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The objective of this study was to evaluate the effects of pharmacological decongestion on nasalance scores.The participants were 20 adults with normal speech and resonance.Nasal patency was first determined by measuring the mean minimal cross-sectional area of the nasal passages by acoustic rhinometry. Each participant then read two passages as two predecongestion nasalance scores were obtained. A nasal decongestant was then administered to each nostril without removing the separation plate. Ten minutes later, nasalance scores were repeated. Finally, the separation plate was removed and the mean minimal cross-sectional area was obtained again.The outcome measures were the pre- and postdecongestion measurements of nasal patency and nasalance scores.Minimal cross-sectional area increased significantly from 0.53 cm2 before decongestion to 0.66 cm2 after decongestion. For the Turtle Passage, the group mean nasalance for the two predecongestion measures (10.70% versus 11.55%) were significantly different and the pre- versus postdecongestion measures (10.70% versus 12.15%) were also significantly different. For the Mouse Passage, the group mean nasalance scores for the two predecongestion measures (32.10% versus 32.00%) were not significantly different but the preversus postdecongestion means (32.10 versus 34.40) were significantly different. Correlation coefficients showed a negligible relationship between measures of nasal patency and nasalance scores for both stimulus passages.Nasalance score variability was small and not meaningful for standard clinical purposes. The correlation between nasalance scores and nasal patency was weak.