Vocal Loudness as Contributory to the Occurrence of Obligatory Posterior Nasal Turbulence.

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.