Everyone has a slightly different quality to their voice. People with a nasal voice can sound as though they’re speaking through a clogged-up or runny nose, which are both possible causes.
Your speaking voice is created when air leaves your lungs and flows upward through your vocal cords and throat into your mouth. The resulting sound quality is called resonance.
As you speak, your soft palate on the roof of your mouth rises until it presses against the back of your throat. This creates a seal that controls the amount of air that passes through your nose depending on the sounds you speak.
The soft palate and side and back walls of your throat together form a gateway called the velopharyngeal valve. If this valve doesn’t work properly, it can create changes in speech.
There are two types of nasal voices:
- Hyponasal. Speech is caused by too little air getting through your nose while you speak. As a result, the sound doesn’t have enough resonance.
- Hypernasal. Speech is caused by too much air leaking out through your nose while you speak. The air gives the sound too much resonance.
If you feel you have a nasal voice that needs attention, especially if this change is new, see an ear, nose, and throat (ENT) doctor. Many of the conditions that cause a nasal voice are very treatable.
A hyponasal voice can sound blocked, as if your nose is stuffed. It’s the same sound you’d make if you pinched your nose closed while speaking.
You might have these symptoms along with a hyponasal voice:
- stuffy or runny nose
- trouble breathing through your nose
- discharge from your nose
- sore throat
- loss of smell and taste
- pain around your eyes, cheeks, and forehead
- bad breath
A hypernasal voice sounds as though you’re talking through your nose, with an accompanying leak of air.
You might have these symptoms along with a hypernasal voice:
- trouble pronouncing consonants that require high air pressure, like p, t, and k
- air escaping through your nose when you say sound combinations like s, ch, and sh
A few factors control the quality of your voice. These include the size and shape of your mouth, nose, and throat, and the movement of air through these structures.
A hyponasal voice is usually due to a blockage in the nose. That blockage can be temporary — such as when you have a cold, sinus infection, or allergies.
Or, it can be caused by a more permanent structural problem such as:
- large tonsils or adenoids
- a deviated septum
- nasal polyps
The main cause of a hypernasal voice is a problem with the velopharyngeal valve, called velopharyngeal dysfunction (VPD).
There are three types of VPD:
- Velopharyngeal insufficiency is caused by a structural problem like a short soft palate.
- Velopharyngeal incompetence happens when the valve doesn’t close all the way because of a movement problem.
- Velopharyngeal mislearning is when a child doesn’t properly learn how to control the movement of air through the throat and mouth.
These are also called resonance disorders.
Causes of VPD include:
- Adenoid surgery. Surgery to remove the glands behind the nose can leave a larger space in the back of the throat through which air can escape up the nose. This is temporary and it should improve a few weeks after surgery.
- Cleft palate. This birth defect happens when a baby’s mouth doesn’t form correctly during pregnancy. Surgery for repair is
usuallydone by age 1. But about 20 percent of babies with a cleft palate will continue to have VPD after surgery.
- A short palate. This creates too much space between the palate and throat through which air can escape.
- DiGeorge syndrome. This chromosome abnormality affects the development of many body systems, particularly the head and neck. It can cause a cleft palate and other abnormalities.
- Brain injury or neurological disease. A traumatic brain injury or conditions like cerebral palsy can prevent your soft palate from moving properly.
- Mislearning. Some children don’t learn how to produce speech sounds correctly.
Which treatment your doctor recommends depends on the cause of your nasal voice.
Decongestants, antihistamines, and steroid nasal sprays may help bring down swelling and relieve congestion in the nose from allergies, sinus infections, polyps, or a deviated septum. Antibiotics can treat a sinus infection that hasn’t improved and is caused by bacteria.
Many of the structural problems that cause a nasal voice are fixable with surgery:
- tonsils or adenoids removal
- septoplasty for a deviated septum
- endoscopic surgery to remove nasal polyps
- Furlow palatoplasty and sphincter pharyngoplasty to lengthen a short soft palate
- corrective surgery for cleft palate in babies around 12 months of age
You can have speech therapy before or after surgery, or on its own. A speech-language therapist will first evaluate your speech to find the best treatment approach for you.
Speech therapy teaches you to change how to move your lips, tongue, and jaw to correctly produce sounds. You’ll also learn how to gain more control over your velopharyngeal valve.
A speech-language therapist will suggest exercises for you to practice at home. Repetition and regular practice is important. Despite some common recommendations, blowing and sucking exercises don’t help keep the velopharyngeal valve closed.
A better approach is to practice speaking the way your therapist suggests. Talk, sing, and vocalize as much as you can to help change the quality of your voice if desired.
If you have a condition causing a nasal voice, there are many treatments available.
Structural problems like polyps and a deviated septum can be fixed with surgery. Speech-language therapy can help you control the movement of air through your mouth and nose, so you can speak more clearly and confidently.
However, remember that everyone’s voice is unique. If you feel your voice has a nasal quality but you don’t have any of the medical conditions we’ve mentioned, consider embracing it as part of you. We are often more critical about our own voices than others are. It may be that others have either not noticed anything about your voice or find that it makes you unique in a positive way.