Melissa Kim M.S., CCC-SLP replies...
Here at the Milton Dance Head & Neck Center, a tracheoesophageal puncture with prosthesis placement is the standard of care for voice rehabilitation after laryngectomy. Our surgeons typically perform this procedure at the same time as the laryngectomy, though it can be performed secondarily. Many of our patients who are able to produce "voice" in this method have previously had radiation therapy, so although a history of radiation to the head and neck area can present some complications in the rehabilitation course, it certainly does not preclude you from this type of procedure. This is not to say that something specific in your medical history makes your a poor candidate for prosthetic voice rehabilitation, but I would not be able to remark on that without evaluating you personally.
As to competence using an electrolarynx, training/ therapy with a speech pathologist is the best way to improve your skills with this type of device; your head and neck surgeon should be able to provide you with a referral to a speech pathologist who specializes in the treatment of patients with head and neck cancer.
Please feel free to respond with any further questions!