Nasal Voice Symptoms
When cold season comes around, we all suffer from the burden of a runny nose. This causes the nose to fail at its most basic functions: allowing us to smell and to breathe air.  But one other often underappreciated function of the nose is the part if plays in phonation, which means the ability to speak. When you speak, air from your lungs vibrates your vocal cords and creates sound waves. These waves then pass through your mouth and your nose, where their character and resonance are changed to create your own unique voice. 
Anything that restricts the flow of air through your nasal passages can give your voice a squeaky nasal sound. Colds, allergies, and congestion are the classic causes. 
Nasal voice may be associated with these common symptoms:
Nasal Voice Causes
Most of the time, a nasal voice is caused by congestion of the nasal turbinates. These are outpouchings of tissue in your nose that help warm and clean the air you breathe. When these become inflamed because of allergies, a cold, or a sinus infection, they change the airflow through your nose and this affects the quality of your voice. 
- Virus, bacterial, or fungal infection: Your nose is the frontline of exposure to common germs. If any of these infections take hold, you may get a stuffy nose and change in your voice. [2,3]
- Allergy: The inflammatory reaction due to allergies can cause nasal congestion and nasal voice.  Certain medications like aspirin can trigger nasal inflammation in some individuals through a similar mechanism. 
- Masses: Tumors or polyps can block airflow and cause nasal voice and frequent infection. 
- Structural: Any alteration of the internal structure of your nose, such as a deviated septum, might change the sound of your voice. 
- Cultural: Some accents are just more nasal in sound! 
5 Possible Nasal Voice Conditions
The list below shows results from the use of our quiz by Buoy users who experienced nasal voice. This list does not constitute medical advice and may not accurately represent what you have.
Acid reflux disease (gerd)
Acid reflux disease, also known as GERD, occurs when the acidic contents of the stomach come back up into the esophagus. The most common symptoms are heartburn and regurgitation.
Top Symptoms: nausea, sore throat, pain below the ribs, cough with dry or watery sputum, deep chest pain, behind the breast bone
Urgency: Primary care doctor
The common cold is a viral infection of the upper respiratory tract, which includes the nose, mouth, sinuses, throat, and larynx. There are over 200 viruses that can cause upper respiratory infections, and usually the exact virus behind a cold is never known.
The common cold is, of course, very common. Americans catch over one billion colds per year, with adults averaging two to three per year, and children averaging as many as eight colds per year.
The common cold usually lasts about a week, and is self-limited (meaning it goes away on its own). Although there is no treatment for the common cold, there are many strategies for prevention and improvement of symptoms.
Top Symptoms: fatigue, headache, cough, sore throat, congestion
Symptoms that never occur with common cold: being severely ill, severe muscle aches, rash, severe headache, sinus pain
Acute bacterial sinusitis
Acute bacterial sinusitis, also called bacterial rhinosinusitis or "sinus infection," has symptoms much like viral rhinosinusitis but a different treatment.
Any sinusitis usually begins with common cold viruses. Sometimes a secondary bacterial infection takes hold. Like cold viruses, these bacteria can be inhaled after an infected person coughs or sneezes.
Anyone with viral sinusitis, upper-respiratory allergy, nasal passage abnormality, lung illness, or a weakened immune system is more prone to bacterial sinusitis.
Symptoms include thick yellowish or greenish nasal discharge; one-sided pain in the upper jaw or teeth; one-sided sinus pain and pressure; fatigue; fever; and symptoms that get worse after first improving.
See a doctor right away for severe headache, high fever, stiff neck, or vision changes. These can indicate a medical emergency.
Diagnosis is made with a simple examination in the doctor's office.
Bacterial sinusitis can be treated with antibiotics, but this is not always necessary. Often rest, fluids, and over-the-counter pain relievers and decongestants are enough.
Prevention is done through good lifestyle and hygiene to keep the immune system strong.
Top Symptoms: fatigue, headache, cough, sinusitis symptoms, muscle aches
Symptoms that always occur with acute bacterial sinusitis: sinusitis symptoms
Symptoms that never occur with acute bacterial sinusitis: clear runny nose, being severely ill
Urgency: Primary care doctor
Acute viral sinusitis
Acute viral sinusitis, also called viral rhinosinusitis or "sinus infection," occurs when viruses take hold and multiply in the sinus cavities of the face.
It is most often caused by the same viruses that cause the common cold and spreads the same way, through an infected person's coughing or sneezing.
Because children have small, underdeveloped sinuses, this illness is far more common in adults.
Symptoms include clear nasal discharge (not greenish or yellowish,) fever, and pain if facial sinuses are pressed.
If there is rash, severe fatigue, or neurologic symptoms (seizures, loss of sensation, weakness, or partial paralysis,) see a medical provider to rule out more serious conditions.
Diagnosis can usually be made through history and examination alone.
Antibiotics only work against bacteria and cannot help against a viral illness. Therefore, treatment consists of rest, fluids, and fever/pain reducers such as ibuprofen. (Do not give aspirin to children.) Symptoms of viral sinusitis last for about seven to ten days. As with the common cold, the best prevention is frequent and thorough handwashing.
Top Symptoms: headache, cough, sinusitis symptoms, sore throat, congestion
Symptoms that always occur with acute viral sinusitis: sinusitis symptoms
Symptoms that never occur with acute viral sinusitis: being severely ill
DiGeorge syndrome (22q11.2 deletion syndrome), a disorder caused by a defect in chromosome 22, results in the poor development of several body systems. Medical problems commonly associated with DiGeorge syndrome include heart defects, poor immune system function, a cleft palate, complications related to low levels of calcium in the blood and behavioral disorders.
Top Symptoms: hearing loss, trouble swallowing, facial asymmetry, nasal voice, having more than 10 fingers or toes
Urgency: Primary care doctor
Nasal Voice Treatments and Relief
Most causes of nasal voice are relatively benign, such as allergies or colds, and can be managed at home. However, if you experience frequent episodes of nasal voice or congestion, chronic nasal voice, a progressively worsening nasal voice, or nasal voice and/or congestion after using certain medications, you should seek advice from a physician. [8,12]
- Saline spray: Sprays of intranasal saline can diminish inflammation and resultant nasal voice. 
- Steroid spray: Steroid sprays are effective at diminishing nasal inflammation such as from allergies and resultant nasal voice. 
- Decongestants: Decongestants such as pseudoephedrine can be effective short-term at diminishing nasal congestion, but they generally should not be used for more than three consecutive days. 
- Antihistamines: If your nasal voice is connected to allergies, you can try over-the-counter antihistamines. 
- Neti pot: You can rinse out your nose with a solution of distilled water, salt, and baking soda to alleviate the symptoms associated with nasal voice. 
- Imaging and Endoscopy: For chronic nasal obstruction or nasal voice, a physician may look inside your nose using X-rays or a special camera (scope). This is done to make sure there are no masses or structural defects causing your nasal voice symptoms. 
- Medication: Physicians may prescribe medications that reduce nasal congestion in an attempt to fix your nasal voice. 
- Surgery: In rare cases, nasal voice may be caused by a mass or a structural defect in the nasal cavity. An otolaryngologist (ENT physician) can perform surgery to remove these masses or fix these defects. 
You should seek help without delay if you have:
- Intractable nosebleed.
- Inability to breathe through your nose or mouth. 
- Airway swelling. 
- Fever. 
- Rapidly progressive fever, (https://www.buoyhealth.com/current/headache-migraine-diagnosis-and-treatment/), (https://www.buoyhealth.com/symptoms-a-z/swollen-face/),  and/or green nasal discharge,  especially if you have diabetes.
Questions Your Doctor May Ask About Nasal Voice
To diagnose this condition, your doctor would likely ask the following questions:
- Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
- Do you have a stuffy nose?
- Do you have a sore throat?
- Are you experiencing a headache?
The above questions are also covered by our A.I. Health Assistant.
If you've answered yes to one or more of these questions
Take a quiz to find out why you're having nasal voice
Nasal Voice Symptom Checker Statistics
People who have experienced nasal voice have also experienced:
- 16% Congestion
- 5% Mouth Breathing
- 5% Mucous Dripping In The Back Of The Throat
People who have experienced nasal voice were most often matched with:
- 50% Acute Bacterial Sinusitis
- 37% Acid Reflux Disease (Gerd)
- 12% Common Cold
Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).
- Sinus Infections and Nasal Disorders. DukeHealth. DukeHealth Link.
- Ahmed S, Hussain A, Kafil MY, et al. Idiopathic Palatal Palsy. Journal of Family Medicine and Primary Care. 2017;6(2):437-438. NCBI Link.
- Galletti B, Mannella VK, Santoro R, et al. Ear, Nose and Throat (ENT) Involvement in Zoonotic Diseases: A Systematic Review. Journal of Infection in Developing Countries. 2014;8(1):17-23. Semantic Scholar Link.
- Makowska J, Lewandowka-Polak A, Kowalski ML. Hypersensitivity to Aspirin and Other NSAIDSs: Diagnostic Approach in Patients with Chronic Rhinosinusitis. Current Allergy and Asthma Reports. 2015;15(8):47. NCBI Link.
- "If You Want to Speak Midwestern, Pretend the Lower Half of Your Jaw Doesn't Exist," Writer Says. Michigan Radio. Published December 5, 2016. Michigan Radio Link.
- Allergic Rhinitis: Your Nose Knows. Harvard Medical School: Harvard Health Publishing. Updated May 21, 2018. Harvard Health Publishing Link.
- Fisher KV, Swank PR. Estimating Phonation Threshold Pressure. Journal of Speech, Language, and Hearing Research. 1997;40(5):1122-1129. NCBI Link.
- Cheung A. Allergic Rhinitis & Asthma. The Royal Children's Hospital Melbourne. RCH Link.
- Brook I. Acute Sinusitis. Antimicrobe. Published 2014. Antimicrobe Link.
- Knott L. Acute Sinusitis. Patient.info. Published November 21, 2018. Patient.info Link.
- Benninger M. Let's Talk About Voice with Michael Benninger, MD. Cleveland Clinic. Published April 15, 2010. Cleveland Clinic Link.
- Pai D. How to Tell if You Have Nasal Polyps. Keck Medicine of USC. Keck Medicine Link.
- Pediatric Infant Apnea. Children's National Health System. Children's National Link.
- Diabetic Ketoacidosis. FamilyDoctor.org. Updated June 27, 2017. FamilyDoctor.org Link.
- Diabetic Hypoglycemia. Mayo Clinic. Published May 10, 2018. Mayo Clinic Link.
- Diabetes: Complications. Cleveland Clinic. Updated October 26, 2017. Cleveland Clinic Link.
- Vijayabala GS, Annigeri RG, Sudarshan R. Mucormycosis in a Diabetic Ketoacidosis Patient. Asian Pacific Journal of Tropical Biomedicine. 2013;3(10):830-833. NCBI Link.