Speech and voice quality problems caused by nasal blockage?

@adam675

Thank you for sharing this.

Did you have these speech issues before surgery? Did they worsen afterwards?

Did you ever have sinuses checked or just nasa passages?

I would like to add here along with your story. I had zero issues ever with talking breathing.

I was wrongly diagnosed with nasal/sinus issues for a minor complaint totally unrelated to something that would have ever needed a septoplasty/nasal/sinus surgery.

Immediately after surgery I could not get the proper air out to speak. When I elevated my voice every thing would seal off and close.

I saw multiple providers explaining this whom, took no responsibility or care to acknowledge such issues.

They diagnosed me the same velopharnygeal insufficiency, which would be impossible as I was in my mid 30’s and have always had clear, concise speaking capabilities.

The altered airflow dynamics in the nose is what causes this. It’s very distressing and causes anxiety with speech as well as tension headaches from overworking muscles to speak and breathe.

I’m in the US where even still very few ENTa will acknowledge this issue. It’s all over.

may i ask you a few things , did your congestion issues only happen lying down or all day long? the stent that you tried is it pretty much the same thing as a nasal strip you could buy at pharmacy ? I have congestion issues only lying down , i did a septoplasty+turbinate reduction but only one side is better , the other side keeps on blocking everynite even if i put a nasal strip........sprays dont work anymore , so annoying it affects sleep. Good luck

My voice is up at least one octave as a result of eye meds. Also my ears pop & make noises & I spit way too much. All this from eye drops…ENT are all connected. Also when I go to the dentist, I make sure she checks neck & glands as well. I eat healthy & use drops sparingly ie only when I have pain…let go & let god is my motto for today. Best Marianne

The eyes drain through the nose and are surrounded by sinuses and their own lacrimal gland of which all of that will pass through the throat on the way down. I’m guessing this new revelation will open new avenues for you. I have a sinus infection and on the third week and 2 antibiotics later, gave me pharyngitis. I wish you the best and will also wish you that you’ll feel much improved soon

Hi.
I had the speech issued prior to my surgery and I had both the sinuses and nasal turbinates checked up at that time. The diagnosis was enlarged turbinates and a deviated septum. the sinus cavities were apparently normal.
After the surgery, I could breathe a little better and my voice was also a little clearer, but nothing like when I started using the stents.

Hi,
Before the surgery the congestion was constant. It's a little better now but breathing still feels forced (regardless of whether I'm standing or lying down). I also used the nasal strips and the sprays but they had very little effect. My current routine is a saline wash every morning and evening as well as using the nasal stents occasionally.
The stents I use are not like the strips you find in pharmacy. they're made of a nitinol braided mesh and look like the stents used in heart surgeries (photo attached). It's a kind of goofy set up. You use an insertion tube to put them in, and once inside the nasal airway you pull said insertion tube out which causes the stents to expand. They're a completely mechanical solution that brute force their way into opening the nose but my breathing gets noticeably easier when I use them. However there are the side effects l mentioned in my original post. It's painful to put them in and bring them out and they initially cause a lot of sneezing because the body reacts to a foreign substance being inside the nose. Now I only use them when I have to make a presentation at university because they make my voice that much clearer. Having said this, pain and discomfort are subjective to a certain degree. What's really uncomfortable for me could be only slightly annoying for you, so maybe give them a try.
Good luck.

I would like to add,
The problem l have now is very similar to what you described. Whenever I tried raising my voice or exhaling more forcibly, everything would seal off. You said this was diagnosed as valopharyngeal insufficiency. As I understand it, valopharyngeal insufficiency is when the valve can't close properly because of a cleft palate letting air out the nose when it should not.
In my case the opposite effect happens. My endoscopy showed the valopharyngeal valve closing while I'm trying to let air out. Basically it closes when it shouldn't. My doctor said this was a functional issue: I was the one commanding these muscle movements because I had learned to breathe wrong.
However when I started using the stents and my nasal passages were forcibly opened, I could speak comfortably and the valopharyngeal valve stopped closing unnaturally. This suggests that the problem is not functional but rather mechanical. My best guess is that trapped air builds up in the narrowing nasal passages potentially creating an area of high pressure beyond the valve. Air flows from high to low pressure so when the outgoing air influx from the lungs stops or reduces the only thing that air could do is reverse direction. The valve could be closing as an autonomic reflex to stop that reverse flow. When the air beyond the valve slowly escapes through the nasal passages and pressure decreases, it would then open again which would also explain the short bursts of relief. I've yet to see another physician and this all just speculation.
You also spoke of over-exerting the muscles for speech and how that causes headaches. Did ever feel unnatural vibrations in your nose when talking? I feel that the energy I input for speech is not proportional to the output volume and I 'm guessing a part of that sound is getting trapped inside the nose because of the congestion and lost as vibration.

Thanks for responding and hope you feel better.

@adam675

Thank you for responding.

I do feel that my own vocal tone has become painful in my nose at times. Like the verberation is off.

I do have a lot of congestion now. Where I did not before.

I do have sinus issues now post surgery. Do you have any sinus issues?

I have found at times that talking while forcefully closing the soft palate, although I sound plugged up on purpose, is less painful into the nose.

I do also feel that possibly the additional space made with septoplasty and other tissue removal can cause the wrong type of echos that were not there before.
Like areas of ricocheting voice.
A congested nose would more dampen the sound, where I feel my sound takes in too much air, hence me trying to dampen the sound on my own.

The way I have heard this happening is called Bernoullis principle.
The anterior of the nasal cavity takes in the most air and the posterior is supposed to work with the anterior portion like a tube.
If you alter this tube function by way of septoplasty/turbinate reduction it can mess up the way the “tube” pulls air in and out.
This is why I believe the only control we have when it changes is the posterior valve that kicks in autonomically to slow control the air.

I know your ENT explains it as something you have trained yourself to do, but I believe it’s a function that kicks in after these surgeries. I believe that’s where my neck muscular pain started because I am using those muscles to slow/control the feedback of air. As where before it was a smooth function.

To me what it sounds like you are doing with placing the tubes in your nose, is evening out the space posterior and anterior.
I’m not sure what type of turbinate reduction you had, but if your surgeon removed bone from the front of you nasal cavity which they typically do, then you posterior turbinate tends to enlarge to compensate/slow air from the enlarged gap in the front.

There a many people with stuffed up congested noses all of the time and their vocal/air/tone doesn’t change to the point of having alterations elsewhere. It’s more of just an annoying stuffy voice.

Might be worth reaching out to a University level trained Rhinologist to assess that.
Dr. Nayak at Stanford is a good one.