Speech in an Orally Intubated Patient

The authors show how an electrolarynx allowed a patient ventilated through an orotracheal tube to communicate with speech. A video is available at NEJM.org. To the Editor: We report the successful use of an electrolarynx in an orally intubated 59-year-old man who was receiving mechanical ventilation. The device enabled him to produce intelligible speech (Figure 1). A video-assisted bilobectomy of the right lung for adenocarcinoma had been performed at another hospital, and the procedure was complicated by the development of a bronchopleural fistula. Because of this complication, there was a need for continued mechanical ventilation. His family informed us that the patient was frustrated by his inability to talk. He consented to the plan to use the electrolarynx, and to his surprise — and . . .