Hearing loss may make individuals perceive that their voice is weaker than it actually is. It may contribute to social isolation and make laryngectomees try to speak louder. In those who use tracheoesophageal speech and are trying to speak louder by generating greater expiratory effort a separation of the HME base plate from the skin can occur. This is especially true in those who use a hands free HME. Wearing a hearing aid enables a laryngectomee to hear their actual voice.
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