In what ways can you adjudicate the game mechanics of the Ventriloquism spell?

The Ventriloquism spell (identical in both 3.5 & PFRPG 1e rules) is noted for having a rather generic text entry description that is devoid of any game mechanic uses. Unlike the easier-to-use visual figment illusion spells, this spell causes a lot of DM / Player debate on how it actually plays out on the tabletop due to its auditory-only manifestation.

I’d like some help in hearing how other tables use practical (and even clever) uses of the Ventriloquism spell to impact such game mechanics like rolling for initiative, effects on action economy, etc. In addition, I’m not aware of any beneficial game mechanics for "distracting an opponent" – such as the ventriloquist throwing her voice by yelling elf battle cries behind some angry orcs.

Thank you!

(To note: we fully understand the unique disbelief/interaction rules of auditory figment spells)