Complete Guide to Hyponasal Speech : Assessment and Management Strategies

Hyponasal speech is a type of resonance disorder that affects the way one speaks. Usually, it is defined as a condition when there is an abnormally reduced nasal airflow during speech often in a setting of nasal congestion or nasal obstruction.⁽¹⁾ Hyponasal speech is mostly caused by a lack of sound resonance in the nasal cavity, which makes one sound like speaking with a stuffy or running nose. Early clinical assessment of the condition is extremely important so that it can be treated or at least managed effectively. Several ways including surgery, speech therapy, and more can be used for managing hyponasal speech.

This article will guide you about the clinical assessment and management strategies for hyponasal speech.

The clinical assessment for hyponasal speech is made by evaluating the velopharyngeal sufficiency and examining nasal and oral cavities. The evaluation or diagnosis is done by a team of doctors, including a prosthodontist, an otolaryngologist (ENT), and a surgeon.

The primary aim when clinically assessing for hyponasal speech is to figure out if speech therapy or medical intervention would be the best way to manage the condition in an individual. The clinical assessment is made in the following ways.

A speech and hearing screening is the first step to follow if there is a doubt about having hyponasal speech. In the case of speech screening, the doctor along with the help of a speech therapist analyzes the consistency and severity of symptoms and sounds affected. Speech screening helps to know the type and presence of articulation errors in an individual. Moreover, an oral exam conducted by the speech therapist also helps to rule out structural defects like cleft palate, enlarged adenoids, and so on.

Hearing screening helps the doctor rule out any hearing loss defect that might be resulting in hyponasal speech. In some cases, if a person is deaf or is hard of hearing, it could seem as though they have a speech disorder like hyponasal speech which is due to a lack of auditory feedback. However, it is not a speech disorder.

Apart from speech and hearing screening, there are various other methods used for detecting hyponasal speech in a particular person. These methods include:

• Pressure-flow technique
• Cinefluroscopy
• Use of a nanometer to calculate the ratio of nasality
• Nasopharyngeal endoscopy method

Hyponasal speech can be managed or treated in the following ways.

Antihistamine, decongestant nasal sprays, and steroids can cure inflammation and relieve any sort of nasal congestion from a deviated septum, allergies, nasal polyps, and sinus infections. Antibiotics can also be prescribed for treating sinus infections.

Many structural defects, such as a deviated nasal septum, enlarged adenoids or tonsils, cleft palate, and nasal polyps that cause hyponasal speech can be treated effectively with surgical methods. These methods include:

• Endoscopic Surgery: This is done to remove nasal polyps in the nasal cavity. The surgery is usually an outpatient procedure, where the surgeon removes the nasal polyps with the help of an endoscope and then enlarges the nasal passageway.
• Septoplasty: This is a surgical procedure that can treat a deviated nasal septum. In this type of surgery, the nasal septum is straightened and recentered.
• Adenoidectomy: Sometimes enlarged adenoids must be removed with a surgery known as adenoidectomy. Most often, the nasal passages remain swollen for several weeks after adenoidectomy, so the articulation disorders continue to persist. However, these phonological problems are mostly temporary.⁽²⁾
• Sphincter Pharyngoplasty and Furlow Palatoplasty: These are the surgical procedures that are used to treat short soft palate that could be causing hyponasal speech.

Apart from physical medical treatments, speech therapy could be one of the most effective means of management strategies for hyponasal speech.  Speech therapists evaluate the affected persons’ speech and then recommend a suitable treatment approach.

Multiple studies have shown that speech therapy is an effective way to help adults and children develop their communication skills. A study that included more than 700 children with speech or language difficulties shows that speech therapy had a significant positive impact.⁽³⁾

In speech therapy, an individual learns how to move the jaw, lips, and tongue to produce the correct sound. However, speech therapy could be effective only with regular practice and if done as suggested by the therapist. Singing, vocalizing, and talking continuously can improve speech quality. In this therapy, adults are also made to learn volume and pitch control, altering the placement of the tongue, auditory, and biofeedback, and also nasal vs. oral production.

Parents play a crucial role in managing hyponasal speech in children who are fighting with this sort of speech disorder and also struggling to attain self-esteem and confidence. As parents, we should help them practice some strategies in speech therapy that can be done at home once they are being trained by specialists. Moreover, it is also important to offer the children plenty of emotional and moral support.

School-going children who struggle in communicating or socializing well at school because of their hyponasal speech issues, should be encouraged and understood well. The school and teachers should be intimated about the problem in such children so that it would be easier for them to understand such children with hyponasal speech. This way those children won’t come across problems when there are activities in school that involve speaking.

Hyponasal speech can affect adults and children as well. So, a person experiencing this condition should seek a doctor’s help as early as possible. This will help the doctor to clinically assess the condition well and start with the most appropriate treatment. Following the doctor’s advice strictly and sticking to the treatment regime can help improve the quality of speech and quality of life.

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Also Read:

• What is Hypernasality & How Do You Reduce It?