The Source of Nasal Rustle (Nasal Turbulence): An Overview of Current Evidence

Abstract

Objective

Nasal rustle (also called nasal turbulence) refers to a loud distracting sound that sometimes occurs with audible nasal emission (ANE) during the production of pressure-sensitive consonants in patients with velopharyngeal insufficiency (VPI). This article examines evidence for two hypotheses of causality: vibration of the soft palate (velar flutter) and periodic motion of mucus above the velopharyngeal port (turbulent mucus).

Conclusion

A review of the relevant literature shows inconclusive evidence to support velar flutter as a cause of nasal rustle. In contrast, clinical observations and research involving high-speed nasopharyngoscopy suggest that nasal rustle is the result of turbulent mucus above a small velopharyngeal opening. Therefore, it is our contention that a plausible explanation for nasal rustle is one of turbulent mucus and not velar flutter.

Keywords

velopharyngeal dysfunction speech disorders etiology evidence-based practice instrumental assessment nasality soft palate nasopharyngoscopy

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