Is it normal to hear my mom's voice even when connected to the vent?

[Livinglifeachday]

Hi, as some of you know, my mother is going on almost 4 month on the vent. She has had a trach for 3 of those months. When we communicate via face time she has only been able to mouth her words. Recently we have been able to hear her voice here and there when she speaks. There is not a speaking valve connected to her vent. I have tried asking if this is normal but have not really gotten answers. Has anyone experienced this personally or with a family member? Is this normal, or should I be concerned?

[Rhyl1 Partner Moderator ICUsteps]

Normally speech happens when a steady stream of air comes from the lungs and passes through the vocal cords. When the trachy tube is inserted, most of the air bypasses the vocal cords and goes out through the tube. Some air may leak up through the vocal cords, but it may not be powerful enough to make the vocal cords vibrate, or it may only be enough for very short sounds.

All trachy tubes should fit easily into the airway with some space around the tube. If the tube fits snugly inside the windpipe then all of the air leaves through the tracheostomy. The goal is to always match the patient with the smallest trach possible that can do the job. So it sounds like your mum’s trachy has some space around it to let some air leak through her vocal cords, enough for the occasional word.

[LeopardGecko]

I started being able to hear my husband when the cuff was still up and they realised that the cuff had failed and wasn't holding the air and they needed to put a new tracheostomy tube in.

It might be worth mentioning to staff just incase as I found that the staff hadn't really noticed that you could hear his voice as they weren't really listening out for it when he didn't have a speech valve.

I will just add that it wasn't anything to worry about and they were able to change it really quickly and easily.

[Livinglifeachday]

UPDATE: I was able to speak to one of my mother's RT's and mentioned to him the possibility of air leak causing us to hear my mother's voice. He told me that the reason we could hear her voice was because they had partially deflated the cuff. Apparently it is a technique they use and completely normal. My mother seems to actually like this because 1. it gives her some sense of relief that she and staff can hear her cough (she is afraid that when they completely inflate the cuff and she has "silent" cough attacks, no one will be able to hear her and she will run out of oxygen) 2. She has major anxiety attacks and having the cuff inflated at all times makes her feel extremely anxious and 3. she can somewhat communicated with nurses and her family of course.