Hyptonicity of the neoglottis

In case of hypotonicity of the neoglottis (characterized by a breathy, whispery, aphonic voice sound) might become more obvious when using a handsfree device. When using digital occlusion of the stoma the finger pressure sometimes supports the esophagus and approximates the esophageal walls in order to create a voice sound. When those patients start using a handsfree device, voice quality might decrease. Applying digital pressure on the esophagus usually helps, but then speech is not handsfree anymore. To keep speech handsfree, consider using a custom made pressure band or using a Dan Kelly pressure band. In some patients, speaking softer and at a lower pitch improves voice quality and sometimes a slight change of head position causes approximation of the esophageal walls and thereby improves voice quality.