What Is Hypernasal Speech in Cleft Patients?
Hypernasal speech is a common speech issue after cleft palate repair. Here is an explanation.
Hypernasal speech (also called hypernasality) occurs when too much air resonates through the nasal cavity during speech. It is the hallmark sign of velopharyngeal insufficiency.
- What it sounds like:
- The voice sounds "nasal" or "hollow"
- Consonants lack power (P sounds like B, T sounds like D)
- The person sounds like they are "talking through their nose"
- Speech may be difficult to understand
- Why it happens:
- The soft palate does not seal against the back of the throat
- Air leaks into the nose during sounds that should be oral
- This is common after cleft palate repair
- May also occur in submucous cleft palate
- How it is measured:
- Speech pathologist evaluation
- Nasometry (measures the ratio of nasal to oral sound)
- Nasopharyngoscopy (camera through the nose to see the palate)
- Treatment:
- Mild: speech therapy
- Moderate to severe: surgery (Furlow, pharyngeal flap, sphincter pharyngoplasty)
Clinical Guidance
Hypernasal speech is a nasal-sounding voice caused by air leaking into the nose during speech. It is the main sign of VPI and is treated with therapy, surgery, or both. Most children achieve normal resonance with appropriate intervention.