A laryngectomee has no voice, and must use an artificial larynx or esophageal speech to communicate.
Writing is not a good substitute for conversational speech. Sign Language is, but more often than not, the community of the patient does not know Sign Language and is reluctant to learn.
The good news is that there are alternatives. Since it is the generator that has been lost, if we can find another, we are back in business.
We have already mentioned "Donald Duck" talk with the back of the oral cavity.
A more viable source of vibration is the esophagus. Everyone has "burped" sometime in their life. If they "mouthed" a word as they did so, they could produce an audible word or two.
Esophageal speech is based on the same principle. Only small amounts of air are injected by the tongue into the top entrance of the esophagus where it is forced out again with a vibration.