Overview

Nasal obturators reduce the airflow through your nose when you speak. They direct the air out of your mouth instead. This creates an increased pressure in your mouth to improve speech sounds.

Nasal obturators are made of silicone, which is a kind of soft rubber. They are custom-made for each person, and fit inside your nostrils.

They are hollow in the middle, but covered at the top. The top section has holes in, which allow you to breathe (although airflow will be reduced from what is normal for you). The number of holes will depend on the effect it has on your speech and breathing.

Your consultant speech surgeon or specialist speech therapist has referred you for nasal obturators because your speech is affected by too much air escaping through your nose. This happens because of a condition called velopharyngeal dysfunction (VPD). 

Velopharyngeal dysfunction (VPD)

VPD is a speech difficulty where the soft palate muscle at the back of the roof of your mouth does not close tightly against the back wall of your throat during speech. This causes air to escape through your nose instead of your mouth.

Symptoms

• Hypernasal speech (too much air vibrating in your nose).
• The sound of air escaping down your nose when you speak (nasal emission or nasal turbulence).
• Speech sounds might be weak, missed out or replaced with other sounds that might be easier for you to make. For example, ‘baby’ becomes ‘mayme’.

Causes

• A repaired cleft palate where the muscles are still not working correctly, or the palate remains too short. A cleft palate is where a baby’s mouth and palate have not fused properly during pregnancy.
• A soft palate that has a ‘hidden’ gap (cleft), and the soft tissues are intact but the muscles underneath are incorrectly aligned.
• A soft palate that has no cleft in it but seems too short for the space between it and the back wall of your throat.
• A soft palate that looks long enough, but where your throat is too large for it to reach across.
• A soft palate that does not move and stretch normally. This can be caused by nerve messages not getting through properly, or for other reasons.

Read the NHS information about cleft lip and palates.

Other treatment options

Other options include surgery, a palate-lifting device, or the option of no device. These options will be discussed with you.

Surgery

Surgery is not suitable for everyone. It will depend on your health (it might be too risky for some people) and the reason for your speech difficulties (surgery does not resolve all types of speech difficulty).

Palate-lifting device

This is a removable device that fits in your mouth. It is made of hard plastic that extends to the back of your mouth, lifting the soft palate.

No device

You can choose not to use any devices to help with your speech.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to have nasal obturators, you will be asked to sign a consent form. This states that you understand what the treatment involves, and agree to have it.

If you would like more information about our consent process, please speak to a member of staff caring for you.