The image shows a case of cleft palate.
It is seen when certain words which have little nasal resonance are resonated through the nose. The defect is in the failure of the nasopharynx to cut off from oropharynx or abnormal.
Common causes are:
1. Velopharyngeal insufficiency
2. The congenitally short soft palate
3. Submucous palate
4. Large nasopharynx
5. Cleft of the soft palate
6. Paralysis of the soft palate
7. Post adenoidectomy
8. Oronasal fistula
9. Familial speech pattern
10. Habitual speech pattern.