Can someone speak with a tracheotomy?

If you are on a ventilator, the tube will have a balloon around it that prevents air from leaking. In this case you will not be able to talk. If you do not need a ventilator, a smaller tube may be used that allows air to pass around it. In this case you may be able to talk.

This information came from: http://www.med.umich.edu/1libr/aha/aha_tracheos_crs.htm