In children, severe to profound deafness results in poor long-term control of frequency and amplitude. Cochlear implantation restores control of amplitude only and implies the need for additional rehabilitative strategies for restoration of control of frequency.

Hypernasality is a commonly perceived characteristic of speech in deaf adults and children, but the mechanismof this abnormal nasal resonance ispoorly understood. The impact of cochlear implantation on nasalance measures in children with severe auditory deprivationhasnot been previously reported. Weconducted a study of nasalityin 6 deaf children who had undergone cochlear implantation. Voice recordings were obtainedbefore surgery and6months after activation of the implants. The MacKay-Kummer SNAP Test-which consists ofasyllable-repetition subtest and apicture-cued subtest-i-was usedtoobtain nasalance scores for oral (bilabial, alveolar, velar, and sibilant) and nasal phonemes. Before cochlear implantation, mean nasalance scores were significantly higher than normal during the production of oralphonemesfor both subtests (p :;; 0.05). Six months after activation, the nasalance measures for all components of the syllable-repetition subtesthad been restored to within 1 standard deviation of normal. For all oralphonemesof the picture-cued subtest, the elevated nasalance scores were consistently lower aftercochlear implant activation, although the difference wasstatistically significant onlyfor velartasks. Nasalance scoresfor nasalphonemeswere within 1standarddeviation of normal both before and after implant activation. Our study showed that cochlear implantation partially corrects elevated nasalance measures. Disturbances in nasal resonance may be caused in part by the inability of deaf speakers tomonitor velopharyngealvalvingwith auditory