What causes hypernasal speech?

Hypernasal speech, or open nasality, occurs when there is increased nasal resonance during the production of oral speech sounds that should not be nasal. This condition is primarily caused by an inability to achieve proper palatal occlusion, which allows air to escape into the nasal cavity during speech.12

Causes of hypernasal speech are categorized into organic and functional factors:

• Organic causes: These involve physical impairments that affect the palate’s function, such as congenital malformations (including cleft palate), paralysis, injury, or other structural defects. Additionally, surgery that results in deformity or restriction of the palate can lead to hypernasality.12
• Functional causes: These relate to palatal sluggishness or behavioral patterns, including imitation, faulty speech habits, dialectal influences, hearing loss, intellectual disability, or psychiatric disorders.1

It is essential to distinguish hypernasality from hyponasal speech (closed nasality), as the treatments for these conditions differ significantly. A comprehensive evaluation by a specialist, such as an otolaryngologist or phoniatrist, is necessary to ensure that interventions—such as the removal of adenoids—do not inadvertently worsen the patient's speech.1