The cause of speech disorders in children lies in disorders of brain activity (the speech center responsible for the perception and reproduction of speech) or in physiological pathologies. Incorrect pronunciation is associated with speech therapy problems, which can be eliminated by working with the child on articulation.

Rhinolalia is a common disorder in preschool children, a change in the timbre of the voice, which for physiological reasons becomes nasal. Translated from Greek, the term rhinolalia sounds like “nasal speech.” A sign of such a disorder is that the child speaks through his nose, as if he has a runny nose, but there is no snot. If this occurs for speech therapy reasons, rhinophonia is diagnosed. Let's look at these two disorders and the factors that provoke them.

Causes of rhinolalia and rhinophonia

Factors influencing a child's pronunciation are different.

Physiological

Open rhinolalia is characterized by defects of the hard and soft palate (congenital cleft, paresis, poor fit), in which air enters the nose when exhaled.

At the same time, the child speaks unclearly, nasally, and the sounds “um” and “en” sound like “mb”, “nb”. Such a defect is eliminated by training the soft palate, articulation exercises, and in the case of physiological pathologies, an operation is performed to fuse the cleft in the palate.

Closed rhinolalia manifests itself in a change in voice timbre, which is caused by physiological processes in the nasopharynx. There are also posterior and anterior nasal sounds, depending on the location of the pathology. The cause of posterior nasality is enlarged adenoids, pathological fusion of the soft palate with the posterior wall of the larynx. With anterior nasality in a closed form, sound pronunciation is distorted due to the curvature of the septum, the formation of ridges, polyps, hypertrophic growth of mucous tissue, and rhinitis.

With rhinophonia, a change in the timbre of the voice is observed, but there is no replacement of some sounds or their unclearness, swallowing, as with rhinolalia.

Adenoids

One of the common problems in childhood, which leads to changes in voice timbre and nasality, is adenoiditis, a pathological proliferation of the lymphatic tissue of the adenoids. The causes of inflammation in children are frequent acute respiratory viral infections due to reduced immunity.

Symptoms of inflamed adenoids:

• mouth breathing;
• snore;
• violation of voice timbre;
• breathing disorders;
• headache;
• congestion of the larynx.

This disease can be treated surgically and conservatively, depending on the form. For the first and second degrees of overgrowth, vitamin therapy, breathing exercises, and symptomatic treatment are used. If the child breathes through the nose and rhinoscopy shows that the adenoids are enlarged, but do not close the lumen, there is no need for surgical removal.

The third degree of adenoid proliferation is characterized by complete blocking of the vomer, which is why the child cannot breathe through the nose. Adenotomy, or surgical removal of enlarged tonsils, is used if drug treatment does not have the desired effect. But there is no guarantee that the lymphatic tissue will not grow again and the pathology will not resume.

Pathology of the nasal passages

Thickening of the mucous membrane, proliferation of bone tissue, formation of ridges and polyps disrupt the movement of air flow and lead to changes in the timbre of the voice. To determine why your child speaks through his nose, undergo a rhinoscopy or endoscopic examination.

The reasons for such formations in the nose:

• vasomotor rhinitis;
• congenital deviated septum;
• chronic

There is no point in treating such diseases with conservative methods, since changes in tissues are irreversible. But it is possible to correct the situation with surgery. For polyposis and hypertrophy of mucous tissue, gentle laser treatment is used, and surgery is used to restore the septum.

Reasons for a temporary change in voice timbre

In addition to pathological changes that are treated surgically, there are diseases in which the symptom of nasal sound is present, but there is no snot. This is sinusitis with complete blockage of the sinus and frontal sinusitis.

Frontitis

The paranasal sinuses are involved in purifying and warming the air during inhalation, and also form the timbre of the voice during pronunciation. In children under five years of age, only the supramillary maxillary sinuses are developed. They become inflamed due to a viral disease and when snot gets into them when rinsing the nose, as well as due to injuries. With frontal sinuses, the frontal sinuses become inflamed, which are also involved in the formation of the voice.

Sinusitis

There is no snot with sinusitis only in the initial stage of inflammation; later, mucous discharge from the nose and with admixtures of pus appear when a bacterial infection is attached.

Swelling of the mucous membrane

Another reason for temporary nasality is swelling of the mucous membrane due to allergies and colds. In the initial stage, there may be no snot. Treatment of such ENT diseases is carried out with medication using vasoconstrictor drugs, antiviral and antiseptic. Sometimes antibiotics are prescribed for topical use or in the form of tablets and injections for complications.

Nasal voice (rhinolalia) is a change in pronunciation associated with a violation of the resonance of sounds in the nasal cavity. This is a fairly widespread phenomenon, especially during cold weather. Every person at least once in his life has encountered a runny nose and nasal congestion, which are the most common causes of impaired diction. This defect can greatly affect people, discouraging the desire to communicate with people around them.

1. Open form. It occurs during the normal passage of air between the oropharynx and the nasal cavity. This form is observed with defects in the development of the upper jaw and palate.
2. Closed form. It is observed when changes occur in the nasopharynx that interfere with normal nasal breathing.

In some people, these forms may be present at the same time. In this case, we can talk about mixed rhinolalia.

Causes

• congenital cleft palate and upper jaw (“cleft lip” and “cleft palate”);
• violation of the correct anatomy of the nasal and oral cavities after injuries, operations, neoplasms;
• inflammation of the nasal mucosa;
• tumors, polyps, hypertrophy of the nasal mucosa;
• curvature of nasal cartilage;
• short frenulum of the tongue;
• removal of overgrown adenoids;
• absence or bifurcation of the tongue;
• disruption of the glossopharyngeal and vagus nerves.

All of the above reasons can be divided into 2 groups: functional and organic changes.

1. Functional factors include those factors that are not associated with a violation of the correct location of organs. Examples include a runny nose or adenoids.
2. Organic changes are those pathologies that are acquired by the fetus before birth or during life and deform the bones and soft tissues of the oral and nasal cavities. Organic rhinolalia includes clefts of the upper lip and palate, scars after injuries or surgical interventions.

There is another separate reason that can make any person temporarily nasal. Crying is such a factor, as it causes swelling of the inner surface of the nasal cavity and a runny nose. This condition does not affect the characteristics of the respiratory system and does not require special medical interventions.

Symptoms

In addition to changes in the pronunciation of sounds, a nasal voice may be accompanied by other symptoms of diseases that cause speech impairment. These signs include:

1. Characteristic cleft palate and upper lip.
2. Difficulty or absence of nasal breathing.
3. Hearing impairment.
4. Frequent respiratory diseases.

Newborn babies with congenital anomalies of the upper jaw have problems with sucking and swallowing. They may leak milk from their nose when feeding. In the future, without surgical correction of these disorders, problems with the development of speech skills develop: lack of babbling, delay in the first words. In adulthood, these pathologies can lead not only to medical (dentition and chewing problems) and cosmetic problems, but also to the development of psychological disorders, which will be expressed in isolation and lack of interest in communicating with peers and people around them.

Diagnostics

It is very easy to suspect a defect such as rhinolalia. To do this, it is not necessary to visit a doctor, since the characteristic pronunciation of sounds is easily captured in everyday speech. But identifying the real causes of this pathology may require the attention of specialists in otolaryngology, dentistry and speech therapy.

A correct diagnosis and the factors that caused its development can be established only after an appropriate examination. It should include:

• visual examination of the mouth and nose;
• rhinoscopy;
• pharyngoscopy;
• X-ray of the nasopharynx;
• electromyography.

Only after evaluating all the examinations completed and consulting a number of doctors can you accurately determine the cause of the disease and choose the tactics for its treatment.

Diagnosis of birth defects is possible even during pregnancy. Mandatory ultrasound screenings allow you to find out about this feature of the unborn baby from 16-18 weeks of pregnancy.

Elimination of rhinolalia

It is worth knowing that almost all types of rhinolalia can be corrected. The approach to choosing methods for getting rid of this condition should be comprehensive.

First, you need to try to remove the cause of the disease, and then correct its consequences using individual techniques. So, for the most common cause of a nasal voice - a runny nose, saline rinses of the nasal cavity (Aqualor, Dolphin, Marimer), vasoconstrictor drops (Tizin, Xymelin, Galazolin), local antiseptics (Miramistin, Protargol or Sialor) are prescribed.

Anatomical disorders usually require surgical intervention. To correct congenital disorders, there are proven plastic surgery techniques that make such a defect almost invisible to others and save a person from the problems it causes. In addition, operations may be required in a number of other cases: polyps and hyperplasia of the nasal mucosa, proliferation of adenoids, the presence of injuries and deforming scars, neoplasms.

After surgical intervention, you need to visit orthodontists in order to assess the condition of the dentition and bite. If these indicators are violated, bracket systems are used, which, using precisely calculated pressure, allow each tooth to be set in its place.

Together with the work of dentists, we need the help of speech therapists and phoniatrists, who help establish the correct pronunciation of sounds, wean them from the habit of nasal sounds, strengthen the muscles of the tongue and palate, and help them gain free communication skills. The sooner this set of measures is carried out, the faster and easier it is to return correct speech to a person after rhinolalia.

Slanko Anna Yurievna

Certain pathologies can not only be annoying and cause poor health, but also significantly affect a person’s voice. Many people are familiar with this unpleasant feeling when, due to the nasality of your voice, others have difficulty understanding you, since some of the sounds disappear and speech becomes slurred.

This phenomenon often occurs with a runny nose and disappears when it is cured. However, if a patient comes to the doctor with the complaint: “The nose is breathing, but I speak through the nose!”, then this is already a reason to seriously worry about health. Therefore, next we will talk about the reasons for this phenomenon and ways to eliminate it.

Nasality is quite common

Before we figure out why a person speaks through his nose, we first briefly consider what this pathological phenomenon is.

Nasality (rhinolalia)– incomplete voice disorder (dysphonia), expressed in a sound defect in the pronunciation of sounds.

Appears due to excessive or insufficient resonance of the nasal cavity.

Reference. Nasality does not allow air to pass through the nose; as a result, a person recreates sounds exclusively with the mouth, and the nasal cavity does not participate.

As a result, speech becomes slurred and sounds are distorted, especially “m” and “n”.

It is worth noting that nasality is divided into several varieties, each of which has certain characteristics:

• open– sounds have the ability to pass not only through the mouth, but also the nasal cavity;
• closed– the patency of the nasal cavity is impaired, due to which it is completely closed to the passage of sounds and air;
• mixed– characterized by nasal obstruction and weakened velopharyngeal seal.

Rhinolalia is divided into several varieties depending on the nature of the disturbance in the passage of sounds and air

The causes of complaints “I talk through my nose” can be divided into two groups. The first group includes the following circumstances:

1. Poor mobility of the palate.
2. Defects of the soft or hard palate.
3. Incorrect form of tongue during pronunciation.
4. Congenital or acquired curvature of the nasal septum.
5. Injuries of various types.

The second group includes ailments accompanied by such a voice disorder:

• nasality after and during it;
• hypertrophy and swelling of the nasal concha;
• tumor formation in the nasopharynx;
• tertiary syphilis.

In addition, nasal sound can be observed in the absence of any pathologies. It may be a consequence of the habit of incorrectly pronouncing words due to hearing impairment (deafness or hearing loss).

Having determined the causes of this condition, let’s move on to considering the issue of how not to speak through the nose, that is, to eliminate this unpleasant voice defect.

How to get rid of nasality

Experts say that it is possible to eliminate almost all cases of this defect, but this cannot be done without medical assistance.

Therapeutic measures depend on the type of illness that provoked the development of nasality.

If the cause was the usual rhinitis, then nasal drops or a spray to relieve nasal congestion will come to the rescue: “”, “”, “Sanorin”, etc.

In addition, rinsing the nasal cavity with products based on sea water or ordinary saline solutions, which have proven themselves to be effective in treating a runny nose ("", "", "Quix"), will help.

If the cause is more serious, the doctor may prescribe surgery to perform the following actions:

1. Elimination of anatomical defect.
2. Correction of nasopharyngeal deformity.
3. Correction of a deviated nasal septum.
4. Installation of a pharyngeal arbitrator.
5. Removal of tumors, adenoids, polyps.

After surgery, it is necessary to massage the scars of the palate and monitor the correctness of the velopharyngeal closure.

In addition, an additional course is prescribed physiotherapy, psychotherapy, and sessions with a speech therapist.

Reference. The surgeon is only able to eliminate the cause of rhinolalia, after which a speech therapist gets to work, who can teach how to pronounce sounds correctly.

Classes with a speech therapist

What should you do if you speak through your nose when no pathologies have been identified during examination?

The speech therapist will form the correct pronunciation of sounds

Perhaps this is just a habit that has been formed over a long time.

Here, classes with a speech therapist will help eliminate nasality, including the following exercises:

• articulation and breathing exercises;
• speech therapy massage of the soft and hard palate;
• correct pronunciation and speech delivery.

Articulatory gymnastics is suitable for performing both open and closed forms of rhinolalia and includes the following exercises:

1. Pull your tongue down to your chin and hold it in this position for 5-10 seconds.
2. Perform movements with your tongue sticking out from one corner of your mouth to the other.
3. Open your mouth wide, stick out your tongue and make circular movements with your tongue.

In addition, the speech therapist teaches the patient to breathe correctly (with open rhinolalia). To do this, the patient is asked to perform fairly simple exercises:

• puff out one's cheeks;
• blow soap bubbles;
• imitate blowing out fire.

Against this background there is a parallel work on the correctness of speech, which consists of pronouncing certain combinations of sounds. Such exercises are performed both with a speech therapist and given to the patient as homework.

Conclusion

I speak through my nose after a cold - a circumstance that worries many people, judging by the number of such statements on forums. However, there is nothing wrong with that. This is simply a residual phenomenon of the disease that passes over time.

But if nasality appears for no apparent reason, in the absence of a runny nose or cold, then this circumstance is a reason to consult a specialist.

Where are the paranasal sinuses located?

Sweating during sinusitis is not uncommon and depends on the form of the disease. First, let's figure out what sinusitis is and where it comes from.

Everyone has heard about the maxillary sinuses, but few know where they are located. In general, the paranasal sinuses are located inside the facial bones. On the inside, they are lined with mucous membrane, which is a continuation of the nasal mucous membranes. The sinuses and nose communicate with each other, so when a healthy person breathes, air constantly enters not only the nose, but also the sinuses (another name for the sinuses).

There are quite a few sinuses on the facial skull, but most often we are faced with inflammatory diseases of the frontal sinus (frontal sinusitis) and the maxillary sinus (sinusitis). The picture clearly shows where they are located.

If several sinuses are involved in the process, then the doctor - an otorhinolaryngologist, also known as an ENT specialist - makes a diagnosis: polysinusitis. When the disease affects all sinuses, we are talking about pansinusitis.

It turns out that there are different types of sinusitis!

Doctors divide sinusitis into several types:

1. Acute catarrhal;
2. Acute purulent;
3. Acute allergic;
4. Acute odontogenic (coming from inflammation of the jaws);
5. Chronic forms: edematous catarrhal;
6. Purulent;
7. Mucopurulent;
8. Odontogenic;
9. Allergic.

Headache and sweating with sinusitis

Most often, doctors deal with the edematous-catarrhal form, then in frequency comes purulent sinusitis, and then the mixed type. Purulent sinusitis causes the most suffering; in addition, it can be complicated by ulcers on the mucous membrane and even damage to bone tissue. And this, in turn, leads to external fistulas: that is, an abscess opens on the skin of the face.

When the purulent contents of the sinuses are supplemented by the development of anaerobic bacteria, the pus itself acquires a fetid odor. In such cases, excessive sweating and sinusitis are inextricably linked, because the body temperature is increased, and, as is known, in case of infectious diseases the body reduces the temperature with the help of abundant water.
And, of course, neither self-medication nor folk remedies will help here; only the help of a qualified specialist in ENT diseases can cure purulent sinusitis.

The most common causes of sinusitis

Sinusitis can be a complication after diseases such as measles, flu, colds with runny nose, and other infectious diseases.

Sinusitis can also be complicated by diseases of the 4 roots of the upper back teeth, including the molars.

Allergic sinusitis can be no less painful and develops in response to contact with any allergen to which the body of a particular person reacts. This can include house dust, pollen, and pet dander (note, not fur itself, but dander).

Sometimes several years of continuous suffering with chronic inflammation of the maxillary sinus pass before the “culprit” of the disease is identified. And when it turns out to be ordinary house dust or microscopic dust mites (by the way, they live in every home), the first reaction can be simply shock. But doctors deal with this every day and know how to diagnose and treat such conditions.

How do different forms of sinusitis manifest themselves?

Procedure in the ENT office - treatment of sinusitis

People who suffer from chronic sinusitis know very well how an exacerbation begins. And those who encounter this for the first time are surprised and frightened when their cheeks near the nose suddenly begin to hurt (look in the picture, these are just projections of the maxillary sinuses). The nose is usually “stuffed”, nasal breathing is difficult. This is accompanied by a headache, and in severe cases, fever and severe sweating.

If acute sinusitis can be completely cured, this is very good, but often it becomes chronic, with exacerbations every few months. It can get worse from the slightest cold; such chronic patients are afraid of drafts, are terrified of hypothermia, because they know that after this there will be another sick leave for 2 (and sometimes more) weeks, a constant headache and malaise.

Treatment of sinusitis - what methods have been used in recent years

Sinusitis is treated by otolaryngologists in clinics - either at the place of residence, or in paid private medical centers, or ENT offices.

First, the doctor, of course, makes a diagnosis to make sure that the patient has sinusitis and not inflammation of the roots of the teeth or another disease. To do this, a general examination and palpation (feeling with fingers) of painful areas are performed. Using special devices, the nasal passages, external auditory canals, and oral cavity are examined.

Sometimes a quick examination is enough to make a preliminary diagnosis. But in most cases, if sinusitis is suspected, an x-ray of all sinuses is taken. The image often shows the level of fluid (pus) in a particular sinus.

Previously, in such cases, the patient was immediately offered to make a puncture and release the pus. A puncture is made through the nasal cavity, the pus is pumped out, and the maxillary sinus is washed with antibiotics. In cases where chronic sinusitis becomes almost continuous, a plastic tube is inserted into the sinus through a puncture, which is attached with an adhesive plaster to the forehead. This causes, in addition to physical, also moral suffering. Therefore, doctors are trying to move away from such methods, because medical science does not stand still and constantly offers new products, including for ENT pathology.

Treatment with strong antibiotics - general and local

Purulent sinusitis is treated only with antibiotics, which are prescribed in the form of tablets and in the form of drops (aerosol), which are injected directly into the nasal cavity. New types of antibiotics are constantly appearing in pharmacies, this is due to the fact that bacteria get used to a certain antibiotic, and it ceases to act on them.

In addition to taking antibiotics orally (tablets), it is imperative to instill medicinal products containing other antibacterial drugs into the nose. Today they are sold in a convenient aerosol form. It’s enough just to spray 1-2 sprays into your nose 2-3 times a day. The only condition is that before this the nose must be “decomposed” with drops like Naphthyzin or Galazolin, so that the mucous membrane is not so swollen and does not block access to the medicine inside the sinus.

Sweating and stuffy nose with sinusitis

The sequence of actions is as follows: first, vasoconstrictor drops are dripped into the nose (by the way, they must be instilled correctly - with your head tilted to the side, into the lower nostril). After 5 minutes, when normal nasal breathing has been restored, an antibiotic is sprayed. Sometimes before these procedures, the nasal cavity is washed with products containing sea salt.

If the measures taken do not help relieve sinusitis, and nasal congestion, fever and sweating recur several times a year, the patient is offered surgery.

Surgery to restore normal nasal breathing

There are three types of nasal surgeries to restore normal breathing:

1. Septoplasty is an operation to correct a deviated nasal septum. The defect may be congenital, in other cases it appears after injury. During the operation, the surgeon restores the normal structure of the nasal septum, after which nasal congestion disappears.
2. Removal of excess nasal mucosa is done in cases of severe overgrowth of the mucous membrane. It blocks the mouths through which the nasal cavity communicates with the sinuses, as a result, bacteria accumulate and multiply in the sinuses, which leads to sinusitis. When part of the mucous membrane is removed, air begins to circulate freely through the sinuses, which leads to normalization of the functions of the nasal sinuses.
3. Removal of the inferior turbinates is performed according to the same indications and is not difficult. The inferior turbinates are small cartilages inside the nose itself; removing them also frees the ostia for normal air circulation.
4. Combined surgery – when all three of the above interventions are performed at once. It takes longer, but its effect is more significant.

The number of allergy sufferers in the world is growing rapidly, so the problem of treating allergies with the help of special means is becoming urgent. Even just following a few rules will help you breathe easier.

Firstly, your home needs to be wet cleaned regularly.

Secondly, monitor the humidity in the house. If the humidity is below 40 percent, be sure to purchase a humidifier.

Thirdly, change pillows and blankets made of down and wool to synthetic ones; remember that it is in natural materials that dust mites love to settle, which cause allergic sinusitis and, as a result, increased sweating.

It happens that people talk as if their nose is constantly stuffy, somehow nasally. As a result, some sounds disappear and speech becomes slurred. The scientific name for twang is rhinolalia– distorted pronunciation of sounds and changes in voice timbre, which is caused by a violation of the resonator function of the nasal cavity. The sounds that suffer most from nasality are “m” and “n”.

There are nasal sounds:

• closed form,
• open form.

With a closed form of nasality the entrance to the nasal cavity is constantly covered by the tongue, and the nose is closed to the passage of exhaled air and sound. Closed nasality is observed with chronic runny nose, adenoids, nasal polyps, and the voice becomes dull.

With an open form of nasality During the pronunciation of sounds, air enters not only the oral cavity, but also the nose. Open nasality is observed with defects of the hard and soft palate, while the voice acquires a nasal tint, and spoken sounds are distorted.

It can be observed in the absence of any anatomical disorders, as a result of the skill of incorrect pronunciation of words, for example, in case of deafness due to lack of auditory control.

In addition to the lips and tongue, resonators take part in the formation of speech sounds, which affect the quality of the spoken sound. The main resonators in humans are the oral and nasal cavities, each separately. This means that the exhaled air stream that produces the sound can come out either through the mouth or through the nose. The nasal resonator takes part in the formation of the sounds “m”, “n”, “m”, “n”, all other sounds are formed using the oral cavity resonator. And the ability of air to pass through the mouth and nose is regulated by the tongue. If the muscles of the tongue are relaxed, it hangs freely, and the air stream passes without obstacles from the lungs into the nasal cavity, forming a “nasal” sound, and if the muscles of the tongue are tense, it is raised upward and the air stream has to exit through the mouth, resulting in the formation of a “oral” sound. sound.

Reasons why people talk through their noses

• congenital defects of the hard and soft and palate;
• irregular shape of the tongue when producing sound and insufficient mobility of the soft palate;
• , causing difficulty in nasal breathing;
• inflammation of the nasal mucosa (runny nose);
• deviated nasal septum;
• injuries.

Nasal Correction

Doctors believe that almost all cases of nasality can be corrected, but in this case it is impossible to do without medical help. The only exception is a runny nose that goes away on its own.

Nasality can be eliminated with the help of special speech therapy exercises to strengthen the speech apparatus. If the nasal tone is caused by anatomical disorders, surgical treatment is often performed.