Introducing the application of continuous positive airway pressure in treatment of hypernasality: a case report

Document Type : Case Reports


1 MSc in Speech Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

2 Academic Member, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Research Center of Cleft Lip and Palate, Isfahan, Iran

3 MD, ENT Surgeon, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran



Introduction: In 1991, Dr. David kuehn employed Continuous Positive Air Pressure (CPAP) in treating patients with mild hypernasality whose velopharyngeal gap was less than 2 mm. The purpose of this case report was to represent the results of CPAP therapy on a Persian-speaking patient with minor hyper nasality.Materials and Methods: The patient was a 12-year-old male adolescent for whom the main complaint of his family was an indistinct speech and hypernasality which has been aggravated after tonsillectomy. The patient had also received 2 months speech therapy without any noticeable improvement. Having been examined by a speech-language therapist, conducting an endoscopy evaluation was considered to be necessary for the patient. The examination of the patient’s endoscopic images showed that the velopharyngeal gap was less than 2 mm. Movement of the velum and lateral pharyngeal walls seemed to be fairly appropriate and hypernasality was observed to be minor and stable. With respect to his speech and anatomical characteristics, CPAP was decided to be the best treatment option. The patient received 8 weeks of treatment completely according to a prescribed program.Results: Post-treatment endoscopic examination showed no signs of a gap and the patient’s indistinct and hypernasal speech was completely treated.Conclusion: If inappropriate learning is the fundamental cause of hypernasality, it is reasonable to assume that some form of information feedback to the individual may influence the treatment of the problem. CPAP can provide a powerful stimulating potential for the adjustment of air pressure in the vocal tract because it has a direct interaction with the positive pressure produced by the respiratory mechanism during speech. Research findings have indicated that during CPAP therapy individuals may achieve better closure of the velopharyngealport in continuous speech due to the training of the velopharyngeal muscles.Keywords: Continuous positive air pressure, Hypernasality, Case report