow air into the esophagus and then release it to create speech-like sounds.
- **Tracheoesophageal Puncture (TEP):** A small hole is made between the trachea and the esophagus during surgery, and a one-way valve (voice prosthesis) is inserted. This allows the patient to redirect air from the lungs into the esophagus for speech.

2. **Artificial Larynx:**
- **Electronic or Mechanical Devices:** These devices are handheld or wearable and produce vibrations that can be used to generate speech. They are held against the throat or placed in the mouth, and the user controls the pitch and intensity.

3. **Communication Devices:**
- **Text-to-Speech Devices:** These devices allow individuals to type or select words using a keyboard or other input method. The device then converts the text into audible speech.
- **Communication Apps:** There are various apps available for smartphones and tablets that facilitate communication for individuals who have lost their voice. These apps often include text-to-speech functionality.

4. **Sign Language or Gesture Communication:**
- Some individuals may choose to learn sign language or develop a system of gestures to communicate with others.

5. **Writing or Typing:**
- Patients can communicate by writing or typing messages on paper, a whiteboard, or electronic devices.

It's important to note that the choice of communication method often depends on the individual's preferences, abilities, and the extent of their surgical procedure. Additionally, speech therapy and support groups can be valuable resources for individuals adapting to life without a voice box.

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