An objective method of assessing nasality: a possible aid in the selection of patients for adenoidectomy

We present an appraisal of an objective technique for assessing nasality, or the nasal component of speech. Evidence suggests that a subjective impression of hyponasal speech is related to the adenoid volume and the radiographic palatal airway, although clinical assessments may have poor inter- and intra-observer agreement. Determination of the oral and nasal acoustic ratio or 'Nasalance' is quick, painless, and non-invasive. There was good agreement and reproducibility within normal subjects when test phrases were used. Words such as 'bananas' which contain nasal consonants showed large reductions in the Nasalance score when the nostrils were occluded and are of use in clinical assessment. This method may be of use in refining the selection of children for adenoidectomy.