Two cases are presented that show increased loudness as contributory to the occurrence of audible posterior nasal turbulence as an obligatory symptom. Case 1 was an 18-month-old boy with repaired cleft palate who exhibited sporadic posterior nasal turbulence with velar flutter that was associated with increased loudness. Case 2 was a 4-year-old boy with repaired cleft palate who exhibited relatively frequent posterior nasal turbulence with velar flutter that was associated with pervasive and excessive loudness. Following 3 therapy sessions, loudness was reduced and audible nasal turbulence was eliminated. Clinical implications are discussed.
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