Windows 11 has a "voice access" application that is amazing, seemingly hidden, and much better than the other built-in Win voice svcs. Voice Access is fully local, poorly documented, and the advanced settings menu is hidden.

*Quick guide to save you time:

-you can say "scroll to top/bottom", "click ok", "open Firefox", etc.

-it will always be typing when you talk unless it a) hears a command, b) you say "command mode", which will listen only for commands, or c) you mute:

-"mute" puts mic to sleep so you don't accidentally type when speaking ("unmute" to unmute)

-say "what can I say" to open advanced menu, allowing you to setup custom voice commands ("open projects folder", "open xyz website", etc.). Works well!

-full voice control of mouse is possible but a little slow. "Open grid" splits screen into a numbered 3x3 grid. You pick a number, it creates a new 3x3 grid in side the box you chose, and repeat until you can tell it to click.

The other thing I tried on Android is Futo voice input via F-droid + an app that turns you phone into a bluetooth keyboard (so as I spoke, it "typed" on the target device). The keyboard app is "Bluetooth Keyboard & Mouse"). It worked smoothly sometimes and other times not.

They make trackball clickers[1] (often with a laser since they're for presentations), and other single handed devices, a search for "finger mouse" surfaces a few different devices

I don't know if any of them have PTT with microphone but you should be able to pair the clicker with a regular bluetooth headset, while the headset may be on all the time you might be able to use something like joy-2-key and a macro/hotkey utility to map the button press to mic mute.

[1] https://www.amazon.com/Wireless-Handheld-Finger-Trackball-Po...

Maybe some of the modern game controllers could fit, I know some of them have mic jacks but I don't know if any have built microphones. They fit the bill for handheld trackpad/etc with plenty of buttons at least.

The PS5 controller (DualSense) has a built in microphone and a trackpad.

Yes, but its gonna be weird. I've done very tangentially related work with game controllers, and my suspicion is you're gonna have to try a few (dozen?) before you find one that even sends reasonable commands. I can imagine a FireTV stick sending game controller inputs. I have no idea, but that's the type of thing that might go wrong.

A MX3 air mouse might be the exact thing you want though.

> MX3 air mouse

This, or similar,

with a hot key for voice input, or a live activation word.

I was looking into this when I got sick and couldn't type anymore. There are some corporate presentation tools that have directional buttons and also mics. I think Microsoft presenter is one? In the end i just ended up using my phone.