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An AL ( artificial larynx) is a device which is one means of communicating after a total laryngectomy. 

An artificial larynx ( AL) can be electronically powered ( electrolarynx/EL) or it can be pneumatically powered ( by lung air). Both pneumatice/lung powered devices and battery-powered electronic devices serve as a vibratory source, which takes the place of the vocal chords, which are removed post surgery.

The vocal chords prior to surgery aided in vibration which formed the sound we use to speak with. Without this vibration, one is left without sound. Major advantage of the EL is: it can be used almost immediately with an intraoral tube, after the surgery. It can be used as one’s primary voice or if you chose, it can be used as a backup speech options, if you chose to use other speech options later.

Why should the stoma be covered?

A. For hygienic reasons: since the air is no longer filtered or warmed by the nasal passages, foreign matter such as dust or clothing particles, and even air of a different temperature may irritate the sensitive walls of the air passage trachea). 
B. To help keep in moisture: when we exhale, we release moisture from the lungs. By covering the stoma, we help to keep that moisture in the airway, easing breathing and reducing the need to cough. 
C. For personal appearances: an opening in the neck, exposed for all to see, may cause unnecessary surprise and discomfort to friends and strangers.