Esophageal speech, also known as esophageal voice, is an airstream mechanism for speech that involves oscillation of the esophagus. This contrasts with traditional laryngeal speech, which involves oscillation of the vocal folds. In esophageal speech, pressurized air is injected into the upper esophagus and then released in a controlled manner to create the airstream necessary for speech. Esophageal speech is a learned skill that requires speech training and much practice. On average it takes 6 months to a year to learn this form of speech. Because of the high level of difficulty in learning esophageal speech, some patients are unable to master the skill. The Voice Quality Symbol for esophageal speech is Œ. Clinical Esophageal speech is a skill that can help patients to communicate after a laryngectomy, the most common surgery used for the treatment of laryngeal cancer. In the operation, the larynx and the vocal cords are removed completely. After this, the end of the trachea is sewn onto the edge of an opening cut out at the lower part of the neck, creating an opening (stoma) the patient will breathe from and cough out mucus from. This hole is called a tracheostoma; the patient uses it to breathe through and cough through after the operation. Character 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. Because it bypasses the vocal folds, speech can be severely impaired, and the development of an esophageal voice becomes necessary. Esophageal speech is produced without an artificial larynx, and is achieved by pumping air from the mouth into the upper esophagus. The esophagus is slightly expanded. The air is then released in a regulated manner through the mouth, with simultaneous articulation of words. Vibration of the pharyngoesophageal sphincter replaces vibration of the glottis to produce the esophageal voice. Many people learn a basic form of esophageal speech as children, when they speak words while burping, e.g. in competitions with friends to see who can say more of the alphabet during a burp. Esophageal speech is quieter and more strenuous than laryngeal speech, and fewer words can be produced successively. Good esophageal speakers can produce an average of 5 words per breath and 120 words per minute. Very good esophageal speakers speak very similarly to TEP speakers. Because of the large, vibrating pharyngo-esophageal segment, the