In some patients, it’s not possible to deflate the cuff. They may require high pressure ventilation, or they are at risk of aspirating oral or gastric secretions into their lungs, where the inflated cuff provides a degree of protection.

In these instances, above cuff vocalisation may be able to help.

This simple technique involves air being pushed from the subglottic port, over the larynx and vocal cords, and out of the mouth. It results in audible vocalisation for up to 80% of patients who would otherwise not have been able to speak.