As we produce sound from the vocal folds, that sound resonates through the nose and mouth creating nasal and oral resonance as it travels through the vocal tract.

The oral and nasal cavities connect at the velopharyngeal port, which is made up of the soft palate/velum and posterior pharyngeal wall. There are a limited number of sounds considered nasal sounds, such as "m", "n", and "-ng", in which the velopharyngeal port is open.

Variations in nasal resonance are referred to as hyponasal (too little nasality) and hypernasal (too much nasality).

Hyponasality is familiarly referred to as the sound of someone with a cold when their nose is stopped up, during which nasal sounds will not come across as nasal.  Hypernasality symptoms include a presence of nasality on non-nasal consonants and vowels.

Nasality problems can occur because of structural deficiencies (congenital or acquired), neurological impairment, or mislearned articulation. Nasality can be evaluated with nasopharyngoscopy in the ENT clinic.

Treatment

Treatment of structural problems will likely require the assistance of an oral prosthetic to aid in velopharyngeal closure. A prosthodontist is able to construct either a palatal lift or palatal obturator that is custom designed for each person.

Speech therapy may be useful in combination with the palatal device to maximize speech intelligibility.