Your voice relies on air passing through your throat. A tracheostomy can make speaking very difficult for some patients. Air will pass through the tracheostomy tube instead of through the vocal cords. Patients may only be able to whisper and speak in short bursts as they take breaths in between. As long as the air is flowing through the tube, the vocal cords will be impaired. A tracheostomy dressing can also hamper a patient’s ability to speak clearly.