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Updated: Jun 15, 2025

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The Source of Nasal Rustle (Nasal Turbulence): An Overview of Current Evidence
1Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA.
Abstract:
ObjectiveNasal rustle (also called nasal turbulence) refers to a loud distracting sound that sometimes occurs with audible nasal emission (ANE) during the production of pressure-sensitive consonants in patients with velopharyngeal insufficiency (VPI). This article examines evidence for two hypotheses of causality: vibration of the soft palate (velar flutter) and periodic motion of mucus above the velopharyngeal port (turbulent mucus).ConclusionA review of the relevant literature shows inconclusive evidence to support velar flutter as a cause of nasal rustle. In contrast, clinical observations and research involving high-speed nasopharyngoscopy suggest that nasal rustle is the result of turbulent mucus above a small velopharyngeal opening. Therefore, it is our contention that a plausible explanation for nasal rustle is one of turbulent mucus and not velar flutter.
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