The Shiley speaking valve is designed for use on alert, awake tracheostomy patients who can breathe independently without assisted mechanical ventilation. The Shiley Speaking Valve connects to the tracheostomy tube and directs airflow past the vocal cords to facilitate speech. It permits easier vocalization without finger occlusion, which may cause hygiene and infection concerns. Directing airflow through the oral and nasal chambers also decreases secretions and improves swallowing and sense of smell.