How Does an Electrolarynx Work?

Written by Nicole Schmidt
Medically Reviewed by Laura J. Martin, MD on June 19, 2025
6 min read

An electrolarynx is a small handheld device that helps people speak after having their voice box (larynx) removed, usually because of cancer. Without a larynx, you’re no longer able to make sound naturally with your vocal cords. An electrolarynx creates vibrations that act as a substitute for your vocal cords. You can shape those vibrations into speech using your mouth, tongue, lips, and teeth.

There are two main types of electrolarynx devices: one that you hold against your neck and use by pressing a button, and another with a small vibrating tube that fits inside your mouth. Both types are battery operated and are about the same size as an electric razor. 

Your larynx, or voice box, sits in the middle of your neck, just above your windpipe. It’s a hollow tube that helps you breathe and contains your vocal cords, which vibrate to create sounds when you speak, hum, sing, or whisper. 

If you’ve had a laryngectomy – surgery to remove part or all of your larynx – you no longer have vocal cords and can’t make sound naturally. This means you’ll need to find new ways to speak and communicate. For some people, that includes using an electrolarynx. 

Doctors may perform a laryngectomy for several reasons, including:

  • Larynx cancer – most often when the cancer is in an advanced stage   
  • Other types of head and neck cancers, such as hypopharyngeal, thyroid or esophageal cancer – usually only if the cancer has spread to the larynx 
  • Laryngeal fracture 
  • Severe trauma or injury to the larynx
  • Damage from radiation therapy – though this is rare 

An electrolarynx works like an artificial larynx for people who no longer have one. It creates vibrations that mimic the normal function of your vocal cords. When you press the device against your neck or place a special tube in your mouth, it makes a buzzing sound that travels through your throat. By moving your mouth, tongue and lips as you normally would when speaking, that buzzing sound turns into words. 

Using an electrolarynx can take some getting used to, but many people learn to speak clearly with help from a speech pathologist and a bit of practice. 

Here’s how to use one: 

  1. Charge and turn on your electrolarynx. Make sure your device is fully charged or has working batteries, then switch it on.
  2. Position the device. Depending on the model, either hold it against your neck or put the attached tube into your mouth.
  3. Press the button to start the vibration.
  4. Speak as you normally would. Use your mouth and tongue to translate the device’s buzzing sound into words.
  5. Try to speak slowly and use short sentences. Press the button that controls the vibrations every three to six words to make your speech easier to understand. 
  6. Adjust your settings if needed. Some models have extra features that let you change the pitch or tone of your voice for more natural-sounding speech. 

Tips for using an electrolarynx right

La Sheron Bankhead, a speech-language pathologist at MedStar Georgetown University Hospital, says that when working with patients who are learning how to use an electrolarynx, she encourages them to focus on what she calls the "big three": placement, timing, and articulation. 

Placement. Everyone has a "sweet spot" where the device works best, Bankhead says. But it can be different for each person. For some, it might be the cheek. For others – especially those with facial hair – on the neck or under the jaw may work better. Some people may prefer using a mouth adapter instead.   

Timing. Knowing when to press and release the button that controls the vibrations is key to being able to speak clearly. Bankhead says it’s important to keep the device off when you’re not forming words, since the constant buzzing can make speech harder to understand. 

Articulation. Because an electrolarynx picks up on the movement of your lips and mouth, Bankhead says that exaggerating your mouth movements can help make your speech sound clearer. 

"Practice, just like anything, is going to make you a better and more proficient speaker," she says. "Just try to be patient and acknowledge that there is a learning curve." 

Here are a few extra tips to help you get comfortable using an electrolarynx: 

  • Control your breathing. You don’t need air from your lungs to speak with an electrolarynx, so try to avoid huffing or taking big breaths while you’re talking. 
  • Slow down your speech. Speaking more slowly than you normally would can make it easier for other people to understand you.
  • Adjust the volume. Since you won’t be able to raise your voice naturally, practice using your device's volume settings to match quieter or louder environments.  
  • Choose quiet spaces. Using your electrolarynx in places without a lot of background noise can make it easier to have conversations. 

The cost of an electrolarynx depends on the model and your insurance coverage, but it usually ranges from $500 to $1,200. Both private insurance and Medicare may cover part of or all of the cost, depending on your plan. 

When choosing an electrolarynx, Bankhead encourages patients to consider the cost, how much voice customization they want, and which models work best with their preferred placement. 

Some older electrolarynx models can make your voice sound robotic or flat because they don’t allow for pitch changes. But many of the newer models include pitch control or noise reduction features, which can make your speech sound more natural and easier to understand. 

When choosing an electrolarynx, you may also want to consider: 

  • How easy the device is to use and adjust
  • Whether you want a rechargeable model or one with replaceable batteries

A speech-language pathologist can help you test different models and find the one that best fits your needs. 

An electrolarynx is just one of several options to help you speak after a laryngectomy. Bankhead says that having more than one option available can help people communicate at their best. 

Other alternatives include: 

Tracheoesophageal puncture (TEP) and tracheoesophageal voice prosthesis: In some cases, your doctor may perform a TEP during your laryngectomy surgery, but you can also have one later on. During the procedure, they make a small hole between your trachea (or windpipe, which connects the larynx to the lungs) and esophagus (the tube between your mouth and stomach). Once it’s healed, a small, one-way valve, called a voice prosthesis, can be placed in the opening. When you cover the opening with your finger and push air up from your lungs through the valve, it creates sound. This method usually produces the most natural-sounding voice compared to other options. 

Esophageal speech: With some practice, you can learn to push air from your mouth into your esophagus and then release it back out. This movement makes the esophagus vibrate, producing sound that you can shape into speech.

Nonverbal communication: Mouthing words, learning sign language, writing things down, or using a text-to-speech device can also be effective ways to communicate.

 

An electrolarynx can be a helpful communication tool for people who no longer have a larynx. It works by mimicking the vibrations of the vocal cords, which you can then shape into speech. Many newer models offer features like pitch control and noise reduction to make your voice sound clearer and more natural. While using an electrolarynx takes practice, a speech pathologist can guide you in choosing the right device and learning how to use it correctly. 

Can you live without a larynx?

Yes, you can live without a larynx. While not having it affects your ability to speak normally, many people without a larynx still lead long, full, and happy lives. 

What are the disadvantages of an electrolarynx?

Using an electrolarynx takes some getting used to, and it also makes your voice sound robotic and less expressive than regular speech. But with practice, most people are able to communicate clearly and comfortably. 

Why are electrolarynxes so expensive?

How much an electrolarynx costs depends on the model and its features. Many insurance companies cover at least part of the cost, so make sure to check in with your provider.