Apparatus for assisting phonation in a wearer of a tracheostomy tube having a first end lying outside the trachea of the wearer in the use orientation, a second end lying inside the trachea of the wearer in the use orientation, and a first lumen coupling the first and second ends of the tracheostomy tube. The tracheostomy tube may or may not include a fenestration through a sidewall of the tracheostomy tube coupling the first lumen to the outside of the tracheostomy tube. The apparatus includes a cannula for insertion into the first lumen from the first end of the tracheostomy tube. The cannula includes a first end lying outside the first end of the tracheostomy tube in the use orientation, a second, opposite end, and a second lumen coupling the first and second ends of the cannula. If the tracheostomy tube has a fenestration, the second end may lie within the first lumen adjacent and toward the first end of the tracheostomy tube from the fenestration, or generally between the first end of the tracheostomy tube and the fenestration, or adjacent the second end of the tracheostomy tube. A one-way valve is provided at the second end of the cannula.
