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Sample records for impaired nasal breathing

  1. [Complex treatment approach for preschool children with impaired nasal breathing].

    PubMed

    Danilova, M A; Tzar'kova, O A; Nikitina, E S

    2015-01-01

    During the treatment of children with impaired nasal breathing (INB) cooperation of medical specialists is needed in order to reveal risk factors. The objective of the study was to prove the necessity of complex approach to the treatment of children with risk factors for INB. Multi-variant analysis of somatic and dental health of 170 children aged 4-6 was performed. The dental health was examined gradually in several steps, including physical examination. The following risk factors of antenatal and postnatal development of a child were revealed: genetic predisposition, complication of pregnancy, birth defects, somatic pathology, mastication dyspraxia, respiratory impairment, and various speech impediments. The following dentofacial anomalies prevailed: disorder of abrasion of primary dentition tubercle, development discord of cranio-facial area. The necessity of doctors' cooperation was proved during the treatment of children with impaired nasal breathing. Accurate execution of proposed treatment schemes allows eliminating risk factors promptly and decreasing the pathology severity.

  2. Does rhinoplasty improve nasal breathing?

    PubMed

    Xavier, Rui

    2010-08-01

    Rhinoplasty is a surgical procedure that aims to improve nasal aesthetics and nasal breathing. The aesthetic improvement of the nose is usually judged subjectively by the patient and the surgeon, but the degree of improvement of nasal obstruction is difficult to assess by clinical examination only. The measurement of peak nasal inspiratory flow (PNIF) is a reliable tool that has been shown to correlate with other objective methods of assessing nasal breathing and with patients' symptoms of nasal obstruction. Twenty-three consecutive patients undergoing rhinoplasty have been evaluated by measurement of PNIF before and after surgery. All but three patients had an increase in PNIF after surgery. The mean preoperative PNIF was 86.5 L/min and the mean postoperative PNIF was 123.0 L/min ( P < 0.001). Not surprisingly, the greatest improvement in PNIF was achieved when bilateral spreader grafts were used. This study suggests that rhinoplasty does improve nasal breathing. (c) Thieme Medical Publishers

  3. A comparative study on oxidative stress role in nasal breathing impairment and obstructive sleep apnoea syndrome.

    PubMed

    Passali, D; Corallo, G; Petti, A; Longini, M; Passali, F M; Buonocore, G; Bellussi, L M

    2016-12-01

    Obstructive sleep apnoea syndrome (OSAS) is a sleep disorder that leads to metabolic abnormalities and increased cardiovascular risk. This study aimed to define the expression and clinical significance of biomarkers involved in oxidative stress in patients with OSAS. A prospective study was designed to compare outcomes of oxidative stress laboratory tests in three groups of subjects. The study involved the recruitment of three groups of subjects, 10 patients with obstructive sleep apnoea syndrome with AHI > 30; 10 patients suffering from snoring at night with AHI < 15; 10 patients with nasal respiratory impairment with AHI < 5. Patients were subjected to skin prick tests for common aero-allergens, nasal endoscopy, active anterior rhinomanometry, fibrolaryngoscopy and polysomnography; and extra-routine diagnostic tests and procedures; analysis of oxidative and antioxidant (plasma thiol groups) biomarkers in blood and urine samples. No statistical differences in age, sex distribution or body mass index were present between the three groups (p > 0.05). There were significant differences in AHI among the three groups of patients (p < 0.05). No statistical significance was found in the Analysis of Variance (ANOVA) test (p > 0.05) between the levels of biomarkers of oxidative stress in the three populations studied. The results of our study show that the nose can play a role in the pathogenesis of OSAS through the production of biomarkers of oxidative stress.

  4. Correlation between subjective and objective nasal breathing assessments in examinees with nasal septum deformities.

    PubMed

    Savović, Slobodan; Smajić, Miroslav; Molnar, Slavko; Jovancević, Ljiljana; Buljcik-Cupić, Maja; Kljajić, Vladimir; Pilija, Vladimir

    2013-04-01

    Nasal obstruction is one of the most frequent disorders because of which patients see their Ear, Nose and Throath (ENT) doctors. Impaired nose breath ing is a subjective symptom and it often does not coincide with clinical nose findings and functional tests of breath ing function. Therefore, the aim of this study was to es tablish if there is an accordance between a subjective nose breathing assessment and objective methods (rhinoma nometry and acoustic rhinometry) in assessing nose breathing function in patients with diverse nasal septum deformity degrees, as well as to establish an accordance between these two objective methods. This study involved the total of 90 examinees divided into three groups. The group I consisted of examinees with nasal septum deformities less than 10 degrees. The group II consisted of examinees with nasal septum deformities ranged from 10 degrees to 15 degrees. The group III involved examinees with nasal septum deformities over 15 degrees. Each examinee had subjec tively graded his/her nasal breathing on the side of the nose septum deformity from 0 to 10, and afterwards the whole noses. Rhinomanometry and acoustic rhinometry were done on the side of the nasal septum deformities and after that on the other side of the nose using the Interacoustics SRE 2000 device. In the groups II and III there was a positive correlation between a subjective nose breathing assessment and rhinomanometric values both on the side of the nasal septum deformities and the nose as a whole, (p < 0.05), and no correlation between these traits in the group I (p > 0.05). In none of the exam ined groups correlation was found between a subjective nose breathing assessment and rhinometric values, both minimum cross-sectional area (MCA) and volume (VOL), both on the side of the nasal septum deformities and the nose as a whole (p > 0.05). There was no correlation found between rhinomanometric and rhinometric MCA and VOL values in either on the sides of nasal septum

  5. Older individuals have increased oro-nasal breathing during sleep.

    PubMed

    Madronio, M R; Di Somma, E; Stavrinou, R; Kirkness, J P; Goldfinch, E; Wheatley, J R; Amis, T C

    2004-07-01

    Breathing route during sleep has been studied very little, however, it has potential importance in the pathophysiology of sleep disordered breathing. Using overnight polysomnography, with separate nasal and oral thermocouple probes, data were obtained from 41 subjects (snorers and nonsnorers; 25 male and 16 female; aged 20-66 yrs). Awake, upright, inspiratory nasal resistance (Rn) was measured using posterior rhinomanometry. Each 30-s sleep epoch (not affected by apnoeas/hypopnoeas) was scored for presence of nasal and/or oral breathing. Overnight, seven subjects breathed nasally, one subject oro-nasally and the remainder switched between nasal and oro-nasal breathing. Oral-only breathing rarely occurred. Nasal breathing epochs were 55.79 (69.78) per cent of total sleep epochs (%TSE; median (interquartile range)), a value not significantly different to that for oro-nasal (TSE: 44.21 (68.66)%). Oro-nasal breathing was not related to snoring, sleep stage, posture, body mass index, height, weight, Rn (2.19 (1.77) cm H2O x L(-1) x sec(-1)) or sex, but was positively associated with age. Subjects > or = 40 yrs were approximately six times more likely than younger subjects to spend >50% of sleep epochs utilising oro-nasal breathing. Ageing is associated with an increasing occurrence of oro-nasal breathing during sleep.

  6. Nasal airway responses to nasal continuous positive airway pressure breathing: An in-vivo pilot study.

    PubMed

    White, David E; Bartley, Jim; Shakeel, Muhammad; Nates, Roy J; Hankin, Robin K S

    2016-06-14

    The nasal cycle, through variation in nasal airflow partitioning, allows the upper airway to accommodate the contrasting demands of air conditioning and removal of entrapped air contaminants. The purpose of this study was to investigate the influence of nasal continuous positive airway pressure (nCPAP) breathing has on both nasal airflow partitioning and nasal geometry. Using a custom-made nasal mask, twenty healthy participants had the airflow in each naris measured during normal nasal breathing followed by nCPAP breathing. Eight participants also underwent magnetic resonance imaging (MRI) of the nasal region during spontaneous nasal breathing, and then nCPAP breathing over a range of air pressures. During nCPAP breathing, a simultaneous reduction in airflow through the patent airway together with a corresponding increase in airway flow within the congested nasal airway were observed in sixteen of the twenty participants. Nasal airflow resistance is inversely proportional to airway cross-sectional area. MRI data analysis during nCPAP breathing confirmed airway cross-sectional area reduced along the patent airway while the congested airway experienced an increase in this parameter. During awake breathing, nCPAP disturbs the normal inter-nasal airflow partitioning. This could partially explain the adverse nasal drying symptoms frequently reported by many users of this therapy. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Using acoustic sensors to discriminate between nasal and mouth breathing.

    PubMed

    Curran, Kevin; Yuan, Peng; Coyle, Damian

    2012-01-01

    The recommendation to change breathing patterns from the mouth to the nose can have a significantly positive impact upon the general well being of the individual. We classify nasal and mouth breathing by using an acoustic sensor and intelligent signal processing techniques. The overall purpose is to investigate the possibility of identifying the differences in patterns between nasal and mouth breathing in order to integrate this information into a decision support system which will form the basis of a patient monitoring and motivational feedback system to recommend the change from mouth to nasal breathing.

  8. A new approach to studying the nasal and oral breathing routes.

    PubMed

    Kukwa, Andrzej; Dymek, Andrzej; Galazka, Adam; Krzeski, Antoni; Kukwa, Wojciech

    2014-01-01

    Nasal obstruction is often reported by patients. It is a consequence of a subjective feeling of impaired airflow through the nasal cavity. Currently, objective measures of nasal patency rates are very limited. Functional tests only analyze nasal breathing; they do not simultaneously assess airflow through the mouth. The aim of this study is to present a new functional test that assesses a single-stage nasal and oral breathing route. The NOFA (Nasal-Oral Flow Analyzer) is a three-channel flow meter used to perform continuous and simultaneous measurements of nasal and oral respiratory parameters. We present the application of the device and the proposed study protocol. The respiratory tracks of four selected patients are presented. Different breathing patterns are visible: exclusive nasal, exclusive oral, and mixed nasal-oral ventilation pattern. The preliminary results suggest the potential use of the NOFA in ENT practice. Further studies are necessary to evaluate the usefulness of this device in the diagnosis of patients with upper respiratory tract disorders. Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

  9. Model identifies causes of nasal drying during pressurised breathing.

    PubMed

    White, David E; Nates, Roy J; Bartley, Jim

    2017-09-01

    Patients nasally breathing pressurised air frequently experience symptoms suggestive of upper airway drying. While supplementary humidification is often used for symptom relief, the cause(s) of nasal drying symptoms remains speculative. Recent investigations have found augmented air pressure affects airway surface liquid (ASL) supply and inter-nasal airflow apportionment. However the influence these two factors have on ASL hydration is unknown. The purpose of this study is to determine how ASL supply and airflow apportionment affect ASL hydration status for both ambient and pressurised air breathing conditions. This is done by modifying and adapting a nasal air-conditioning and ASL supply model. Model predictions of change in inter-nasal airflow apportionment closely follow in-vivo results and demonstrate for the first time abnormal ASL dehydration occurring during augmented pressure breathing. This work quantitatively establishes why patients nasal breathing pressurised air frequently report adverse airway drying symptoms. The findings from this investigation demonstrate that both nasal airways simultaneously experience severe ASL dehydration during pressurised breathing. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Nasal and Oral Inspiration During Natural Speech Breathing

    PubMed Central

    Lester, Rosemary A.; Hoit, Jeannette D.

    2015-01-01

    Purpose The purpose of this study was to determine the typical pattern for inspiration during speech breathing in healthy adults, as well as the factors that might influence it. Method Ten healthy adults, 18–45 years of age, performed a variety of speaking tasks while nasal ram pressure, audio, and video recordings were obtained. Inspirations were categorized as a nasal only, oral only, simultaneous nasal and oral, or alternating nasal and oral inspiration. The method was validated using nasal airflow, oral airflow, audio, and video recordings for two participants. Results The predominant pattern was simultaneous nasal and oral inspirations for all speaking tasks. This pattern was not affected by the nature of the speaking task or by the phonetic context surrounding the inspiration. The validation procedure confirmed that nearly all inspirations during counting and paragraph reading were simultaneous nasal and oral inspirations; whereas for sentence reading, the predominant pattern was alternating nasal and oral inspirations across the three phonetic contexts. Conclusions Healthy adults inspire through both the nose and mouth during natural speech breathing. This pattern of inspiration is likely beneficial in reducing pathway resistance while preserving some of the benefits of nasal breathing. PMID:24129013

  11. Nasal and oral inspiration during natural speech breathing.

    PubMed

    Lester, Rosemary A; Hoit, Jeannette D

    2014-06-01

    The purpose of this study was to determine the typical pattern for inspiration during speech breathing in healthy adults, as well as the factors that might influence it. Ten healthy adults, 18–45 years of age, performed a variety of speaking tasks while nasal ram pressure, audio, and video recordings were obtained. Inspirations were categorized as nasal-only, oral-only, simultaneous nasal and oral, or alternating nasal and oral inspiration. The method was validated using nasal airflow, oral airflow, audio, and video recordings for 2 participants. The predominant pattern was simultaneous nasal and oral inspirations for all speaking tasks. This pattern was not affected either by the nature of the speaking task or by the phonetic context surrounding the inspiration. The validation procedure confirmed that nearly all inspirations during counting and paragraph reading were simultaneous nasal and oral inspirations, whereas for sentence reading, the predominant pattern was alternating nasal and oral inspirations across the 3 phonetic contexts. Healthy adults inspire through both the nose and mouth during natural speech breathing. This pattern of inspiration is likely beneficial in reducing pathway resistance while preserving some of the benefits of nasal breathing.

  12. Breath Powered Nasal Delivery: A New Route to Rapid Headache Relief

    PubMed Central

    Djupesland, Per G; Messina, John C; Mahmoud, Ramy A

    2013-01-01

    The nose offers an attractive noninvasive alternative for drug delivery. Nasal anatomy, with a large mucosal surface area and high vascularity, allows for rapid systemic absorption and other potential benefits. However, the complex nasal geometry, including the narrow anterior valve, poses a serious challenge to efficient drug delivery. This barrier, plus the inherent limitations of traditional nasal delivery mechanisms, has precluded achievement of the full potential of nasal delivery. Breath Powered bi-directional delivery, a simple but novel nasal delivery mechanism, overcomes these barriers. This innovative mechanism has now been applied to the delivery of sumatriptan. Multiple studies of drug deposition, including comparisons of traditional nasal sprays to Breath Powered delivery, demonstrate significantly improved deposition to superior and posterior intranasal target sites beyond the nasal valve. Pharmacokinetic studies in both healthy subjects and migraineurs suggest that improved deposition of sumatriptan translates into improved absorption and pharmacokinetics. Importantly, the absorption profile is shifted toward a more pronounced early peak, representing nasal absorption, with a reduced late peak, representing predominantly gastrointestinal (GI) absorption. The flattening and “spreading out” of the GI peak appears more pronounced in migraine sufferers than healthy volunteers, likely reflecting impaired GI absorption described in migraineurs. In replicated clinical trials, Breath Powered delivery of low-dose sumatriptan was well accepted and well tolerated by patients, and onset of pain relief was faster than generally reported in previous trials with noninjectable triptans. Interestingly, Breath Powered delivery also allows for the potential of headache-targeted medications to be better delivered to the trigeminal nerve and the sphenopalatine ganglion, potentially improving treatment of various types of headache. In brief, Breath Powered bi

  13. [Numerical flow simulation : A new method for assessing nasal breathing].

    PubMed

    Hildebrandt, T; Osman, J; Goubergrits, L

    2016-08-01

    The current options for objective assessment of nasal breathing are limited. The maximum they can determine is the total nasal resistance. Possibilities to analyze the endonasal airstream are lacking. In contrast, numerical flow simulation is able to provide detailed information of the flow field within the nasal cavity. Thus, it has the potential to analyze the nasal airstream of an individual patient in a comprehensive manner and only a computed tomography (CT) scan of the paranasal sinuses is required. The clinical application is still limited due to the necessary technical and personnel resources. In particular, a statistically based referential characterization of normal nasal breathing does not yet exist in order to be able to compare and classify the simulation results.

  14. Electromyographic muscle EMG activity in mouth and nasal breathing children.

    PubMed

    Ribeiro, Eliane C; Marchiori, Susana C; da Silva, Ana Maria T

    2004-04-01

    Mouth breathing may cause changes in muscle activity, because an upper airway obstruction leads may cause a person to extend his/her head forward, demanding a higher inspiratory effort on the accessory muscles (sternocleidomastoids). This purpose of this study is to compare, using electromyography (EMG), the activity pattern the sternocleidomastoid and upper trapezius muscles in mouth breathing children and nasal breathing children. Forty-six children, ages 8-12 years, 33 male and 13 female were included. The selected children were divided into two groups: Group I consisted of 26 mouth breathing children, and Group II, 20 nasal breathing children. EMG recordings were made using surface electrodes bilaterally in the areas of the sternocleidomastoideus and upper trapezius muscles, while relaxed and during maximal voluntary contraction. The data were analyzed using the Kruskall-Wallis statistical test. The results indicated higher activity during relaxation and lower activity during maximal voluntary contraction in mouth breathers when compared to the nasal breathers. It is suggested that the activity pattern of the sternocleidomastoid and upper trapezius muscles differs between mouth breathing children and nasal breathing children. This may be attributed to changes in body posture which causes muscular imbalance. Because of the limitations of surface EMG, the results need to be confirmed by adding force measurements and repeating the experiments with matched subjects.

  15. Comparison of maximal oxygen consumption with oral and nasal breathing.

    PubMed

    Morton, A R; King, K; Papalia, S; Goodman, C; Turley, K R; Wilmore, J H

    1995-09-01

    The major cause of exercise-induced asthma (EIA) is thought to be the drying and cooling of the airways during the 'conditioning' of the inspired air. Nasal breathing increases the respiratory system's ability to warm and humidity the inspired air compared to oral breathing and reduces the drying and cooling effects of the increased ventilation during exercise. This will reduce the severity of EIA provoked by a given intensity and duration of exercise. The purpose of the study was to determine the exercise intensity (%VO2 max) at which healthy subjects, free from respiratory disease, could perform while breathing through the nose-only and to compare this with mouth-only and mouth plus nose breathing. Twenty subjects (11 males and 9 females) ranging from 18-55 years acted as subjects in this study. They were all non-smokers and non-asthmatic. At the time of the study, all subjects were involved in regular physical activity and were classified, by a physician, as free from nasal polyps or other nasal obstruction. The percentage decrease in maximal ventilation with nose-only breathing compare to mouth and mouth plus nose breathing was three times the percentage decrease in maximal oxygen consumption. The pattern of nose-only breathing at maximal work showed a small reduction in tidal volume and large reduction in breathing frequency. Nasal breathing resulted in a reduction in FEO2 and an increase in FECO2. While breathing through the nose-only, all subjects could attain a work intensity great enough to produce an aerobic training effect (based on heart rate and percentage of VO2 max).

  16. Evaluation of nasal airway patency by analysis of breathing sounds.

    PubMed

    Primov-Fever, Adi; Zaretsky, Uri; Elad, David; Wolf, Michael

    2016-01-01

    A simple non-invasive method, based on acoustic analysis of breathing signals, revealed a potential for objective evaluation of differences between the patency of nasal passageways. To examine whether acoustic signals of nasal breathing contain information that can differentiate between obstructed and patent nasal passageways. A technical study aimed to examine measurements of nasal airflow acoustic signals, taken, non-invasively, simultaneously from both external sides of the nostrils. The signals were acquired for several breathing cycles, with different respiratory efforts, before and after application of a nasal decongestant to the (narrower) side that yielded lower amplitudes. Data processing of the expiratory phase yielded the power spectrum density (PSD), which was used to compute the ratio of PSD areas between the signals from both sides of the nose. The study group was composed of 20 healthy volunteers. PSD changes were noted in accordance with the rise in expiratory efforts. The ratio of PSD areas between the two sides of the nasal cavity, calculated for maximal expiratory efforts, correlated well with the side that was treated with nasal decongestant in 18 out of the 20. Changes in the opposite direction were noted in two examinees.

  17. Video-rhino-hygrometer: a new method for evaluation of nasal breathing after nasal surgery.

    PubMed

    Casale, Manuele; Pappacena, Marco; Setola, Roberto; Soda, Paolo; Cusimano, Valerio; Vitali, Massimiliano; Mladina, Ranko; Salvinelli, Fabrizio

    2010-01-01

    Nasal obstruction is one of the most frequent symptoms in the ear, nose, and throat (ENT) setting. It can be evaluated either subjectively or objectively. In a subjective way, a visual analog scale (VAS) and the Sino-Nasal Outcome Test 20 (SNOT 20) can rapidly quantify the degree of obstruction, whereas the most commonly used objective methods are nasal endoscopy and active anterior rhinomanometry (AAR). It is still a matter of controversy to what extent the sense of nasal obstruction is associated with objective measures for nasal space and airflow. The aim of the study was to evaluate nasal breathing before and after functional nasal surgery by video-rhino-hygrometer (VRH) comparing the results with widely accepted methods. Twenty patient candidates for septoplasty and inferior turbinate reduction were included in the study. SNOT-20, VAS, nasal endoscopy, and AAR were analyzed and compared with VRH values. Before surgery VRH showed variability of nasal respiratory flow between individuals and between nostrils. After surgery we had an increase (p < 0.05) of airflow in both nostrils. VRH data were found to be correlated with VAS and SNOT-20 values (p < 0.05) both pre- and postoperatively. Despite the statistically significant correlation of AAR with SNOT-20 and VAS, no statistically significant correlation between AAR and VRH was found. VRH provides an immediate, easy, and noninvasive assessment of nasal respiration. For these reasons it can be used, in association with rhinoscopic data and other instrumental tests, to evaluate nasal breathing in daily ENT practice.

  18. [Effect of the external nasal dilator breathe right and nasal cycle influence].

    PubMed

    Yoshinami, Hiroyoshi; Takegoshi, Hideki; Kikuchi, Shigeru; Iinuma, Toshitaka

    2005-11-01

    The external nasal dilator Breathe Right is a nonprescription disposable mechanical device worn over the bridge of the nose that supports the outer walls of the nasal vestibule to increase cross-sectional nasal valve area and enhance air flow through the nose. When worn, the device applies a gentle outward pull to the outside walls of the nasal vestibule that helps prevent collapse of the lateral walls of the nasal vestibule. The device appears similar to an adhesive bandage with two polyester springs attached lengthwise to the nonadhesive side of the backing material. The form of the external nose varies significantly between racial groups and some comment is possible about the form of the nasal valve, i.e., Caucasian noses are leptorrhine, Negroid noses platyrrhine, and Oriental noses intermediate. A question exists about whether Breathe Right is as effective in Japanese as in Caucasians against nasal obstruction. We measured the effect by acoustic rhinometry in 35 healthy subjects. We measured 2 cross-sectional areas-the I-notch and C-notch-and 3 nasal volumes-V(0-1), from 0 to 1 cm corresponding to the I-notch, V(1-3), from 1 to 3cm corresponding to the C notch, and V (3-6), from 3 to 6cm. We studied the influence of the nasal cycle on the effect of Breathe Right in the nasal cavity. We evaluated subjects in a stable sitting position before applying Breathe Right, after using 5 minutes, and in a free interval of 25 minutes following. The experiment was repeated 10 times. We found that Breathe Right increases the nasal volume especially in V(1-3) and the cross-sectional area especially in the C-notch. Interestingly, the change in the C-notch decreased gradually with time. One possible mechanism may be the change in compliance between the skin under the Breathe Right and the nasal mucous membrane. The nasal cycle did not significantly influence the effect of Breathe Right.

  19. Posture and posterior crossbite in oral and nasal breathing children.

    PubMed

    Costa, Jecilene Rosana; Pereira, Silvia Regina Amorim; Pignatari, Shirley S N; Weckx, Luc Louis Maurice

    2010-01-01

    The most known etiologic factors of oral breathing may influence the craniofacial development leading to anatomical and functional alterations. A proper head and cervical spine posture allows a well functioning of the stomatognathic system structures and vice versa. This study was conducted to evaluate the prevalence of posterior crossbite in a group of oral breathing children (OB) and nasal (NB) and associate the type of bite with the head and cervical spine posture. It was concluded that most of the children, either oral or nasal breathers, did not present a crossbite and any kind of head posture and cervical spine can vary independently of a posterior crossbite.

  20. Response of nasal airway and heart rate variability to controlled nasal breathing.

    PubMed

    Fan, W-H; Ko, J-H; Lee, M-J; Xu, G; Lee, Guo-She

    2011-04-01

    To investigate the responses of nasal airway and autonomic nervous system (ANS) under controlled nasal breathings. Ten healthy volunteers, aged between 21 and 37 years, were enrolled. The participants breathed either through bilateral nostrils (BNB) or unilaterally through the left nostril (UNB) at 0.25 Hz for 5 min. The electrocardiography was simultaneously recorded and the ANS activities were evaluated using heart rate variability analysis. Nasal airway resistance and related factors were measured by rhinomanometry. The results showed that the mean heartbeat interval during UNB was significantly greater than during BNB. The sympathetic modulation decreased significantly during UNB. The correlations between nasal airway resistance and mean heartbeat interval were significant for both UNB and BNB. The increase of heartbeat intervals during UNB was associated with the decrease of cardiac sympathetic activities. The changes of ANS activities and nasal airway resistance during UNB are similar to the changes caused by a prolonged lying.

  1. Mouth breathing, "nasal disuse," and pediatric sleep-disordered breathing.

    PubMed

    Lee, Seo-Young; Guilleminault, Christian; Chiu, Hsiao-Yean; Sullivan, Shannon S

    2015-12-01

    Adenotonsillectomy (T&A) may not completely eliminate sleep-disordered breathing (SDB), and residual SDB can result in progressive worsening of abnormal breathing during sleep. Persistence of mouth breathing post-T&As plays a role in progressive worsening through an increase of upper airway resistance during sleep with secondary impact on orofacial growth. Retrospective study on non-overweight and non-syndromic prepubertal children with SDB treated by T&A with pre- and post-surgery clinical and polysomnographic (PSG) evaluations including systematic monitoring of mouth breathing (initial cohort). All children with mouth breathing were then referred for myofunctional treatment (MFT), with clinical follow-up 6 months later and PSG 1 year post-surgery. Only a limited subgroup followed the recommendations to undergo MFT with subsequent PSG (follow-up subgroup). Sixty-four prepubertal children meeting inclusion criteria for the initial cohort were investigated. There was significant symptomatic improvement in all children post-T&A, but 26 children had residual SDB with an AHI > 1.5 events/hour and 35 children (including the previous 26) had evidence of "mouth breathing" during sleep as defined [minimum of 44 % and a maximum of 100 % of total sleep time, mean 69 ± 11 % "mouth breather" subgroup and mean 4 ± 3.9 %, range 0 and 10.3 % "non-mouth breathers"]. Eighteen children (follow-up cohort), all in the "mouth breathing" group, were investigated at 1 year follow-up with only nine having undergone 6 months of MFT. The non- MFT subjects were significantly worse than the MFT-treated cohort. MFT led to normalization of clinical and PSG findings. Assessment of mouth breathing during sleep should be systematically performed post-T&A and the persistence of mouth breathing should be treated with MFT.

  2. Rashmdeep's method: a novel method to confirm nasal breathing.

    PubMed

    Prajapati, Deepesh; Nayak, Rashmi

    2013-03-01

    Mouth breathing has been a very prevalent oral habit, especially among children. Common etiologies behind this common occurrence can be physiologic enlargement of lymphoid tissue like adenoids leading to decrease nasopharyngeal airway or allergic rhinitis. The traditional or the latest methods used for diagnosing mouth breathing either are too subjective or cannot be performed in usual dental setups. This article presents an innovative method to confirm whether patient can breathe through the nose. This can also be used to diagnose any unilateral nasal blockade.

  3. Nasal and Oral Inspiration during Natural Speech Breathing

    ERIC Educational Resources Information Center

    Lester, Rosemary A.; Hoit, Jeannette D.

    2014-01-01

    Purpose: The purpose of this study was to determine the typical pattern for inspiration during speech breathing in healthy adults, as well as the factors that might influence it. Method: Ten healthy adults, 18-45 years of age, performed a variety of speaking tasks while nasal ram pressure, audio, and video recordings were obtained. Inspirations…

  4. Nasal and Oral Inspiration during Natural Speech Breathing

    ERIC Educational Resources Information Center

    Lester, Rosemary A.; Hoit, Jeannette D.

    2014-01-01

    Purpose: The purpose of this study was to determine the typical pattern for inspiration during speech breathing in healthy adults, as well as the factors that might influence it. Method: Ten healthy adults, 18-45 years of age, performed a variety of speaking tasks while nasal ram pressure, audio, and video recordings were obtained. Inspirations…

  5. [Nasal breath recovery and rhinoplasty in cleft lip and palate patient with unilateral choanal atresia].

    PubMed

    Chkadua, T Z; Ivanova, M D; Daminov, R O; Brusova, L A; Savvateeva, D M

    2016-01-01

    The paper presents the analysis of clinical case of endoscopic nasal breath restoration and elimination of the secondary cleft lip nasal deformity in 27 years old patient with unilateral choanal atresia and secondary nasal deformity after rhinocheiloplasty. Preoperative examination revealed the absence of nasal breathing on collateral side due to complete bone choanal atresia. Surgical treatment included endoscopic choanal repair, elimination of the secondary nasal deformity, septoplasty, conchotomy and lateroposition of the inferior conchae. The treatment resulted in nasal breath restoration and elimination of nasal deformity. Long-term follow-up at 1 and 12 months post-operatively proved stable positive aesthetic and functional results.

  6. The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients.

    PubMed

    Harari, Doron; Redlich, Meir; Miri, Shalish; Hamud, Tachsin; Gross, Menachem

    2010-10-01

    To determine the effect of mouth breathing during childhood on craniofacial and dentofacial development compared to nasal breathing in malocclusion patients treated in the orthodontic clinic. Retrospective study in a tertiary medical center. Clinical variables and cephalometric parameters of 116 pediatric patients who had undergone orthodontic treatment were reviewed. The study group included 55 pediatric patients who suffered from symptoms and signs of nasal obstruction, and the control group included 61 patients who were normal nasal breathers. Mouth breathers demonstrated considerable backward and downward rotation of the mandible, increased overjet, increase in the mandible plane angle, a higher palatal plane, and narrowing of both upper and lower arches at the level of canines and first molars compared to the nasal breathers group. The prevalence of a posterior cross bite was significantly more frequent in the mouth breathers group (49%) than nose breathers (26%), (P = .006). Abnormal lip-to-tongue anterior oral seal was significantly more frequent in the mouth breathers group (56%) than in the nose breathers group (30%) (P = .05). Naso-respiratory obstruction with mouth breathing during critical growth periods in children has a higher tendency for clockwise rotation of the growing mandible, with a disproportionate increase in anterior lower vertical face height and decreased posterior facial height.

  7. Nasal nitric oxide in sleep-disordered breathing in children.

    PubMed

    Gut, Guy; Tauman, Riva; Greenfeld, Michal; Armoni-Domany, Keren; Sivan, Yakov

    2016-03-01

    Inflammation plays a role in the pathogenesis and consequences of sleep-disordered breathing (SDB). The nasal mucosa and paranasal sinuses produce high levels of nitric oxide (NO). In asthma, exhaled NO is a marker of airway inflammation. There is only limited information whether nasal NO (nNO) accompanies also chronic upper airway obstruction, specifically, SDB. The objective of this study was to investigate nNO levels in children with SDB in comparison to healthy non-snoring children. Nasal NO was measured in children who underwent overnight polysomnographic studies due to habitual snoring and suspected SDB and in healthy non-snoring controls. One hundred and eleven children participated in the study: 28 with obstructive sleep apnea (OSA), 60 with primary snoring (PS), and 23 controls. Nasal NO levels were significantly higher in children with OSA and PS compared to controls (867.4 ± 371.5, 902.0 ± 330.9, 644.1 ± 166.5 ppb, respectively, p = 0.047). No difference was observed between children with OSA and PS. No correlations were found between nNO levels and any of the PSG variables, nor with age, BMI percentile or tonsils size. Compared to healthy controls, nNO is increased in children with SDB, but it is not correlated with disease severity. This is probably due to the local mechanical processes and snoring.

  8. [The effectiveness of measurement of nasal resistance in patients with sleep disordered breathing].

    PubMed

    Shimoyama, Kumiko; Yasuda, Kyo; Kawano, Masako; Satoh, Makoto

    2009-06-01

    Nasal breathing disorder has been associated with the condition and treatment of sleep disordered breathing (SDB). In the current study, we investigated the utility of measurement of nasal resistance in patients with SDB. We examined the relationship between nasal symptoms and nasal resistance in 219 patients, and how the results affected the administration of nasal continuous positive airway pressure (nCPAP) in 34 SDB patients. Total nasal resistance was not significantly different between patients who were divided into two groups: those with nasal symptoms, and those without. The left-right ratio of nasal flow in the group with nasal symptoms was higher than in the group without nasal symptoms (p < 0.01). The mean percentage of nCPAP use was not significantly different between two groups divided by total nasal resistance. The mean percentage of nCPAP use > or = 4 hours was lower in the group in which total nasal resistance was more than 0.25Pa/cm3/sec (p < 0.05). The left-right ratio of nasal flow does not affect nCPAP use. We conclude that measurement of nasal resistance for confirming nasal breathing disorder is effective in patients with SDB, whether a patient complains of nasal symptoms or not.

  9. Nasal Contribution to Breathing and Fine Particle Deposition in Children Versus Adults

    EPA Science Inventory

    Both the route of breathing, nasal versus oral, and the effectiveness of the nose to filter inhaled, fine particles may differ between children and adults. This study compared (1) the nasal contribution to breathing at rest and during mild to moderate exercise in children (age 6–...

  10. Nasal Contribution to Breathing and Fine Particle Deposition in Children Versus Adults

    EPA Science Inventory

    Both the route of breathing, nasal versus oral, and the effectiveness of the nose to filter inhaled, fine particles may differ between children and adults. This study compared (1) the nasal contribution to breathing at rest and during mild to moderate exercise in children (age 6–...

  11. [A comparative study on numerical simulation of the normal nasal airflow during periodic breathing and steady-state breathing].

    PubMed

    Xiong, Guan-xia; Li, Jian-feng; Zhuang, Hui-wen; Zhou, Xu-hui; Zhan, Jie-min; Xu, Geng

    2010-09-01

    To compare the characteristics of normal nasal airflow during periodic breathing and steady-state breathing. Fluent software was used to simulate the nasal cavity and paranasal sinus structures following CT scanning of a normal adult subject. Air flow velocity, pressure, distribution and streamlines were calculated and compared during periodic breathing and steady-state breathing. The same flux, the performance of nasal airflow on 15.600 s of periodic breathing and steady-state expiratory (entrance flow was 697.25 ml/s) were as follows: air flow in the common and middle meatus accounted for more than 50% and 30% of total nasal cavity flow during two respiratory status. Flow velocity and pressure of nasal cavity and each paranasal sinus were extremely similar. The flow trace during two respiratory status in the inferior and lower part of the common meatus were predominately straight in form.Flow were parabolic in the middle and superior meatus and the middle and upper parts of the common meatus. The flow trace of nasal airflow on 16.495 s of periodic breathing had wide areas vortex in nasopharynx and limen nasi, the average speed was 0.0706 m/s, while the entrance flow 7.62 ml/s stable state of the left nasal expiratory, the average speed was 0.0415 m/s, the flow trace was similar to 697.25 ml/s. The same flow, except in the junction of the respiratory cycle, the performance of normal nasal airflow during periodic breathing and steady-state breathing were similar.

  12. Craniofacial growth variations in nasal-breathing, oral-breathing, and tracheotomized children.

    PubMed

    Bakor, Silvia Fuerte; Enlow, Donald H; Pontes, Paulo; De Biase, Noemi Grigoletto

    2011-10-01

    Childhood oral breathing can alter muscular balance and lead to facial deformities. No articles in the literature have reported on the alteration of facial growth patterns in patients who have received tracheotomies. The purpose of this study was to evaluate craniofacial developmental consequences originating from variations in breathing mechanisms in children who are nasal breathers or oral breathers, and those who have been tracheotomized. The sample was divided into 3 groups of 10 each. The nasal group had a mean age of 13.9 years, the oral group had a mean age of 12.7 years, and the tracheotomy group had a mean age of 12.8 years. The masseter and suprahyoid muscles were evaluated with electromyography. The following measurements were made: facial, maxillary, and mandibular widths; nasion-sella-gnathion angle; and facial index. The tracheotomized group was similar to the nasal group for greater activity of the masseter muscles than of the suprahyoid muscles during mastication, as well as in the measurements of facial, maxillary, and mandibular widths. The oral group showed reductions in each category. The tracheotomized group was similar to the oral group during maximum dental occlusion for significantly higher activity of the suprahyoid muscles compared with the masseter muscles, with reductions in vertical values. A childhood tracheotomy might affect facial development in a way comparable with that of oral breathers, including abnormal facial growth variations. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  13. Nasal contribution to breathing and fine particle deposition in children versus adults.

    PubMed

    Bennett, William D; Zeman, Kirby L; Jarabek, Annie M

    2008-01-01

    Both the route of breathing, nasal versus oral, and the effectiveness of the nose to filter inhaled, fine particles may differ between children and adults. This study compared (1) the nasal contribution to breathing at rest and during mild to moderate exercise in children (age 6-10 yr) versus young adults and (2) the nasal deposition efficiency (NDE) of fine particles (1 and 2 microm MMAD, GSD < 1.2) under resting and light exercise breathing conditions in the same children and adults. Nasal contribution to breathing was assessed by respiratory inductance plethysmography and a nasal mask with flow meter during incremental exercise on a bicycle ergometer. Fine particle deposition fractions for nasal and oral breathing were assessed by inhalation of monodisperse carnauba wax particles and laser photometry to determine inhaled/exhaled concentrations. There was a trend for children to have a lesser nasal contribution to breathing at rest and during exercise, but the differences from adults were not statistically significant. Children did, however, have significantly decreased NDE for 2-microm particles under light exercise breathing conditions compared to adults, suggesting less efficient nasal filtering for larger particles and higher flow conditions. These results suggest that the lungs of children may be exposed to higher concentrations of inhaled, ambient particles than adults.

  14. A decrease in nasal CO2 stimulates breathing in the tegu lizard.

    PubMed

    Coates, E L; Furilla, R A; Ballam, G O; Bartlett, D

    1991-10-01

    Tegu lizards decrease ventilatory frequency (f) when constant CO2, as low as 0.4%, is delivered to the nasal cavities. In contrast, CO2, as high as 6%, pulsed into the nasal cavities during the expiratory phase of the breathing cycle does not alter f. The purpose of the present study was to investigate further the effect of nasal CO2 pattern on f in tegu lizards. Specifically, we tested: (1) whether f was affected by CO2 delivered to the nasal cavities during the inspiratory phase of the breathing cycle, and (2) whether pulsed decreases in nasal CO2 from 4% to 2% and from 4% to 0% would remove the f inhibition caused by constant nasal CO2. Ventilation was measured using a pneumotachograph and pressure transducer in-line with an endotracheal T-tube inserted through the glottis. CO2 was delivered to the nasal cavities through small tubes inserted into the external nares. Ventilatory frequency was not significantly altered when 4% CO2 was pulsed into the nasal cavities during inspiration. Dropping the CO2 in the nasal cavities from 4% to 0% at either 15 cycles/min (0.25 Hz) or for one cycle stimulated breathing. There was no significant difference between the f response to a drop in CO2 from 4% to 0% and that to a drop in CO2 from 4% to 2%. The failure to link the phasic CO2 ventilatory response to a phase in the respiratory cycle indicates that the nasal CO2 receptors do not participate in the breath-by-breath regulation of breathing in these lizards. The observation that small decreases in nasal CO2 abolished the f inhibition caused by constant nasal CO2 provides further evidence for the ability of the nasal CO2 receptors to distinguish between pulsed and constant CO2.

  15. Decreased pulmonary vascular resistance during nasal breathing: modulation by endogenous nitric oxide from the paranasal sinuses.

    PubMed

    Settergren, G; Angdin, M; Astudillo, R; Gelinder, S; Liska, J; Lundberg, J O; Weitzberg, E

    1998-07-01

    Nitric oxide is present in high concentration in the human nasal airways. During inspiration through the nose a bolus is transported to the lungs. In a randomized cross-over study the effect of two different patterns of breathing, nasal breathing and mouth breathing, was evaluated in 10 patients (mean age 65 years), breathing room air the morning of the first post-operative day after open heart surgery. Nasal breathing is defined as inspiration through the nose and expiration through the mouth, whilst mouth breathing is the converse of this: inspiration through the mouth and expiration through the nose. Pressure in the pulmonary artery and left atrium or pulmonary artery wedge was measured together with thermodilution cardiac output and arterial and mixed venous oxygenation and acid-base parameters. Pulmonary vascular resistance index (PVRI), venous admixture and alveolar-arterial gradient were calculated. Nasal breathing resulted in a lower PVRI, 256 dyn s cm-5 cm-2 vs. 287 (P < 0.01). The oxygen and carbon dioxide tension and pH of arterial and mixed venous blood, venous admixture and the alveolar-arterial gradient remained unchanged. The decreased level of PVRI during nasal breathing compared to that during mouth breathing supports the notion, that endogenous nitric oxide acts as an airborne messenger to modulate the pulmonary vascular tone during normal breathing.

  16. Improvement of nasal breathing and patient satisfaction by the endonasal dilator Airmax®.

    PubMed

    Hellings, P W; Nolst Trenite, G J

    2014-03-01

    Patients suffering from nasal obstruction due to external nasal valve dysfunction may benefit from either corrective surgery or a conservative approach with a nasal dilator. At present, devices for widening the external nasal valve region can be applied externally or endonasally. It remains unknown to what extent the en dona sal dilator Airmax® objectively improves the nasal flow and can be offered as an alternative for surgery. Thirty patients suffering from nasal obstruction due to external nasal valve problems were proposed to use the nasal dilator for 4 weeks as an alternative for corrective surgery. The improvement of nasal flow by the dilator was evaluated by measuring the peak nasal inspiratory flow (PNIF). Then, patients were asked for their willingness to continue to use the nasal dilator or to undergo nasal valve surgery. The endonasal dilator improved the mean PNIF from baseline values with a mean increase of 176.1 o/o. After a 4 week trial period, 19 of 30 patients expressed the intention to continue the use of the nasal dilator. Inappropriate size, local irritation and/or aesthetic nasal complaints were mentioned by the other patients as reasons for discontinuation of using the nasal dilator. The endonasal dilator Airmax® represents a powerful device to improve nasal breathing in the target patients and therefore represents a good alternative for corrective surgery.

  17. Mouth breathing evaluation: use of Glatzel mirror and peak nasal inspiratory flow.

    PubMed

    Melo, Danielle de Lima e; Santos, Roberta Viviane Moreira; Perilo, Tatiana Vargas de Castro; Becker, Helena Maria Gonçalves; Motta, Andréa Rodrigues

    2013-01-01

    To compare the use of the Glatzel mirror and peak nasal inspiratory flow in the evaluation of mouth-breathing participants and to analyze the correlation between these instruments. Sixty-four children were evaluated--32 mouth breathers and 32 nasal breathers; the children were aged 4 to 12 years. The mouth breathers were subdivided according to the cause of obstruction by a multidisciplinary team. The Glatzel mirror and peak nasal inspiratory flow were used in both groups to evaluate patency and nasal airflow. Data were then subjected for statistical analysis. The Glatzel mirror allowed us to differentiate the breathing mode considering gender, age, weight, height, and body mass index, but it did not help in identifying the cause of mouth breathing. The peak nasal inspiratory flow did not allow differentiation of the breathing mode and identification of the cause of mouth breathing. In our sample, there was no correlation between the instruments used. The Glatzel mirror was reliable in identifying participants with and without nasal obstruction, although it was not possible to differentiate subgroups of mouth breathers using this instrument. The peak nasal inspiratory flow showed differences only between nasal breathers and surgical mouth breathers. Low correlation was found between these two instruments.

  18. Facial type and head posture of nasal and mouth-breathing children.

    PubMed

    Bolzan, Geovana de Paula; Souza, Juliana Alves; Boton, Luane de Moraes; Silva, Ana Maria Toniolo da; Corrêa, Eliane Castilhos Rodrigues

    2011-12-01

    To verify the facial type and the head posture of nasal and mouth-breathing children from habitual and obstructive etiologies, as well as to correlate the morphological facial index to the head angulation position in the sagittal plane. Participants were 59 children with ages between 8 years and 11 years and 10 months. All subjects were undergone to speech-language pathology screening, otorhinolaryngologic evaluation, and nasopharyngoscopy, allowing the constitution of three groups: nasal breathers--15 children; mouth breathers from obstructive etiology--22 children; and habitual mouth breathers--22 children. In order to determine facial type and morphological facial index, the height and the width of the face were measured using a digital caliper. The head posture was assessed through physical examination and computerized photogrammetry. It was verified the predominance of short face in nasal breathers, and long face in mouth breathers. There was an association among facial type and breathing mode/mouth breathing etiology: the brachyfacial type was more frequent among nasal breathers, and less frequent in subjects with obstructive nasal breathing. Head posture was similar in all three groups. No correlation was found between morphological facial index and head posture. The brachyfacial type favors the nasal-breathing mode and the head posture is not influenced by breathing mode and by the etiology of mouth breathing, as well as it is not related to facial type.

  19. Impact of short term forced oral breathing induced by nasal occlusion on respiratory function in mice.

    PubMed

    Xie, Jiaxing; Xi, Yin; Zhang, Qingling; Lai, Kefang; Zhong, Nanshan

    2015-01-01

    Inconsistent findings regarding the experimental nasal obstruction on respiratory functions in small animals have been reported. The purpose of this study was to investigate the impact of short term forced oral breathing on respiratory functions as well as the therapeutic implication of esophageal intubation in BALB/c mice. Thirty BALB/c mice were randomized equally to two groups: an experimental group and control group. Oral breathing was induced by applying petrolatum ointment in nostrils for occlusion both nasal cavities. Esophageal tube was inserted to enlarge the oropharyngeal airway in the experimental mice. Respiratory parameters were measured by barometric whole-body plethysmography (WBP) in the following condition: normal nasal breathing; nasal breathing loading in a soft bag; forced oral breathing loading in a soft bag; forced oral breathing loading in a soft bag after undergoing esophageal intubation. After applying petrolatum ointment of nostrils, all the mice switch to oral breathing with apparent discomfort (bradypnea). Nasal occlusion was associated with a decrease in the average respiratory rate (268±36 vs. 90±10 breaths/min; P<0.01) and an increase in Penh (0.67±0.14 vs. 19.23±2.12; P<0.01). After undergoing esophagus intubation, these mice switched to oral breathing with less discomfort. Compared with the control mice, respiratory rate (175±25 vs. 90±10) was higher; the Penh (8.84±1.05 vs. 18.09±2.03; P<0.01) was lower. Short term forced oral breathing induced by nasal occlusion caused respiratory insufficiency in mice. Stenotic oropharyngeal airway was supposed to be one of the most important factors. Enlarging oropharyngeal airway by esophagus intubation could improve the respiratory insufficiency under nasal occlusion. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Snoring exclusively during nasal breathing: a newly described respiratory pattern during sleep.

    PubMed

    Hsia, Jennifer C; Camacho, Macario; Capasso, Robson

    2014-03-01

    The aim of this study is to describe a distinctive respiratory pattern seen in subjects with inferior turbinate hypertrophy, nasal obstruction, and a polysomnogram-proven diagnosis of primary snoring or mild obstructive sleep apnea. These subjects demonstrated increased snoring with purely nasal breathing and alleviation of snoring with oral breathing. The study design is case series with chart review. The setting was a university-based tertiary care hospital. A retrospective chart review was performed for patients with complaints of nasal obstruction with associated inferior turbinate hypertrophy and a polysomnogram-proven diagnosis of mild obstructive sleep apnea or primary snoring. Demographic and polysomnography information were collected and analyzed. Snoring and airflow patterns were reviewed. Twenty-five subjects were identified as having met the inclusion and exclusion criteria on polysomnography for either primary snoring or mild obstructive sleep apnea with inferior turbinate hypertrophy and no other significant nasal deformity or abnormality. Seventeen (68 %) of these patients had polysomnograms which demonstrated snoring during nasal breathing and alleviation of snoring with oral breathing. Of the 17 who snored during nasal breathing, ten of the subjects were female and seven of the subjects were male. The mean age was 27 years (range 18 to 68 years). The mean apnea-hypopnea index was 2.3 events/h (range 0 to 9.7 events/h). The mean body mass index was 25 kg/m(2) (range 20 to 43 kg/m(2)). Our study describes a newly recognized pattern of snoring in patients with a polysomnogram-proven diagnosis of either primary snoring or mild obstructive sleep apnea. This pattern of breathing demonstrates patients who snore during nasal breathing even with known nasal obstruction present and subsequently have resolution or improvement of the snoring with oral breathing.

  1. The concept of rhinorespiratory homeostasis--a new approach to nasal breathing.

    PubMed

    Hildebrandt, Thomas; Heppt, Werner Johannes; Kertzscher, Ulrich; Goubergrits, Leonid

    2013-04-01

    The suggested concept of rhinorespiratory homeostasis is a new theoretical model for the discussion of physiologic and physical principles of nasal breathing. This model is based on a comprehensive view of nasal functions that takes comparative animal physiology into account. Consequently, it has a universal cross-species character and emphasizes the central role of nasal secretion. In contrast to the established view, the focus is transferred from the inspired air to the nasal wall. This concept considers the parietal effect of airflow represented by wall shear stress with special regard to the epithelial lining fluid. It delivers one possible mechanism of an inherent triggering of the nasal cycle. Furthermore, the issue of biological fluid-structure interaction is introduced. This article presents a rethinking of nasal breathing that was inspired by clinical experience and results of flow field investigations through computational fluid dynamics. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  2. Change in the nose areas in children with mouth breathing after nasal cleansing and massage.

    PubMed

    Melo, Ana Carolina Cardoso de; Gomes, Adriana de Oliveira Camargo; Cunha, Daniele Andrade da; Lima, Sandro Júnior Henrique; Lima, Wigna Rayssa Pereira; Cunha, Renata Andrade da; Silva, Hilton Justino da

    2016-01-01

    To analyze the changes occurred in the nasal cavity geometry, before and after nasal cleansing, through nasal aeration and acoustic rhinometry in children with oral breathing. Twenty children aged four to 12 years were included in the study. The gathering of participants was conducted at the Multifunctional Laboratory of the Speech Pathology Department of the Federal University of Pernambuco - UFPE. The following procedures were conducted: Identification Index of Signs and Symptoms of Oral Breathing; marking of nasal expiratory airflow using the graded mirror of Altmann, and examination of the Nasal Geometry by Acoustic Rhinometry. The same procedures were performed after nasal massage and cleansing with saline solution. Significant change was observed in the areas with respect to the nasal airflow on both sides after nasal cleansing and massage. As for nasal geometry, measured by acoustic rhinometry, comparison between the nostrils showed that the effect of cleansing and massage was discrete. Nasal aeration measures showed sensitivity to the cleansing and massage technique and measures of nasal geometry confirmed its effect on respiratory physiology.

  3. Effort of breathing in children receiving high-flow nasal cannula.

    PubMed

    Rubin, Sarah; Ghuman, Anoopindar; Deakers, Timothy; Khemani, Robinder; Ross, Patrick; Newth, Christopher J

    2014-01-01

    High-flow humidified nasal cannula is often used to provide noninvasive respiratory support in children. The effect of high-flow humidified nasal cannula on effort of breathing in children has not been objectively studied, and the mechanism by which respiratory support is provided remains unclear. This study uses an objective measure of effort of breathing (Pressure. Rate Product) to evaluate high-flow humidified nasal cannula in critically ill children. Prospective cohort study. Quaternary care free-standing academic children's hospital. ICU patients younger than 18 years receiving high-flow humidified nasal cannula or whom the medical team planned to extubate to high-flow humidified nasal cannula within 72 hours of enrollment. An esophageal pressure monitoring catheter was placed to measure pleural pressures via a Bicore CP-100 pulmonary mechanics monitor. Change in pleural pressure (ΔPes) and respiratory rate were measured on high-flow humidified nasal cannula at 2, 5, and 8 L/min. ΔPes and respiratory rate were multiplied to generate the Pressure.Rate Product, a well-established objective measure of effort of breathing. Baseline Pes, defined as pleural pressure at end exhalation during tidal breathing, reflected the positive pressure generated on each level of respiratory support. Twenty-five patients had measurements on high-flow humidified nasal cannula. Median age was 6.5 months (interquartile range, 1.3-15.5 mo). Median Pressure,Rate Product was lower on high-flow humidified nasal cannula 8 L/min (median, 329 cm H2O·min; interquartile range, 195-402) compared with high-flow humidified nasal cannula 5 L/min (median, 341; interquartile range, 232-475; p = 0.007) or high-flow humidified nasal cannula 2 L/min (median, 421; interquartile range, 233-621; p < 0.0001) and was lower on high-flow humidified nasal cannula 5 L/min compared with high-flow humidified nasal cannula 2 L/min (p = 0.01). Baseline Pes was higher on high-flow humidified nasal

  4. Effect of race on fine particle deposition for oral and nasal breathing.

    PubMed

    Bennett, William D; Zeman, Kirby L

    2005-11-01

    Nasal efficiency for removing fine particles from inhaled air may be affected by variations in nasal structure associated with race. In 11 African American and 11 Caucasian adults (age 18-31 yr) we measured the fractional deposition (DF) of fine particles (1 and 2 mum mass median aerodynamic diameter) (MMAD) for oral and nasal breathing using individual breathing patterns previously measured by respiratory inductance plethysmography during a graded exercise protocol. DF for both nasal and mouth breathing was measured separately by laser photometry at the same tidal volume and breathing rate for resting and light exercise (20% of maximum work load) conditions. From these DF measures, nasal deposition efficiency (NDE) was calculated for each condition. For light exercise conditions, NDE for both 1- and 2-microm particles was less in African Americans versus Caucasians, 0.15 +/- 0.07 (SD) versus 0.24 +/- 0.11 for 1-microm particles (p = .03), and 0.29 +/- 0.13 versus 0.44 +/- 0.11 for 2-microm particles (p = .006). The racial differences in NDE were associated with racial differences in nasal resistance and nostril shape. These race-dependent nasal efficiencies are dosimetric factors that should be considered in modeling and assessing particulate dose from human exposure to air pollutants.

  5. Oxygenation and Exercise Performance-Enhancing Effects Attributed to the Breathe-Right Nasal Dilator

    PubMed Central

    Trocchio, Marc; Fisher, Jean; Wimer, Jeffrey W.; Parkman, Anna W.

    1995-01-01

    Recently, many professional football players have elected to wear spring-loaded nasal dilators during competition. Many athletes believe that wearing the “Breathe-Right” nasal dilator will increase nasal gas conduction and oxygenation to their body, subsequently improving their performance. The purpose of this experiment was to investigate the advantages of wearing a nasal dilator while performing aerobic and anaerobic exercise, as opposed to not wearing a nasal dilator. It was hypothesized that the “Breathe-Right” nasal dilator, manufactured by CNS, Inc (Chanhassen, MN) would increase nasal gaseous conduction and increase oxygenation to the body. Nasal gaseous conduction and oxygenation are essential components for using aerobic power. We examined whether wearing a nasal dilator improves performance by using a ramped cycle ergometer stress test on athletes until they reached VO2 maximum progressing from aerobic to anaerobic exercise. Baseline data were collected (ie, VO2, VO2/Kg, respiratory exchange ratio, anaerobic threshold time, and onset of VO2 max) using a MedGraphics CardiO2 System. The subjects included 16 college-aged male athletes. Dependent t-tests implemented on each physiological response; VO2 max, peak VO2 kg, onset of anaerobic threshold, onset of VO2 max, respiratory exchange ratio at VO2 max, and maximum WATT output, showed there was no difference in the athletes' performance when they wore the nasal dilators and when they did not wear the dilators. ImagesFig. 1.Fig. 2.Fig. 3. PMID:16558338

  6. Changes in the palatal dimensions of mouth breathing children caused by nasal obstruction

    NASA Astrophysics Data System (ADS)

    Indiarti, I. S.; Setyanto, D. B.; Kusumaningrum, A.; Budiardjo, S. B.

    2017-08-01

    During children’s growth and development, the breathing process plays an important role in craniofacial growth, especially of the palate. Nose breathing can stimulate the lateral growth of the maxilla, thus making the palate flat. Disturbances in nose breathing caused by nasal obstruction such as allergic rhinitis, adenoid hypertrophy, rhinosinusitis, nasal polyps, and obstructive sleep apnea can lead to a mouth breathing habit in children. This habit can cause palatal dimension changes such as a narrow V-shaped maxillary arch and a high palatal vault. This study analyzed the relationship between the mouth breathing habit in children who have nasal obstruction and palatal dimension changes. A cross-sectional descriptive study was conducted with a consecutive sampling method on children 7-18 years old with a history of allergic rhinitis, adenoid hypertrophy, rhinosinusitis, nasal polyps, and obstructive sleep apnea in the Pediatric Respirology and Pediatric Immunology Allergy Outpatient Clinic Kiara Maternal and Child Health Center at Cipto Mangunkusumo Hospital in Jakarta. The palatal dimensions were measured by the height and transversal width of the hard palate of castings of each child’s upper dental arch using vernier calipers. Palatal dimension changes were found in children with a mouth breathing habit due to nasal obstruction.

  7. Breathing parameters associated to two different external nasal dilator strips in endurance athletes.

    PubMed

    Ottaviano, Giancarlo; Ermolao, Andrea; Nardello, Ennio; Muci, Flavio; Favero, Vittorio; Zaccaria, Marco; Favero, Lorenzo

    2017-12-01

    The aim of the study was to investigate and compare the effects of two different external nasal dilator strips (ENDS) on nasal respiratory flow, maximal oxygen uptake (VO2max), nasal VO2max, time to exhaustion and subjective nasal obstruction in adult triathletes participating in exhaustive, controlled physical exercise tests. Thirteen healthy triathletes without nasal symptoms were recruited and randomly tested in three different conditions: without ENDS, wearing the Breathe Right(®) dilator strip and wearing the Master-aid Roll-flex(®) strip. We investigated the variations in the peak nasal inspiratory flow (PNIF) and the Nasal Obstruction Symptom Evaluation questionnaire before and after an exhaustive treadmill test. VO2max, nasal VO2max, time to exhaustion, total time of nasal respiration values were also registered and compared. Post-exercise PNIF was higher than the pre-exercise PNIF. Pre-exercise PNIF was higher in athletes wearing the Master-aid Roll-Flex(®) than in those wearing the Breathe Right(®) strips; no differences in post-exercise PNIF values were found in the three different conditions. Nasal VO2max value was higher when both types of ENDS were worn. Nasal respiration time to exhaustion was longer when the athletes were wearing either type of ENDS. Both ENDS gave a better sensation of nasal airflow passage after physical exercise. ENDS had similar effects, improving the subjective sensation of nasal patency, the nasal respiration time, and the nasal VO2max, anyway Master-aid Roll-flex(®) is more economic than the Breathe Right(®) and it can be cut to fit the nasal anatomy. As ENDS affect the cross-sectional area, especially at the level of the nasal valve, in future studies should be conducted also by means of acoustic rhinometry in order to evaluate if any difference could be find at this level when wearing either one of the two ENDS. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Clinical evaluation of a novel internal nasal dilation stent for the improvement of nasal breathing.

    PubMed

    Brandt, Michael G; Moore, Corey C; Doyle, Philip C

    2008-05-01

    This study assessed rhinometric improvement in nasal airflow, perceived comfort, and the utility of nasal dilation devices for individuals with nasal obstruction treated with an external nasal dilator (END) or a novel internal nasal dilation stent (INDS). Prospective, randomized, crossover trial. Individuals with symptoms of nasal obstruction. Twenty-three participants underwent rhinometry and a trial with a novel INDS and a validated END. Devices were used in a randomized, crossover fashion. Nasal airflow, maximum use, continuous use, comfort, and challenge with these devices were assessed. The END and INDS showed greater nasal airflow from baseline, with the INDS being significantly better than the END. The INDS was used significantly more than the END, and demonstrated significantly greater comfort and less associated challenge. The novel INDS showed 3.4 times improved nasal airflow from baseline, was used maximally and continuously longer than a validated END, and was judged to be significantly more tolerable.

  9. Stenting the nasal airway for maximizing inspiratory airflow: internal Max-Air Nose Cones versus external Breathe Right strip.

    PubMed

    Raudenbush, Bryan

    2011-01-01

    Several nasal dilator devices designed to stent the anterior nasal airway to increase peak nasal inspiratory flow (PNIF) currently exist; however, comparisons of such devices are limited. This study was designed to compare the efficacy of two different nasal dilator devices, an internal device (Max-Air Nose Cones; Sanostec Corp., Beverly Farms, MA) and an external device (Breathe Right nasal strip; GlaxoSmithKline, Brentford, Middlesex, U.K.) on stenting of the anterior nasal airway to maximize PNIF. Repeated measurements of PNIF were obtained in 30 individuals noting complaints of sleep-disordered breathing due to nasal breathing discomfort and nasal airway obstruction, both with and without the two different nasal dilator devices. A one-within analysis of variance (ANOVA) was performed among the three conditions (control, Max-Air Nose Cones, and Breathe Right nasal strip), and a statistically significant effect was found (F[2,58] = 298.13; p< 0.00001). Tukey post hoc contrasts revealed that the control condition PNIF (66.07 L/min) was significantly lower than both the Max-Air Nose Cones (138.73 L/min) and the Breathe Right nasal strip (102.17 L/min) conditions. The Max-Air Nose Cone increased inspiratory airflow by 73 L/min, or a 110% improvement over baseline. In addition, the Max-Air Nose Cone condition PNIF was significantly higher than both the control condition and the nasal strip condition. Although both the Max-Air Nose Cones and the Breathe Right nasal strips increased PNIF from baseline, the Max-Air Nose Cones showed significantly greater efficacy at stenting the anterior nasal airway, providing twice the improvement in PNIF over baseline than did the Breathe Right nasal strips.

  10. Increased levels of exhaled nitric oxide during nasal and oral breathing in subjects with seasonal rhinitis.

    PubMed

    Martin, U; Bryden, K; Devoy, M; Howarth, P

    1996-03-01

    Allergic rhinitis is associated with nasal mucosal inflammation. Exhaled nitric oxide may be a useful marker of inflammation and has recently been shown to be increased in patients with asthma. The purpose of this study was to determine whether exhaled levels of nitric oxide are increased with nasal breathing in patients with seasonal allergic rhinitis compared with nonatopic individuals and whether there is an increase with oral breathing consistent with lower respiratory inflammation in the absence of clinical asthma. Nitric oxide levels in exhaled air were measured by chemiluminescence in 18 nonatopic volunteers and 32 patients with seasonal rhinitis. Measurements were made with both nasal and oral exhalation and orally after 10 seconds and 60 seconds of breath-holding. The detection limit was 1 part per billion (ppb). In control subjects nasal levels of nitric oxide in exhaled air (mean +/- SD, 24.7 +/- 9.2 ppb) were higher than those after oral exhalation (11.1 +/- 2.5 ppb, p less than 0.0001). Breath-holding significantly increased levels of nitric oxide in exhaled air in a time-dependent manner. Levels of exhaled nitric oxide were significantly higher for all measurements in patients with seasonal rhinitis, with levels without breath-holding of 35.4 +/- 11.3 ppb (p less than 0.001) in nasally exhaled air and 16.3 +/- 5.9 ppb (p less than 0.001) in orally exhaled air. Nasal levels were significantly higher than oral levels in subjects with rhinitis (p less than 0.0001). The results indicate that exhaled nitric oxide may be a useful marker for nasal inflammation in patients with seasonal rhinitis and suggest that generalized airway inflammation may be present, even without clinical asthma, in such patients.

  11. Effects of Nasal or Oral Breathing on Anaerobic Power Output and Metabolic Responses

    PubMed Central

    RECINTO, CHRISTINE; EFTHEMEOU, THEODORE; BOFFELLI, P. TONY; NAVALTA, JAMES W.

    2017-01-01

    Nasal and oral exclusive breathing modes have benefits and drawbacks during submaximal exercise. It is unknown whether these responses would extend to anaerobic work performed at high intensity. Nine individuals (males N = 7, females N = 2) performed a standard Wingate Anaerobic cycle test on a cycle ergometer under nose (N) and mouth (M) only respiratory conditions, performed in a counterbalanced order. A 2 (condition: nose, mouth) × 6 (time: 0–5 sec, 5–10 sec, 10–15 sec, 15–20 sec, 20–25 sec, 25–30 sec) repeated measures ANOVA was used to analyze the data with significance accepted at the p<0.05 level. No differences between breathing mode were observed for any power output or performance measures associated with the Wingate Anaerobic cycle test. Respiratory exchange ratio (RER) was significantly higher in the oral respiration condition from 10 seconds to 25 seconds during the test (p<0.05). On the other hand, heart rate (HR) in the nasal condition was significantly greater during the final two time intervals (p<0.05). Nasal breathing was effective in reducing hyperventilation as RER remained below 1.0. However, elevated HR with nasal breathing indicates increased cardiovascular stress associated with this mode. As breathing mode does not affect power output or performance measures during completion of a high-intensity anaerobic test, preference of the participant should be the determining factor if a choice is available. PMID:28674596

  12. Effects of Nasal or Oral Breathing on Anaerobic Power Output and Metabolic Responses.

    PubMed

    Recinto, Christine; Efthemeou, Theodore; Boffelli, P Tony; Navalta, James W

    2017-01-01

    Nasal and oral exclusive breathing modes have benefits and drawbacks during submaximal exercise. It is unknown whether these responses would extend to anaerobic work performed at high intensity. Nine individuals (males N = 7, females N = 2) performed a standard Wingate Anaerobic cycle test on a cycle ergometer under nose (N) and mouth (M) only respiratory conditions, performed in a counterbalanced order. A 2 (condition: nose, mouth) × 6 (time: 0-5 sec, 5-10 sec, 10-15 sec, 15-20 sec, 20-25 sec, 25-30 sec) repeated measures ANOVA was used to analyze the data with significance accepted at the p<0.05 level. No differences between breathing mode were observed for any power output or performance measures associated with the Wingate Anaerobic cycle test. Respiratory exchange ratio (RER) was significantly higher in the oral respiration condition from 10 seconds to 25 seconds during the test (p<0.05). On the other hand, heart rate (HR) in the nasal condition was significantly greater during the final two time intervals (p<0.05). Nasal breathing was effective in reducing hyperventilation as RER remained below 1.0. However, elevated HR with nasal breathing indicates increased cardiovascular stress associated with this mode. As breathing mode does not affect power output or performance measures during completion of a high-intensity anaerobic test, preference of the participant should be the determining factor if a choice is available.

  13. Oral or nasal breathing? Real-time effects of switching sampling route onto exhaled VOC concentrations.

    PubMed

    Sukul, Pritam; Oertel, Peter; Kamysek, Svend; Trefz, Phillip

    2017-03-21

    There is a need for standardisation in sampling and analysis of breath volatile organic compounds (VOCs) in order to minimise ubiquitous confounding effects. Physiological factors may mask concentration changes induced by pathophysiological effects. In humans, unconscious switching of oral and nasal breathing can occur during breath sampling, which may affect VOC patterns. Here, we investigated exhaled VOC concentrations in real-time while switching breathing routes. Breath from 15 healthy volunteers was analysed continuously by proton transfer reaction time-of-flight mass spectrometry during paced breathing (12 breaths min(-1)). Every two minutes breathing routes were switched (Setup-1: Oral → Nasal → Oral → Nasal; Setup-2: OralinNasalout → NasalinOralout → OralinNasalout → NasalinOralout). VOCs in inspiratory and alveolar air and respiratory and hemodynamic parameters were monitored quantitatively in parallel. Changing of the breathing routes and patterns immediately affected exhaled VOC concentrations. These changes were reproducible in both setups. In setup-1 cardiac output and acetone concentrations remained constant, while partial pressure of end-tidal CO2 (pET-CO2), isoprene and furan concentrations inversely mirrored tidal-volume and minute-ventilation. H2S (hydrogen-sulphide), C4H8S (allyl-methyl-sulphide), C3H8O (isopropanol) and C3H6O2 increased during oral exhalation. C4H10S increased during nasal exhalations. CH2O2 steadily decreased during the whole measurement. In setup-2 pET-CO2, C2H6S (dimethyl-sulphide), isopropanol, limonene and benzene concentrations decreased whereas, minute-ventilation, H2S and acetonitrile increased. Isoprene and furan remained unchanged. Breathing route and patterns induced VOC concentration changes depended on respiratory parameters, oral and nasal cavity exposure and physico-chemical characters of the compounds. Before using breath VOC concentrations as biomarkers it is essential that the breathing

  14. Assessment of nasal and sinus nitric oxide output using single-breath humming exhalations.

    PubMed

    Maniscalco, M; Weitzberg, E; Sundberg, J; Sofia, M; Lundberg, J O

    2003-08-01

    Nasal nitric oxide (NO) levels increase greatly during humming compared to silent exhalation. In this study, the physiological and anatomical factors that regulate NO release during humming have been characterised in 10 healthy subjects and in a model of the sinus and the nose. Single-breath humming caused a large initial peak in nasal NO output, followed by a progressive decline. The NO peak decreased in a step-wise manner during repeated consecutive humming manoeuvres but recovered completely after a silent period of 3 min. Topical nasal application of an NO synthase inhibitor reduced nasal NO by >50% but had no effect on the increase evoked by humming. Silently exhaled nasal NO measured immediately after repeated humming manoeuvres was between 5-50% lower than basal silent NO exhalation, suggesting variable continuous contribution from the sinuses to nasal NO. Among the factors known to influence normal sinus ventilation, ostium size was the most critical during humming, but humming frequency was also of importance. In conclusion, humming results in a large increase in nasal nitric oxide, which is caused by a rapid gas exchange in the paranasal sinuses. Combined nasal nitric oxide measurement with and without humming could be of use to estimate sinus ventilation and to better separate nasal mucosal nitric oxide output from sinus nitric oxide in health and disease.

  15. Comparison of Effort of Breathing for Infants on Nasal Modes of Respiratory Support.

    PubMed

    Kamerkar, Asavari; Hotz, Justin; Morzov, Rica; Newth, Christopher J L; Ross, Patrick A; Khemani, Robinder G

    2017-06-01

    To directly compare effort of breathing between high flow nasal cannula (HFNC), nasal intermittent mechanical ventilation (NIMV), and nasal continuous positive airway pressure (NCPAP). This was a single center prospective cross-over study for patients <6 months in the cardiothoracic or pediatric intensive care unit receiving nasal noninvasive respiratory support after extubation. We measured effort of breathing using esophageal manometry with pressure-rate product (PRP) on all 3 modes. NIMV synchrony was determined by comparing patient efforts (esophageal manometry) with mechanically delivered breaths (spirometry in ventilator circuit). On NIMV, PRP and synchrony was also measured after adding a nasal clip on 26 patients. Forty-two children were included. Median (IQR) age was 2 (0.5, 4) months. There was no difference in median PRP between HFNC 6 liters per minute, 355 (270,550), NIMV 12/5 cm H2O, 341 (235, 472), and NCPAP 5 cm H2O, 340 (245,506) (P?=?.33). Results were similar regardless of HFNC flow rate or NIMV inspiratory pressure. Median PRP on CPAP of 5 cm H2O prior to extubation 255 (176, 375) was significantly lower than all postextubation values (P?breath, which was not improved with a nasal clip (P?>?.07)). However, as NIMV synchrony improved (>60%), PRP on NIMV was lower than on HFNC. For infants, effort of breathing is similar on HFNC, NIMV, and NCPAP after extubation, regardless of flow rate or inspiratory pressure. We speculate that bi-level NIMV may be superior if high levels of synchrony can be achieved. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Nasal Reflexes: Implications for Exercise, Breathing, and Sex

    PubMed Central

    Baraniuk, James N.; Merck, Samantha J.

    2014-01-01

    Nasal patency, with both congestion and decongestion, is affected in a wide variety of reflexes. Stimuli that lead to nasal reflexes include exercise, alterations of body position, pressure, and temperature, neurological syndromes, and dentists. As anticipated, the vagal and trigeminal systems are closely integrated through nasobronchial and bronchonasal reflexes. However, perhaps of greater pathophysiological importance are the naso-hypopharyngea-laryngeal reflexes that become aggravated during sinusitis. None other than Sigmund Freud saw deeply beyond the facial adornment and recognized the deeper sexual tensions that can regulate nasal functions and psychoanalytical status. Wine, women and song are linked with airflow through the nose, the nose, that by any other name would still smell as sweetly. PMID:18417057

  17. Effects of Breathing Pattern on Oxygen Delivery Via a Nasal or Pharyngeal Cannula.

    PubMed

    Yamamoto, Natsuhiro; Miyashita, Tetsuya; Takaki, Shunsuke; Goto, Takahisa

    2015-12-01

    During sedation for upper gastrointestinal endoscopy, oxygen delivery via a nasal cannula is often necessary. However, the influences of the oxygen delivery route and breathing pattern on the F(IO2) have not been thoroughly investigated. The aim of this simulation study was to investigate the difference in the F(IO2) with a pharyngeal cannula versus nasal cannula during high- or low-tidal volume (V(T)) ventilation and open- or closed-mouth breathing. Six healthy volunteers were asked to breathe using 2 patterns of ventilation (high or low V(T)) via a sealed face mask connected to an endotracheal tube that was retrogradely inserted into the trachea of a mannequin. The mannequin also had a pharyngeal or nasal cannula inserted into the pharynx or attached to the nose, through which oxygen (2 or 5 L/min) was delivered. The mouth of the mannequin was kept open or closed by packing. We measured the F(IO2) of every breath for 1 min at each setting. During low- and high-V(T) ventilation, the F(IO2) was highest at a flow of 5 L/min with a pharyngeal cannula. Oxygen delivery was higher with the pharyngeal cannula compared with the nasal cannula at all settings. Differences in flow did not result in significant differences in the F(IO2) with high- and low-V(T) ventilation. At a flow of 5 L/min via a pharyngeal cannula, open-mouth breathing resulted in a significantly higher F(IO2) compared with closed-mouth breathing. A pharyngeal cannula provided a higher F(IO2) compared with a nasal cannula at the same oxygen flow. Open-mouth breathing resulted in a higher F(IO2) compared with closed-mouth breathing when 5 L/min oxygen was delivered via a pharyngeal cannula. The breathing pattern did not affect the F(IO2) in this study. Copyright © 2015 by Daedalus Enterprises.

  18. Nasal versus face mask for multiple-breath washout technique in preterm infants.

    PubMed

    Schulzke, S M; Deeptha, K; Sinhal, S; Baldwin, D N; Pillow, J J

    2008-09-01

    The large dead space associated with face masks might impede the accuracy and feasibility of multiple-breath washout (MBW) measurements in small infants. We asked if a low dead space nasal mask would provide measurements of resting lung volume and ventilation inhomogeneity comparable to those obtained with a face mask, when using the MBW technique. Unsedated preterm infants breathing without mechanical assistance and weighing between 1.50 and 2.49 kg were studied. Paired MBW tests with nasal and face masks were obtained using sulphur hexafluoride (SF(6)) as the tracer gas. The order of mask application was quasi-randomized. Bland-Altman method and intraclass correlation coefficient were used to analyze outcomes. Measurements were obtained in 20 infants with a mean (SD) postmenstrual age of 36 (1.4) w and a test weight of 2.0 (0.3) kg. The mean difference (95% CI) for nasal vs. face mask was -3.2 breaths/min (-6.2, -0.1 breaths/min) for respiratory rate, -1.0 ml/kg (-2.3, 0.3 ml/kg) for lung volume, 0.6 (0.1, 1.1) for lung clearance index, 0.2 (0.1, 0.3) for first to zeroeth moment ratio and 1.33 (0.6, 2.4) for second to zeroeth moment ratio. Paired measurements of lung volume showed acceptable agreement and good correlation, but there was poor agreement and poor correlation between indices of ventilation inhomogeneity obtained with the two masks. Functional dead space of the nasal mask was similar to that of the face mask despite its smaller water displacement volume. During MBW in infants below 2.5 kg body weight, a nasal mask results in comparable lung volume measurements. Indices of ventilation inhomogeneity may not be directly comparable using masks with different dead space. (c) 2008 Wiley-Liss, Inc.

  19. Changes in nasal air flow and school grades after rapid maxillary expansion in oral breathing children.

    PubMed

    Torre, Hilda; Alarcón, Jose-Antonio

    2012-09-01

    To analyse the changes in nasal air flow and school grades after rapid maxillary expansion (RME) in oral breathing children with maxillary constriction. Forty-four oral breathing children (mean age 10.57 y) underwent orthodontic RME with a Hyrax screw. Forty-four age-matched children (mean age 10.64 y) with nasal physiological breathing and adequate transverse maxillary dimensions served as the control group. The maxillary widths, nasal air flow assessed via peak nasal inspiratory flow (PNIF), and school grades were recorded at baseline, and 6 months and one year following RME. After RME, there were significant increases in all the maxillary widths in the study group. PNIF was reduced in the study group (60.91±13.13 l/min) compared to the control group (94.50±9.89 l/min) (P<0.000) at the beginning of the study. Six months after RME, a significant improvement of PNIF was observed in the study group (36.43±22.61). School grades were lower in the study group (85.52±5.74) than in the control group (89.77±4.44) (P<0.05) at the baseline, but it increased six months after RME (2.77±3.90) (P<0.001) and one year later (5.02±15.23) (P<0.05). Nasal air flow improved in oral breathing children six months and one year after RME. School grades also improved, but not high enough to be academically significant.

  20. Growth of nasal and laryngeal airways in children: implications in breathing and inhaled aerosol dynamics.

    PubMed

    Xi, Jinxiang; Si, Xiuhua; Zhou, Yue; Kim, Jongwon; Berlinski, Ariel

    2014-02-01

    The human respiratory airway undergoes dramatic growth during infancy and childhood, which induces substantial variability in air flow pattern and particle deposition. However, deposition studies have typically focused on adult subjects, the results of which cannot be readily extrapolated to children. We developed models to quantify the growth of human nasal-laryngeal airways at early ages, and to evaluate the impact of that growth on breathing resistance and aerosol deposition. Four image-based nasal-laryngeal models were developed from 4 children, ages 10 days, 7 months, 3 years, and 5 years, and were compared to a nasal-laryngeal model of a 53-year-old adult. The airway dimensions were quantified in terms of different parameters (volume, cross-section area, and hydraulic diameter) and of different anatomies (nose, pharynx, and larynx). Breathing resistance and aerosol deposition were computed using a high-fidelity fluid-particle transport model, and were validated against the measurements made with the 3-dimensional models fabricated from the same airway computed tomography images. Significant differences in nasal morphology were observed among the 5 subjects, in both morphology and dimension. The turbinate region appeared to experience the most noticeable growth during the first 5 years of life. The nasal airway volume ratios of the 10-day, 7-month, 3-year, and 5-year-old subjects were 6.4%, 18.8%, 24.2%, and 40.3% that of the adult, respectively. Remarkable inter-group variability was observed in air flow, pressure drop, deposition fraction, and particle accumulation. The computational fluid dynamics predicted pressure drops and deposition fractions were in close agreement with in vitro measurements. Age effects are significant in both breathing resistance and micrometer particle deposition. The image/computational-fluid-dynamics coupled method provides an efficient and effective approach in understanding patient-specific air flows and particle deposition

  1. Comparison of exhaled nitric oxide and cardiorespiratory indices between nasal and oral breathing during submaximal exercise in humans.

    PubMed

    Yasuda, Y; Itoh, T; Miyamura, M; Nishino, H

    1997-10-01

    In order to examine the origin and role of nitric oxide (NO) in exhaled air during exercise, exhaled NO outputs of 8 healthy human subjects were compared using different breathing methods, through the mouth or nose, at two intensities of bicycle exercise. The concentration of NO in the exhaled air and ventilatory gas exchange variables were measured by a chemiluminescence analyzer and a mixing chamber method, respectively. The concentration and total output of NO in the expired air was significantly higher under nasal breathing than under oral breathing for both exercise intensities, whereas no significant difference was observed in cardiorespiratory variables between them. NO output increased significantly when exercise intensity was increased from unloaded (0 W) to 60 W under nasal breathing, but not under oral breathing. A negative correlation among subjects was found between NO output and minute ventilation in both breathing methods only for unloaded exercise. Data indicate that nasal airways have a large contribution, at least 50% of total NO output in the exhaled air during nasal breathing, but this nasal NO may have no further modulation on respiratory function during submaximal exercise by healthy humans.

  2. Electrical activity of the anterior temporal and masseter muscles in mouth and nasal breathing children.

    PubMed

    Ferla, Aline; Silva, Ana Maria Toniolo da; Corrêa, Eliane Castilhos Rodrigues

    2008-01-01

    Mouth breathing has been associated with severe impact on the development of the stomatognathic system. This paper aims to analyze the electromyographical findings and patterns of electrical activity of the anterior temporal and masseter muscles in mouth and nasal breathing children. The patients were divided into two groups: mouth breathers (n=17) and nasal breathers (n=12). The children underwent bilateral electromyographic examination of the anterior temporal and masseter muscles at maximal intercuspal position and during usual mastication. A Myosystem Br-1 electromyograph with 12 acquisition channels, amplification with total gain of 5938, rate of acquisition of 4000 Hz, and band-pass filter of 20-1000Hz, was used in the examination. The signal was processed in Root Mean Square(RMS), measured in microV, analyzed and expressed as a normalized percentage. The data set was statistically treated with the T-test (Student). The observed level of electrical activity in the mouth breathing (MB) group was lower in all analyzed muscles, with statistical significance found only in the left temporal muscle; during mastication, mouth breathers also presented increased electrical activity on the right side and on the temporal muscle. Mouth breathing impacts the electrical activity of the muscles studied at maximal intercuspal position and during usual mastication.

  3. Computational modeling and validation of human nasal airflow under various breathing conditions.

    PubMed

    Li, Chengyu; Jiang, Jianbo; Dong, Haibo; Zhao, Kai

    2017-09-05

    The human nose serves vital physiological functions, including warming, filtration, humidification, and olfaction. These functions are based on transport phenomena that depend on nasal airflow patterns and turbulence. Accurate prediction of these airflow properties requires careful selection of computational fluid dynamics models and rigorous validation. The validation studies in the past have been limited by poor representations of the complex nasal geometry, lack of detailed airflow comparisons, and restricted ranges of flow rate. The objective of this study is to validate various numerical methods based on an anatomically accurate nasal model against published experimentally measured data under breathing flow rates from 180 to 1100ml/s. The numerical results of velocity profiles and turbulence intensities were obtained using the laminar model, four widely used Reynolds-averaged Navier-Stokes (RANS) turbulence models (i.e., k-ε, standard k-ω, Shear Stress Transport k-ω, and Reynolds Stress Model), large eddy simulation (LES) model, and direct numerical simulation (DNS). It was found that, despite certain irregularity in the flow field, the laminar model achieved good agreement with experimental results under restful breathing condition (180ml/s) and performed better than the RANS models. As the breathing flow rate increased, the RANS models achieved more accurate predictions but still performed worse than LES and DNS. As expected, LES and DNS can provide accurate predictions of the nasal airflow under all flow conditions but have an approximately 100-fold higher computational cost. Among all the RANS models tested, the standard k-ω model agrees most closely with the experimental values in terms of velocity profile and turbulence intensity. Copyright © 2017. Published by Elsevier Ltd.

  4. Restorative procedures in disturbed function of the upper airways - nasal breathing

    PubMed Central

    Mlynski, Gunter

    2005-01-01

    These days, functional rhinosurgery is almost always taken to mean the improvement of nasal airflow. However, air should not only pass through the nose without obstruction. It needs to be warmed, moistened and filtered. This requires sufficient air/mucous membrane contact by spreading airflow over the entire turbinate region, as well as regulation of nasal airway resistance and the degree of turbulence within the nasal cycle. These factors are not considered enough in the concept of functional rhinosurgery. There cannot be a rigid concept for functional/aesthetic rhinosurgery, the surgical procedure must be adapted to the individual anatomy and pathology. In spite of this, it must be clear (based on evidence) which surgical steps can solve a functional problem of the nose in the long term. This paper cannot explain evidence-based treatment strategies to restore nasal respiratory function because in all branches of rhinosurgery, there are no prospective studies available with a sufficiently high sample size and long-term results objectivized by functional diagnosis. Studies available on septal surgery show better results for SP after Cottle than for SMR after Killian. However, the success rate of a 70 to 80% improvement in nasal breathing is not satisfactory. The incidence of postoperative, dry nasal mucosa is also too high. The task of rhinology is to stress the functional side of rhinosurgery more. This includes preoperative analysis of the causes of disturbed respiratory function using the functional diagnosis methods available, the use of evidence-based surgical techniques and postoperative, objectivized quality control. More research needs to be done on the physiology and pathophysiology of nasal airflow as well as on the effect of rhinosurgery on airflow. Numerical flow simulation can contribute greatly to this because the effects of shape changes on the flow can be visualized. Methods need to be developed which can be used for routine, diagnostic recording of

  5. Diaphragmatic amplitude and accessory inspiratory muscle activity in nasal and mouth-breathing adults: a cross-sectional study.

    PubMed

    Trevisan, Maria Elaine; Boufleur, Jalusa; Soares, Juliana Corrêa; Haygert, Carlos Jesus Pereira; Ries, Lilian Gerdi Kittel; Corrêa, Eliane Castilhos Rodrigues

    2015-06-01

    The purpose of this study was to evaluate the electromyographic activity of the accessory inspiratory muscles and the diaphragmatic amplitude (DA) in nasal and mouth-breathing adults. The study evaluated 38 mouth-breathing (MB group) and 38 nasal-breathing (NB group) adults, from 18 to 30years old and both sexes. Surface electromyography (sEMG) was used to evaluate the amplitude and symmetry (POC%) of the sternocleidomastoid (SCM) and upper trapezius (UT) muscles at rest, during nasal slow inspiration at Lung Total Capacity (LTC) and, during rapid and abrupt inspiration: Sniff, Peak Nasal Inspiratory Flow (PNIF) and Maximum Inspiratory Pressure (MIP). M-mode ultrasonography assessed the right diaphragm muscle amplitude in three different nasal inspirations: at tidal volume (TV), Sniff and inspiration at LTC. The SCM activity was significantly lower in the MB group during Sniff, PNIF (p<0.01, Mann-Whitney test) and MIP (p<0.01, t-test). The groups did not differ during rest and inspiration at LTC, regarding sEMG amplitude and POC%. DA was significantly lower in the MB group at TV (p<0.01, Mann-Whitney) and TLC (p=0.03, t-test). Mouth breathing reflected on lower recruitment of the accessory inspiratory muscles during fast inspiration and lower diaphragmatic amplitude, compared to nasal breathing. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Technical and practical issues for tidal breathing measurements of nasal nitric oxide in children.

    PubMed

    Beydon, Nicole; Chambellan, Arnaud; Alberti, Corinne; de Blic, Jacques; Clément, Annick; Escudier, Estelle; Le Bourgeois, Muriel

    2015-12-01

    To promote early screening of patients with suspected Primary Ciliary Dyskinesia (PCD), nasal nitric oxide (nNO) measurements during tidal breathing (TB) have been developed for children unable to ensure velum closure (VC) during breath hold or expiration against resistance. To investigate technical and practical issues related to TB-nNO methods in children referred for suspected or asserted PCD, we recorded, in a prospective multicenter study, TB-nNO (calculated as the mean of 5 peaks, 10 or 30 sec during tidal breathing) and VC-nNO when available. We studied 142 children (PCD diagnosis asserted in 47, excluded in 39). Nasal NO values were significantly different according to methods, VC-nNO being higher than TB-nNO (TB-nNO 5 peaks higher than mean of 10 or 30 sec). Specificity (90-94%) and sensitivity (86-97%) were similar between TB-nNO and VC-nNO methods. Age was more correlated with VC-nNO than with TB-nNO. TB-nNO could differ between the two nostrils by more than 10% (or 10 ppb when nNO absolute value lower 100 ppb) in 32-43% of the tested children, according to the different tidal breathing values, and was reproducible in the long term but influenced by ambient NO. Despite TB-nNO values being lower than VC-nNO, TB-nNO was found to be as discriminant for PCD, and probably more discriminant in children less than 8 years old, as the VC method. These results were obtained using the chemiluminescence technique which allows an easier assessment of relevant factors such as nasal permeability and ambient NO than the electrochemical technique. © 2015 Wiley Periodicals, Inc.

  7. Nasal contribution to exhaled nitric oxide during exhalation against resistance or during breath holding

    PubMed Central

    Kharitonov, S. A.; Barnes, P. J.

    1997-01-01

    BACKGROUND: The concentration of nitric oxide (NO) is increased in the exhaled air of patients with inflammation of the airways, suggesting that this may be a useful measurement to monitor inflammation in diseases such as asthma. However, there have been concerns that exhaled NO may be contaminated by the high concentrations of NO derived from the upper airways, and that this may account for differences in reported values of exhaled NO using different techniques. A study was performed, with argon as a tracer, to determine the extent of nasal contamination of exhaled NO using different expiratory manoeuvres. METHODS: Exhaled and nasal NO were measured by a chemiluminescence analyser. Argon (4.8%) was delivered continuously to the nose. Gas was sampled from the posterior oropharynx and argon and carbon dioxide were measured by mass spectrometry at the same time as NO. RESULTS: During a single expiration against a low resistance and during breath holding there was no evidence for nasal contamination, whereas during exhalation without resistance argon concentration in the oropharynx was increased from 0.91% (95% CI 0.84% to 0.98%) in ambient air to 1.28% (0.9% to 2.24%, p < 0.0001) during a single breath or 2.37% (2.29% to 2.51%, p < 0.0001) during tidal breathing. CONCLUSIONS: Collection of exhaled NO in a reservoir during tidal breathing is likely to be contaminated by NO derived from the nose and this may underestimate any increases in NO derived from the lower respiratory tract in inflammatory diseases. However, with slow expiration against a resistance and created back pressure to close the soft palate, there is no contamination of exhaled air which then reflects concentrations of NO in the lower airways. 


 PMID:9227721

  8. Nasal contribution to exhaled nitric oxide during exhalation against resistance or during breath holding.

    PubMed

    Kharitonov, S A; Barnes, P J

    1997-06-01

    The concentration of nitric oxide (NO) is increased in the exhaled air of patients with inflammation of the airways, suggesting that this may be a useful measurement to monitor inflammation in diseases such as asthma. However, there have been concerns that exhaled NO may be contaminated by the high concentrations of NO derived from the upper airways, and that this may account for differences in reported values of exhaled NO using different techniques. A study was performed, with argon as a tracer, to determine the extent of nasal contamination of exhaled NO using different expiratory manoeuvres. Exhaled and nasal NO were measured by a chemiluminescence analyser. Argon (4.8%) was delivered continuously to the nose. Gas was sampled from the posterior oropharynx and argon and carbon dioxide were measured by mass spectrometry at the same time as NO. During a single expiration against a low resistance and during breath holding there was no evidence for nasal contamination, whereas during exhalation without resistance argon concentration in the oropharynx was increased from 0.91% (95% CI 0.84% to 0.98%) in ambient air to 1.28% (0.9% to 2.24%, p < 0.0001) during a single breath or 2.37% (2.29% to 2.51%, p < 0.0001) during tidal breathing. Collection of exhaled NO in a reservoir during tidal breathing is likely to be contaminated by NO derived from the nose and this may underestimate any increases in NO derived from the lower respiratory tract in inflammatory diseases. However, with slow expiration against a resistance and created back pressure to close the soft palate, there is no contamination of exhaled air which then reflects concentrations of NO in the lower airways.

  9. Improved Pharmacokinetics of Sumatriptan With Breath Powered™ Nasal Delivery of Sumatriptan Powder

    PubMed Central

    Obaidi, Mohammad; Offman, Elliot; Messina, John; Carothers, Jennifer; Djupesland, Per G; Mahmoud, Ramy A

    2013-01-01

    Objectives.— The purpose of this study was to directly compare the pharmacokinetic (PK) profile of 22-mg sumatriptan powder delivered intranasally with a novel Breath Powered™ device (11 mg in each nostril) vs a 20-mg sumatriptan liquid nasal spray, a 100-mg oral tablet, and a 6-mg subcutaneous injection. Background.— A prior PK study found that low doses of sumatriptan powder delivered intranasally with a Breath Powered device were efficiently and rapidly absorbed. An early phase clinical trial with the same device and doses found excellent tolerability with high response rates and rapid onset of pain relief, approaching the benefits of injection despite significantly lower predicted drug levels. Methods.— An open-label, cross-over, comparative bioavailability study was conducted in 20 healthy subjects at a single center in the USA. Following randomization, fasted subjects received a single dose of each of the 4 treatments separated by a 7-day washout. Blood samples were taken pre-dose and serially over 14 hours post-dose for PK analysis. Results.— Quantitative measurement of residuals in used Breath Powered devices demonstrated that the devices delivered 8 ± 0.9 mg (mean ± standard deviation) of sumatriptan powder in each nostril (total dose 16 mg). Although the extent of systemic exposure over 14 hours was similar following Breath Powered delivery of 16-mg sumatriptan powder and 20-mg liquid nasal spray (area under the curve [AUC]0-∞ 64.9 ng*hour/mL vs 61.1 ng*hour/mL), sumatriptan powder, despite a 20% lower dose, produced 27% higher peak exposure (Cmax 20.8 ng/mL vs 16.4 ng/mL) and 61% higher exposure in the first 30 minutes compared with the nasal spray (AUC0-30 minutes 5.8 ng*hour/mL vs 3.6 ng*hour/mL). The magnitude of difference is larger on a per-milligram basis. The absorption profile following standard nasal spray demonstrated bimodal peaks, consistent with lower early followed by higher later absorptions. In

  10. Flow modeling of actual human nasal cavity for various breathing conditions

    NASA Astrophysics Data System (ADS)

    Mokhtar, Nur Hazwani; Yaakob, Muhammad Syauki; Osman, Kahar; Kadir, Mohammed Rafiq Abdul; Abdullah, Wan Kamil Wan; Haron, Juhara

    2012-06-01

    Flow in the human nasal cavity varies when the body is under various physical activities. However, in order to visualize the flow pattern, traditional in-vivo technique may disturb the flow patterns. In this study, computational method was used to model the flow in the nasal cavity under various breathing conditions. Image from CT-Scan was used to mimic the actual cavity geometry. The image was computationally constructed and EFD. Lab was used to predict the flow behavior. Steady incompressible flow was considered for all case studies. The result shows that, for all breathing conditions, vortices were observed in the turbinate region which confirms the turbinate functions as a filter before the flow reaches the olfactory area. Larger vortices were detected when the flow rates were higher. In the olfactory region, the flow velocities were shown to be dramatically dropped to the ideal odorant uptake velocity range for all cases studied. This study had successfully produced visual description of air flow pattern in the nasal cavity.

  11. Recovery of Percent Vital Capacity by Breathing Training in Patients With Panic Disorder and Impaired Diaphragmatic Breathing.

    PubMed

    Yamada, Tatsuji; Inoue, Akiomi; Mafune, Kosuke; Hiro, Hisanori; Nagata, Shoji

    2017-09-01

    Slow diaphragmatic breathing is one of the therapeutic methods used in behavioral therapy for panic disorder. In practice, we have noticed that some of these patients could not perform diaphragmatic breathing and their percent vital capacity was initially reduced but could be recovered through breathing training. We conducted a comparative study with healthy controls to investigate the relationship between diaphragmatic breathing ability and percent vital capacity in patients with panic disorder. Our findings suggest that percent vital capacity in patients with impaired diaphragmatic breathing was significantly reduced compared with those with normal diaphragmatic breathing and that diaphragmatic breathing could be restored by breathing training. Percent vital capacity of the healthy controls was equivalent to that of the patients who had completed breathing training. This article provides preliminary findings regarding reduced vital capacity in relation to abnormal respiratory movements found in patients with panic disorder, potentially offering alternative perspectives for verifying the significance of breathing training for panic disorder.

  12. Three-dimensional assessment of pharyngeal airway in nasal- and mouth-breathing children.

    PubMed

    Alves, Matheus; Baratieri, Carolina; Nojima, Lincoln I; Nojima, Matilde C G; Ruellas, Antônio C O

    2011-09-01

    The aim of this study was to assess the pharyngeal airway space (PAS) in nasal and mouth-breathing children using cone beam computed tomography (CBCT). Volume, area, minimum axial area and linear measurements (PAS-NL, PAS-UP, PAS-OccL, PAS-UT, PAS-Bgo, PAS-ML, PAS-TP) of the pharyngeal airway of 50 children (mean age 9.16 years) were obtained from the CBCT images. The means and standard deviations were compared according to sexes (28 male and 22 female) and breathers patterns (25 nasal breathers and 25 mouth breathers). There were no statistically significant differences (p>0.05) between all variables when compared by sexes. Comparisons between nasal and mouth breathers showed significant differences only in two linear measurements: PAS-OccL (p<0.001) and PAS-UP (P<0.05). Airway volume (p<0.001), area (p<0.001) and minimum axial area (p<0.01) had significant differences between the groups. The CBCT evaluation showed that pharyngeal airway dimensions were significantly greater in nasal-breathers than in mouth-breathers. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  13. Menthol: effects on nasal sensation of airflow and the drive to breathe.

    PubMed

    Eccles, Ronald

    2003-05-01

    Menthol, in lozenges, nasal sprays, vapo-rubs, inhalers, and cough syrups, is widely used as a treatment for rhinitis that is associated with acute upper respiratory tract infection and allergy. Menthol as a plant extract has been used in traditional medicine in Asia for the treatment of respiratory diseases for hundreds of years, but it was only introduced to the West as a medicine at the end of the 19th century. With the recent discovery of a menthol receptor on the sensory nerves that modulate the cool sensation, menthol has graduated from the realms of herbal medicine into the field of molecular pharmacology. This review concerns the physiologic and pharmacologic mechanisms that underlie the widespread use of menthol as a treatment for the relief of nasal congestion associated with rhinitis and its effects on the drive to breathe and symptomatic relief of dyspnea.

  14. The effect of formulation variables and breathing patterns on the site of nasal deposition in an anatomically correct model.

    PubMed

    Guo, Yang; Laube, Beth; Dalby, Richard

    2005-11-01

    This study was conducted to evaluate the effect of formulation variables and breathing patterns on aerosol distribution in the nasal cavity. Placebo nasal spray formulations containing 0.25% w/v Avicel CL611 (viscosity = 4 cP) and 2% w/v methylcellulose (MC; viscosity = 18.2 cP) were radiolabeled with (99m)Technicium. Following spraying into a silicone nose model, through which air was drawn at one of three constant rates (0, 10, and 20 L/min) or one of two breathing profiles (representing fast and slow inhalations), aerosol deposition in the model was quantified by gamma scintigraphy. Regional deposition was expressed as horizontal[inner, middle (h), outer] and vertical distribution [upper, middle (v), lower] in the nose model. Compared to 2% MC, Avicel CL611 significantly increased aerosol deposition in the middle (h) region of the nasal cavity under all breathing conditions, and in the inner region at 0 and 20 L/min and with a slow inhalation. The different breathing rates showed no effect on deposition of 2% MC. However, 10 L/min significantly increased the upper deposition of Avicel compared to 0 and 20 L/min. Nasal sprays with a low viscosity provided greater surface coverage of the nasal mucosa than higher viscosity formulations. Changes in breathing profiles did not affect aerosol deposition in this nose model.

  15. Effects of ozone exposure: a comparison between oral and nasal breathing

    SciTech Connect

    Hynes, B.; Silverman, F.; Cole, P.; Corey, P.

    1988-09-01

    Mode of inhalation, by nose or by mouth, as a determinant of pulmonary toxicity to acute inhalant exposure has been investigated incompletely. This communication addresses whether there are significant differences in toxic pulmonary responses to acute ozone (O/sub 3/) exposure between differing modes of inhalation (nasal vs. oral breathing). Changes in the results of pulmonary function tests and symptomatology of healthy young adults were compared following both exclusive nose and exclusive mouth breathing during a 30-min exposure to approximately 0.4 ppm O/sub 3/ under conditions of moderate continuous exercise. In this single-blind, randomized, crossover study, no significant differences in either the results of pulmonary function tests or in symptomatology were found between the two modes of inhalation.

  16. Electromyographic fatigue of orbicular oris muscles during exercises in mouth and nasal breathing children.

    PubMed

    Busanello-Stella, Angela Ruviaro; Blanco-Dutra, Ana Paula; Corrêa, Eliane Castilhos Rodrigues; Silva, Ana Maria Toniolo da

    2015-01-01

    To investigate the process of fatigue in orbicularis oris muscles by analyzing the median frequency of electromyographic signal and the referred fatigue time, according to the breathing mode and the facial pattern. The participants were 70 children, aged 6 to 12 years, who matched the established criteria. To be classified as 36 nasal-breathing and 34 mouth-breathing children, they underwent speech-language, otorhinolaryngologic, and cephalometric evaluation. For the electromyographic assessment, the children had to sustain lip dumbbells weighing 40, 60, and 100 g and a lip exerciser, until the feeling of fatigue. Median frequency was analyzed in 5, 10, 15, and 20 seconds of activity. The referred time of the feeling of fatigue was also recorded. Data were analyzed through the analysis of variance--repeated measures (post hoc Tukey's test), Kruskal-Wallis test, and Mann-Whitney U-test. A significant decrease in the median frequency from 5 seconds of activity was observed, independently from the comparison between the groups. On comparison, the muscles did not show significant decrease. The reported time for the feeling of fatigue was shorter for mouth-breathing individuals. This feeling occurred after the significant decrease in the median frequency. There were signals that indicated myoelectric fatigue for the orbicularis oris muscles, in both groups analyzed, from the first 5 seconds of activity. Myoelectric fatigue in the orbicularis oris muscles preceded the reported feeling of fatigue in all groups. The account for fatigue time was influenced by only the breathing pattern, occurring more precociously in mouth-breathing children.

  17. Impaired sense of smell in patients with nasal surgery.

    PubMed

    Briner, H R; Simmen, D; Jones, N

    2003-10-01

    The aim of the study was to determine the incidence of olfactory disorders before and following nasal and paranasal sinus surgery. It was a prospective observational study. Over a 6-month period, all patients who had been listed for nasal and paranasal sinus surgery underwent preoperative and postoperative evaluation of their sense of smell. A questionnaire and the 'Smell Diskettes Test' were used to assess olfaction. One hundred and eighty-four patients were studied. Preoperatively, 19 patients (10.3%) had an impaired sense of smell (8.1% before septoplasty, 6.1% before rhinoplasty and 17.1% before endoscopic sinus surgery). Only 16 (84%) of these patients were aware of their impaired sense of smell. Following surgery, four patients (2.5%) who were normal preoperatively developed impaired olfaction on questioning, and this was supported by testing it. In the subgroup that had a septoplasty, no patient developed hyposmia compared to one patient (2.6%) after rhinoplasty and one patient (3%) after endoscopic sinus surgery. No patient developed anosmia. Preoperatively, 10.3% of patients had an altered sense of smell, making it desirable that this is documented in order to avoid postoperative claims that this was caused by surgery. It also helps to audit the results of surgery.

  18. Usage of four-phase high-resolution rhinomanometry and measurement of nasal resistance in sleep-disordered breathing.

    PubMed

    Toh, Song-Tar; Lin, Cheng-Hui; Guilleminault, Christian

    2012-10-01

    To investigate the ease of use of four-phase high-resolution rhinomanometry (HRR), a new way of measuring nasal resistance, in measuring change in nasal resistance from supine to inclined position in a clinical sleep laboratory setting, and to correlate findings with continuous positive airway pressure (CPAP) tolerance. Retrospective review of clinical charts. Forty successively seen Caucasian subjects diagnosed with sleep-disordered breathing (SDB) with complete charts were analyzed. Using four-phase HRR and acoustic rhinometry, nasal resistance and minimal cross-sectional area of the nasal cavity were objectively measured with the patient in the supine position and repeated in the inclined position (30° from the horizontal plane), respectively. From the supine to inclined position, reduction in total nasal resistance was observed in 87.5% (35 out of 40). There was a mean reduction of nasal resistance by 37.1 ± 21.6%. Five (12.5%) out of 40 subjects showed no change or mild increase in nasal resistance. Subjects with nasal resistance unresponsive to the inclined position change tended to have difficulty using nasal CPAP based on downloaded compliance card data. Four-phase HRR and acoustic rhinometry are tests that can be easily performed by sleep specialists to characterize nasal resistance in SDB patients and determine changes in resistance with positional changes. In this study, we found that patients who did not demonstrate a decrease in nasal resistance with inclined position were more likely to be noncompliant with nasal CPAP. These measurements may help us objectively identify patients who might have trouble tolerating nasal CPAP. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  19. High flow nasal heliox improves work of breathing and attenuates lung injury in a newborn porcine lung injury model.

    PubMed

    Jassar, R K; Vellanki, H; Zhu, Yan; Hesek, A M; Wang, J; Rodriguez, E; Wolfson, M R; Shaffer, T H

    2015-01-01

    High flow nasal cannula (HFNC) has been shown to improve ventilation and oxygenation and reduce work of breathing in newborns with respiratory distress. Heliox, decreases resistance to airflow, reduces the work of breathing, facilitates the distribution of inspired gas, and has been shown to attenuate lung inflammation during the treatment of acute lung injury. Heliox delivered by HFNC will decrease resistive load, decrease work of breathing, improve ventilation and attenuate lung inflammation during spontaneous breathing following acute lung injury in the newborn pig. Spontaneously breathing neonatal pigs received Nitrox or Heliox by HFNC and studied over 4 hrs following oleic acid injury. Gas exchange, pulmonary mechanics and systemic inflammation were measured serially. Lung inflammation biomarkers were assessed at termination. Heliox breathing animals demonstrated lower work of breathing reflected by lower tracheal pressure, phase angle and phase relationship. Ventilation efficiency index was greater compared to Nitrox. Heliox group showed less lung inflammation reflected by lower tissue interleukin-6 and 8. High flow nasal Heliox decreased respiratory load, reduced resistive work of breathing indices and attenuated lung inflammatory profile while ventilation was supported at less pressure effort in the presence of acute lung injury.

  20. Nasal Dilators (Breathe Right Strips and NoZovent) for Snoring and OSA: A Systematic Review and Meta-Analysis

    PubMed Central

    Malu, Omojo O.; Kram, Yoseph A.; Song, Sungjin A.; Tolisano, Anthony M.; Kushida, Clete A.

    2016-01-01

    Objective. To systematically review the international literature for studies evaluating internal (NoZovent) and external (Breathe Right Strips) nasal dilators as treatment for obstructive sleep apnea (OSA). Study Design. Systematic review with meta-analysis. Methods. Four databases, including PubMed/MEDLINE, were searched through September 29, 2016. Results. One-hundred twelve studies were screened, fifty-eight studies were reviewed, and fourteen studies met criteria. In 147 patients, the apnea-hypopnea index (AHI) was reported, and there was an improvement from a mean ± standard deviation (M ± SD) of 28.7 ± 24.0 to 27.4 ± 23.3 events/hr, p value 0.64. There was no significant change in AHI, lowest oxygen saturation, or snoring index in OSA patients when using nasal dilators. However, a subanalysis demonstrated a slight reduction in apnea index (AI) with internal nasal dilators (decrease by 4.87 events/hr) versus minimal change for external nasal dilators (increase by 0.64 events/hr). Conclusion. Although nasal dilators have demonstrated improved nasal breathing, they have not shown improvement in obstructive sleep apnea outcomes, with the exception of mild improvement in apnea index when internal nasal dilators were used. PMID:28070421

  1. Effects of non-synchronised nasal intermittent positive pressure ventilation on spontaneous breathing in preterm infants.

    PubMed

    Owen, L S; Morley, C J; Dawson, J A; Davis, P G

    2011-11-01

    Nasal intermittent positive pressure ventilation (NIPPV) may be beneficial but the mechanisms of action are undetermined. To investigate the effects of non-synchronised NIPPV on spontaneous breathing in premature infants. 10 infants receiving ventilator generated non-synchronised NIPPV were studied for 30 min. Delivered pressure was measured at the nose; respiration was recorded using respiratory inductance plethysmography. Oxygen saturation, carbon dioxide, heart rate, inspired oxygen and video images were recorded. Median gestational age, birth weight, age and study weight were 25(+3) weeks, 797 g, 24 days and 1076 g. When the NIPPV pressure peak commenced during spontaneous inspiration the inspiratory time increased by 21% (p=0.002), relative tidal volume increased by 15% (p=0.01) and expiratory time was unchanged. When the NIPPV pressure peak commenced during spontaneous expiration the expiratory time increased by 13% (p=0.04). NIPPV pressures delivered during apnoea (range 8-28 cm H(2)O) produced chest inflation 5% of the time, resulting in small tidal volumes (26.7% of spontaneous breath size) but reduced oxygen desaturation. NIPPV pressure peaks occurred throughout spontaneous respiration proportional to the inspiratory: expiratory ratio. NIPPV pressure peaks only resulted in a small increase in relative tidal volumes when delivered during spontaneous inspiration. During apnoea pressure peaks occasionally resulted in chest inflation, which ameliorated oxygen desaturations. Infants did not become entrained with the NIPPV pressure changes. Synchronising every rise in applied pressure with spontaneous inspiration may increase the effectiveness of NIPPV and warrants investigation.

  2. Mouth breathing in obstructive sleep apnea prior to and during nasal continuous positive airway pressure.

    PubMed

    Ruhle, Karl Heinz; Nilius, Georg

    2008-01-01

    Patients with obstructive sleep apnea syndrome (OSAS) often complain of dryness of mouth and throat prior to and during nasal continuous positive airway pressure (nCPAP). It is believed that this is due to mouth breathing (MB). However, the association between mouth breathing and apneas/hypopneas and the effect of CPAP on MB has not been studied. The purpose of the present study was, therefore, to assess the frequency and duration of episodes of MB prior to and during treatment with nCPAP. MB was recorded prior to and during nCPAP with a closely fitting mouth mask connected to a pneumotachograph and nasal flow was measured via nasal prongs. MB episodes were expressed as the number of events divided by total sleep time x 60, to give the MB event index per hour of sleep. MB time divided by total sleep time x 60 was calculated in minutes to get the MB time index per hour of sleep. Eleven male patients with OSAS (mean age 57.9 +/- 8.3 years, body mass index 30.2 +/- 3.8) were recruited to the study. Prior to nCPAP, the apnea/hypopnea index was 55.8 +/- 26 and decreased during nCPAP to 8.0 +/- 3.4. The lowest SaO2 measured was 82.9 +/- 4.7%, and increased to 87.5 +/- 2.7% under nCPAP. The mean nCPAP was 7.8 +/- 1.6 cm H2O. MB event index per hour of sleep decreased from 35.2 +/- 19.7 prior to treatment to 5.0 +/- 5.2 under nCPAP (p < 0.01). In 52.2 +/- 27.4% of obstructive respiratory events, MB started at the end of an apnea/hypopnea episode, decreasing to 8.5 +/- 12.5% with nCPAP treatment. MB time index per hour of sleep was reduced from 13.5 +/- 10.2 min prior to treatment to 4.6 +/- 5.5 min under nCPAP (p < 0.05). In OSAS patients, MB episodes often appear at the termination of an apnea/hypopnea episode. In many cases, MB episodes can be markedly reduced by nCPAP treatment. When patients on nCPAP complain of dry mouth, appropriate measurements should be performed to verify MB. 2007 S. Karger AG, Basel.

  3. The Relationship between High Flow Nasal Cannula Flow Rate and Effort of Breathing in Children.

    PubMed

    Weiler, Thomas; Kamerkar, Asavari; Hotz, Justin; Ross, Patrick A; Newth, Christopher J L; Khemani, Robinder G

    2017-10-01

    To use an objective metric of effort of breathing to determine optimal high flow nasal cannula (HFNC) flow rates in children <3 years of age. Single-center prospective trial in a 24-bed pediatric intensive care unit of children <3 years of age on HFNC. We measured the percent change in pressure∙rate product (PRP) (an objective measure of effort of breathing) as a function of weight-indexed flow rates of 0.5, 1.0, 1.5, and 2.0 L/kg/minute. For a subgroup of patients, 2 different HFNC delivery systems (Fisher & Paykel [Auckland, New Zealand] and Vapotherm [Exeter, New Hampshire]) were compared. Twenty-one patients (49 titration episodes) were studied. The most common diagnoses were bronchiolitis and pneumonia. Overall, there was a significant difference in the percent change in PRP from baseline (of 0.5 L/kg/minute) with increasing flow rates for the entire cohort (P < .001) with largest change at 2.0 L/kg/min (-21%). Subgroup analyses showed no significant difference in percent change in PRP from baseline when comparing the 2 different HFNC delivery systems (P = .12). Patients ≤8 kg experienced a larger percent change in PRP as HFNC flow rates were increased (P = .001) than patients >8 kg. The optimal HFNC flow rate to reduce effort of breathing in infants and young children is approximately 1.5-2.0 L/kg/minute with more benefit seen in children ≤8 kg. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Mouth Breathing Syndrome: cervical muscles recruitment during nasal inspiration before and after respiratory and postural exercises on Swiss Ball.

    PubMed

    Corrêa, Eliane C R; Bérzin, Fausto

    2008-09-01

    This study aimed to evaluate the recruitment of cervical muscles during nasal inspiration before and after breathing and postural exercises on the Swiss Ball in children with Mouth Breathing Syndrome (MBS). Surface electromyography from the sternocleidomastoid (SCM), sub-occipitals and upper Trapezius muscles was recorded during nasal inspiration, before and at the end of three months of the treatment. A physical therapy program consisting in muscular stretching and strengthening exercises along with naso-diaphragmatic breathing on the Swiss Ball were carried out for body posture realignment and respiratory training. Nineteen mouth breathing children, mean age of 10.6 years, both genres, were the subjects of this study. In order to establish a comparison between the eletromyographic results (normalized values) obtained from pre and post-physical therapy program it was used the Wilcoxon non-parametric test for dependent data. It was found a significant decrease (p<0.01) in the electromyographic activity during nasal inspiration in all tested muscles after treatment (11.3-3.6% in the SCM, 22.4-11.7% in the sub-occipitals and 8.9-3.1% in the upper Trapezius). At the end of the treatment, the assessed muscles reached lower activity electromyographic levels during nasal inspiration and they became closer of those in the quiet position. The lower activity after the physical therapy program in these muscles indicates a less effort of the accessory inspiratory muscles, probably due to a better performance of diaphragm muscle with the improvement of the body posture.

  5. Nasal obstruction and smell impairment in nasal polyp disease: correlation between objective and subjective parameters.

    PubMed

    Hox, V; Bobic, S; Callebaux, I; Jorissen, M; Hellings, P W

    2010-12-01

    Chronic rhinosinusitis with nasal polyposis (NP) represents an invalidating disorder that causes mainly nasal blockage and loss of smell. The aim of this study is to investigate correlations between individual subjective and objective parameters of stable NP disease. 65 NP patients scored their sinonasal symptoms on a visual analogue scale (VAS) and questionnaires (SNOT-22 and SF-36). Peak nasal inspiratory flow (PNIF) measurement, Sniffinatm Sticks (SS) smell test, blood analysis for eosinophilia, total IgE and culture for Staphylococcus aureus (SA) were performed. VAS scores for nasal blockage correlated with the SNOT-22 and SF-36 scores, which was not observed for VAS of other symptoms. VAS scores for nasal blockage correlated well with PNIF values as well as VAS scores for smell dysfunction and SS results (both p<0.001). NP size correlated with VAS scores for nasal blockage (p<0.01) but not with VAS for other symptoms. NP size showed an inverse correlation with PNIF and SS scores (both p<0.05). Blood eosinophilia correlated with subjective smell reduction (p<0.05). The presence of SA or total IgE levels were not associated with symptoms of NP disease. PNIF and SS are good tools to evaluate symptoms of nasal obstruction and smell reduction in NP disease. Nasal blockage is the only symptom that correlates well with NP size and SNOT-22 scores, whereas smell reduction correlates with blood eosinophilia.

  6. Randomized controlled trial of discontinuation of nasal-CPAP in stable preterm infants breathing room air.

    PubMed

    Abdel-Hady, H; Mohareb, S; Khashaba, M; Abu-Alkhair, M; Greisen, G

    1998-01-01

    This trial assessed the consequences of discontinuation of nasal-CPAP in stable preterm infants breathing room air. Eighty-eight infants with a mean gestational age of 29 (24-33) weeks and a mean birthweight of 1264 (665-2060)g, randomized to either discontinuation of CPAP or its continuation, were clinically observed and monitored for 6 h by cardiorespiratory monitor, pulse oximeter and transcutaneous blood gas monitor. The abdominal circumference and gastric air and aspirate volumes were measured prior to meals at trial entry and after 6 h. Discontinuation of CPAP led to a small but significant decrease in oxygenation at 1 and 6 h. During the trial, five infants in the experimental group required supplemental oxygen and one infant was put back on CPAP owing to excessive apnoeas. Discontinuation of CPAP did not influence the TcPCO2 or the number of apnoeas and bradycardias during the trial, but led to significantly increased respiratory rate, retractions, and flaring at 6 h. It also led to a significant decrease in the abdominal circumference and gastric air volume. Thirty-nine percent of infants were put back on CPAP some time after the trial, mainly because of recurrent apnoeas and bradycardias. Taking the infant off CPAP during the trial reduced subsequent use of CPAP.

  7. Nasal Cancer

    MedlinePlus

    ... the way to your throat as you breathe. Cancer of the nasal cavity and paranasal sinuses is ... be like those of infections. Doctors diagnose nasal cancer with imaging tests, lighted tube-like instruments that ...

  8. Change in upper airway geometry between upright and supine position during tidal nasal breathing.

    PubMed

    Van Holsbeke, Cedric S; Verhulst, Stijn L; Vos, Wim G; De Backer, Jan W; Vinchurkar, Samir C; Verdonck, Pascal R; van Doorn, Johanna W D; Nadjmi, Nasser; De Backer, Wilfried A

    2014-02-01

    As the upper airway is the most important limiting factor for the deposition of inhalation medication in the lower airways, it is interesting to assess how its morphology varies between different postures. The goal of this study is to compare the upper airway morphology and functionality of healthy volunteers in the upright and supine positions during tidal nasal breathing and to search for baseline indicators for these changes. This is done by performing three-dimensional measurements on computed tomography (CT) and cone beam computed tomography (CBCT) scans. This prospective study was approved by all relevant institutional review boards. All patients gave their signed informed consent. In this study, 20 healthy volunteers (mean age, 62 years; age range, 37-78 years; mean body mass index, 29.26; body mass index range, 21.63-42.17; 16 men, 4 women) underwent a supine low-dose CT scan and an upright CBCT scan of the upper airway. The (local) average (Savg) and minimal (Smin) cross-sectional area, the position of the latter, the concavity, and the airway resistance were examined to determine if they changed from the upright to the supine position. If changes were found, baseline parameters were sought that were indicators for these differences. There were five dropouts due to movement artifacts in the CBCT scans. Savg and Smin were 9.76% and 26.90% larger, respectively, in the CBCT scan than in the CT scan, whereas the resistance decreased by 26.15% in the upright position. The Savg of the region between the hard palate and the bottom of the uvula increased the most (49.85%). In people with a high body mass index, this value changed the least. The airway resistance in men decreased more than in women. This study demonstrated that there are differences in upper airway morphology and functionality between the supine and upright positions and that there are baseline indicators for these differences.

  9. Sleep-disordered breathing children: Measurement of nasal nitric oxide and fractional exhaled nitric oxide.

    PubMed

    Huang, Y; Zou, Y; Mai, F; Zhang, X; Liu, Y; Lin, X

    2016-03-01

    To assess the clinical significance of nasal nitric oxide (nNO) and fractional exhaled nitric oxide (FeNO) concentrations in children with sleep-disordered breathing (SDB). Enrolled in this study were 30 children with SDB and 15 healthy children. The nNO and FeNO concentrations were measured noninvasively using a NIOX MINO system (Aerocrine AB, Solna, Sweden). SPSS statistics 20.0 software (IBM SPSS statistics 20.0, Armonk, NY, USA) was used to analyze the data. The median (25th and 75th percentiles) nNO concentration of SDB children measured in parts per billion (ppb) was 111.0 (44.0; 349.0) ppb; FeNO concentration of SDB children was 12.0 (9.8; 14.0) ppb. The nNO concentration of healthy children was 52.0 (22.0; 139.0) ppb; FeNO concentration of healthy children was 12.0 (10.0; 16.0) ppb. Compared to healthy children, nNO concentration was significantly higher in children with SDB (Z = -2.215, P = 0.027). Correlation analysis showed that SDB children's nNO concentration directly correlated with apnea-hypopnea index (AHI; r = 0.429, P = 0.018), and inversely correlated with nadir oxygen saturation (SaO2; r = -0.482, P = 0.007). No other polysomnographic parameters significantly correlated with nNO concentration. Our data suggest that nNO concentration might be useful for diagnosis and evaluation of disease severity in SDB children. Furthermore, these results suggest that nNO concentration has a greater prognostic value than FeNO concentration.

  10. The Influence of Speaking Rate on Nasality in the Speech of Hearing-Impaired Individuals

    ERIC Educational Resources Information Center

    Dwyer, Claire H.; Robb, Michael P.; O'Beirne, Greg A.; Gilbert, Harvey R.

    2009-01-01

    Purpose: The purpose of this study was to determine whether deliberate increases in speaking rate would serve to decrease the amount of nasality in the speech of severely hearing-impaired individuals. Method: The participants were 11 severely to profoundly hearing-impaired students, ranging in age from 12 to 19 years (M = 16 years). Each…

  11. [The possibility of using соformulated intranasal drugs after surgical correction of nasal breathing].

    PubMed

    Nikiforova, G N; Svistushkin, V M; Zakharova, N M; Shevchik, E A; Zolotova, A V; Dedova, M G

    2016-01-01

    One of the major causes of chronic nasal obstruction is the nasal septum deformation and increase of the lower nasal turbinates. The number of septoplasty--operations ranges from 14% to 44,2% of all ENT-operations. The results of surgery are swelling of the tissues and damaged ciliar epithelium, that leads to the inparament of the mucociliar transport. In the postoperati e period the nasal cavity should be cleaned. Drugs, that are used, should reduce swelling, improve regeneration and should not supress ciliar activity. The results of supervisory, non-interventional study have shown, that application of Nasiс after septoplasty and submucose vasotomy of inferior nasal turbinates increases reparative process and leads to more rapid recovery of respiratory function of nasal cavity.

  12. Impact of breathing 100% oxygen on radiation-induced cognitive impairment.

    PubMed

    Wheeler, Kenneth T; Payne, Valerie; D'Agostino, Ralph B; Walb, Matthew C; Munley, Michael T; Metheny-Barlow, Linda J; Robbins, Mike E

    2014-11-01

    Future space missions are expected to include increased extravehicular activities (EVAs) during which astronauts are exposed to high-energy space radiation while breathing 100% oxygen. Given that brain irradiation can lead to cognitive impairment, and that oxygen is a potent radiosensitizer, there is a concern that astronauts may be at greater risk of developing cognitive impairment when exposed to space radiation while breathing 100% O(2) during an EVA. To address this concern, unanesthetized, unrestrained, young adult male Fischer 344 × Brown Norway rats were allowed to breathe 100% O(2) for 30 min prior to, during and 2 h after whole-body irradiation with 0, 1, 3, 5 or 7 Gy doses of 18 MV X rays delivered from a medical linear accelerator at a dose rate of ~425 mGy/min. Irradiated and unirradiated rats breathing air (~21% O(2)) served as controls. Cognitive function was assessed 9 months postirradiation using the perirhinal cortex-dependent novel object recognition task. Cognitive function was not impaired until the rats breathing either air or 100% O(2) received a whole-body dose of 7 Gy. However, at all doses, cognitive function of the irradiated rats breathing 100% O(2) was improved over that of the irradiated rats breathing air. These data suggest that astronauts are not at greater risk of developing cognitive impairment when exposed to space radiation while breathing 100% O(2) during an EVA.

  13. Impact of Breathing 100% Oxygen on Radiation-Induced Cognitive Impairment

    PubMed Central

    Wheeler, Kenneth T.; Payne, Valerie; D’Agostino, Ralph B.; Walb, Matthew C.; Munley, Michael T.; Metheny-Barlow, Linda J.; Robbins, Mike E.

    2015-01-01

    Future space missions are expected to include increased extravehicular activities (EVAs) during which astronauts are exposed to high-energy space radiation while breathing 100% oxygen. Given that brain irradiation can lead to cognitive impairment, and that oxygen is a potent radiosensitizer, there is a concern that astronauts may be at greater risk of developing cognitive impairment when exposed to space radiation while breathing 100% O2 during an EVA. To address this concern, unanesthetized, unrestrained, young adult male Fischer 344 × Brown Norway rats were allowed to breathe 100% O2 for 30 min prior to, during and 2 h after whole-body irradiation with 0, 1, 3, 5 or 7 Gy doses of 18 MV X rays delivered from a medical linear accelerator at a dose rate of ~425 mGy/min. Irradiated and unirradiated rats breathing air (~21% O2) served as controls. Cognitive function was assessed 9 months postirradiation using the perirhinal cortex-dependent novel object recognition task. Cognitive function was not impaired until the rats breathing either air or 100% O2 received a whole-body dose of 7 Gy. However, at all doses, cognitive function of the irradiated rats breathing 100% O2 was improved over that of the irradiated rats breathing air. These data suggest that astronauts are not at greater risk of developing cognitive impairment when exposed to space radiation while breathing 100% O2 during an EVA. PMID:25338095

  14. [The application of nasal ventilation function on sleep-disordered breathing disorders].

    PubMed

    Yan, Xiaoling; Xu, Yali; Li, Minxiong; Huang, Minqi; Liao, Libing; Wang, Xiaoli; Huang, Yinghong; Zhang, Jianguo

    2014-08-01

    To explore the change of nasal ventilation function in a group of SDB patients and its relationship to PSG parameters. One hundred twenty-eight controls, 11 habitual snorers, 33 cases of mild-moderate OSAHS and 33 cases of severe OSAHS were examined. NN1 Rhinospirometer was used to measure unilateral nasal respiratory capacity (NC(un)) and bilateral nasal respiratory capacity (NC(bi)), and the nasal partitioning ratio (NPR) can be calculated. NR6 Rhinomanometry was used to measure total nasal inspiratory and expiratory resistance (TNRi, TNRe). A1 acoustic rhinometry was used to measure distances of the two notches to the nostril (MD1, MD2), cross-sectional areas of the two notches (MCA1, MCA2) and nasal volume from 0-5 cm (NV(0-5)). Moreover, make the correlational analysis on different index of nasal functional tests and PSG. (1) Significant group differences were shown in NPR (P < 0.01). (2) TNRi and TNRe were statistical different among the groups (P < 0.01 or P < 0.05). (3) There are significant difference on MD1, MCA1, MCA2, NV(0-5) in male, but just on MD1 in female. (4) There was no correlation between PSG parameters and nasal functional parameters in SDB patients. But for certain subgroup analysis in female patients with a body mass index below 25, minimum oxygen saturation correlated significantly with MCA2 (r = 0.688, P < 0.05), arousal index correlated significantly with MCA1 (r = 0.543, P < 0.05). The nasal anatomical structure and physiological function contribute to the pathogenesis of OSAHS, which may play a larger role in non-obese female patients.

  15. The effect of cochlear implantation on nasalance of speech in postlingually hearing-impaired adults.

    PubMed

    Hassan, Sabah M; Malki, Khalid H; Mesallam, Tamer A; Farahat, Mohamad; Bukhari, Manal; Murry, Thomas

    2012-09-01

    Hypernasality is considered a prevalent speech abnormality that could significantly contribute to the unintelligibility of the hearing-impaired speakers. The aim of this study was to evaluate the effect of cochlear implantation and the duration of hearing loss on nasalance of speech of a postlingually impaired group of Saudi adult patients. Retrospective study. This study included 25 postlingually hearing-impaired patients who underwent cochlear implantation and 25 age-matched control subjects. Patients were divided into three groups according to the duration of hearing loss. The nasometric data of the hearing-impaired group were compared with the control group. Also, the preoperative values were compared with the postoperative values 6, 12, and 24 months after surgery. Significant differences were demonstrated between the preimplantation nasalance scores of the three subgroups and between the patients and control groups. There were statistically significant differences demonstrated between the pre- and the postimplantation nasalance values for the three groups of patients. Cochlear implantation appears to have significant effects on improving the nasalance of the speech of postlingually hearing-impaired adult patients. However, the degree of improvement might vary according to the duration of hearing loss the patients had preimplantation. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  16. Effects of High-Flow Nasal Cannula on the Work of Breathing in Patients Recovering From Acute Respiratory Failure.

    PubMed

    Delorme, Mathieu; Bouchard, Pierre-Alexandre; Simon, Mathieu; Simard, Serge; Lellouche, François

    2017-08-28

    High-flow nasal cannula is increasingly used in the management of respiratory failure. However, little is known about its impact on respiratory effort, which could explain part of the benefits in terms of comfort and efficiency. This study was designed to assess the effects of high-flow nasal cannula on indexes of respiratory effort (i.e., esophageal pressure variations, esophageal pressure-time product/min, and work of breathing/min) in adults. A randomized controlled crossover study was conducted in 12 patients with moderate respiratory distress (i.e., after partial recovery from an acute episode, allowing physiologic measurements). Institut Universitaire de Cardiologie et de Pneumologie de Québec, QC, Canada. Twelve adult patients with respiratory distress symptoms were enrolled in this study. Four experimental conditions were evaluated: baseline with conventional oxygen therapy and high-flow nasal cannula at 20, 40, and 60 L/min. The primary outcomes were the indexes of respiratory effort (i.e., esophageal pressure variations, esophageal pressure-time product/min, and work of breathing/min). Secondary outcomes included tidal volume, respiratory rate, minute volume, dynamic lung compliance, inspiratory resistance, and blood gases. Esophageal pressure variations decreased from 9.8 (5.8-14.6) cm H2O at baseline to 4.9 (2.1-9.1) cm H2O at 60 L/min (p = 0.035). Esophageal pressure-time product/min decreased from 165 (126-179) to 72 (54-137) cm H2O • s/min, respectively (p = 0.033). Work of breathing/min decreased from 4.3 (3.5-6.3) to 2.1 (1.5-5.0) J/min, respectively (p = 0.031). Respiratory pattern variables and capillary blood gases were not significantly modified between experimental conditions. Dynamic lung compliance increased from 38 (24-64) mL/cm H2O at baseline to 59 (43-175) mL/cm H2O at 60 L/min (p = 0.007), and inspiratory resistance decreased from 9.6 (5.5-13.4) to 5.0 (1.0-9.1) cm H2O/L/s, respectively (p = 0.07). High-flow nasal cannula, when set

  17. Impaired Air Conditioning within the Nasal Cavity in Flat-Faced Homo.

    PubMed

    Nishimura, Takeshi; Mori, Futoshi; Hanida, Sho; Kumahata, Kiyoshi; Ishikawa, Shigeru; Samarat, Kaouthar; Miyabe-Nishiwaki, Takako; Hayashi, Misato; Tomonaga, Masaki; Suzuki, Juri; Matsuzawa, Tetsuro; Matsuzawa, Teruo

    2016-03-01

    We are flat-faced hominins with an external nose that protrudes from the face. This feature was derived in the genus Homo, along with facial flattening and reorientation to form a high nasal cavity. The nasal passage conditions the inhaled air in terms of temperature and humidity to match the conditions required in the lung, and its anatomical variation is believed to be evolutionarily sensitive to the ambient atmospheric conditions of a given habitat. In this study, we used computational fluid dynamics (CFD) with three-dimensional topology models of the nasal passage under the same simulation conditions, to investigate air-conditioning performance in humans, chimpanzees, and macaques. The CFD simulation showed a horizontal straight flow of inhaled air in chimpanzees and macaques, contrasting with the upward and curved flow in humans. The inhaled air is conditioned poorly in humans compared with nonhuman primates. Virtual modifications to the human external nose topology, in which the nasal vestibule and valve are modified to resemble those of chimpanzees, change the airflow to be horizontal, but have little influence on the air-conditioning performance in humans. These findings suggest that morphological variation of the nasal passage topology was only weakly sensitive to the ambient atmosphere conditions; rather, the high nasal cavity in humans was formed simply by evolutionary facial reorganization in the divergence of Homo from the other hominin lineages, impairing the air-conditioning performance. Even though the inhaled air is not adjusted well within the nasal cavity in humans, it can be fully conditioned subsequently in the pharyngeal cavity, which is lengthened in the flat-faced Homo. Thus, the air-conditioning faculty in the nasal passages was probably impaired in early Homo members, although they have survived successfully under the fluctuating climate of the Plio-Pleistocene, and then they moved "Out of Africa" to explore the more severe climates of

  18. Impaired Air Conditioning within the Nasal Cavity in Flat-Faced Homo

    PubMed Central

    Nishimura, Takeshi; Mori, Futoshi; Hanida, Sho; Kumahata, Kiyoshi; Ishikawa, Shigeru; Samarat, Kaouthar; Miyabe-Nishiwaki, Takako; Hayashi, Misato; Tomonaga, Masaki; Suzuki, Juri; Matsuzawa, Tetsuro; Matsuzawa, Teruo

    2016-01-01

    We are flat-faced hominins with an external nose that protrudes from the face. This feature was derived in the genus Homo, along with facial flattening and reorientation to form a high nasal cavity. The nasal passage conditions the inhaled air in terms of temperature and humidity to match the conditions required in the lung, and its anatomical variation is believed to be evolutionarily sensitive to the ambient atmospheric conditions of a given habitat. In this study, we used computational fluid dynamics (CFD) with three-dimensional topology models of the nasal passage under the same simulation conditions, to investigate air-conditioning performance in humans, chimpanzees, and macaques. The CFD simulation showed a horizontal straight flow of inhaled air in chimpanzees and macaques, contrasting with the upward and curved flow in humans. The inhaled air is conditioned poorly in humans compared with nonhuman primates. Virtual modifications to the human external nose topology, in which the nasal vestibule and valve are modified to resemble those of chimpanzees, change the airflow to be horizontal, but have little influence on the air-conditioning performance in humans. These findings suggest that morphological variation of the nasal passage topology was only weakly sensitive to the ambient atmosphere conditions; rather, the high nasal cavity in humans was formed simply by evolutionary facial reorganization in the divergence of Homo from the other hominin lineages, impairing the air-conditioning performance. Even though the inhaled air is not adjusted well within the nasal cavity in humans, it can be fully conditioned subsequently in the pharyngeal cavity, which is lengthened in the flat-faced Homo. Thus, the air-conditioning faculty in the nasal passages was probably impaired in early Homo members, although they have survived successfully under the fluctuating climate of the Plio-Pleistocene, and then they moved “Out of Africa” to explore the more severe climates of

  19. Effectiveness of breathing through nasal and oral routes in unconscious apneic adult human subjects: a prospective randomized crossover trial.

    PubMed

    Jiang, Yandong; Bao, Fang Ping; Liang, Yafen; Kimball, William R; Liu, Yanhong; Zapol, Warren M; Kacmarek, Robert M

    2011-07-01

    The authors hypothesized that mouth ventilation by a resuscitator via the nasal route ensures a more patent airway and more effective ventilation than does ventilation via the oral route and therefore would be the optimal manner to ventilate adult patients in emergencies, such as during cardiopulmonary resuscitation. They tested the hypothesis by comparing the effectiveness of mouth-to-nose breathing (MNB) and mouth-to-mouth breathing (MMB) in anesthetized, apneic, adult subjects without muscle paralysis. Twenty subjects under general anesthesia randomly received MMB and MNB with their heads placed first in a neutral position and then an extended position. A single operator performed MNB and MMB at the target breathing rate of 10 breaths/min, inspiratory:expiratory ratio 1:2 and peak inspiratory airway pressure 24 cm H₂O. A plethysmograph was used to measure the amplitude change during MMB and MNB. The inspiratory and expiratory tidal volumes during MMB and MNB were calculated retrospectively using the calibration curve. All data are presented as medians (interquartile ranges). The rates of effective ventilation (expired volume > estimated anatomic dead space) during MNB and MMB were 91.1% (42.4-100%) and 43.1% (42.5-100%) (P < 0.001), and expired tidal volume with MMB 130.5 ml (44.0-372.8 ml) was significantly lower than with MNB 324.5 ml (140.8-509.0 ml), regardless of the head position (P < 0.001). Direct mouth ventilation delivered exclusively via the nose is significantly more effective than that delivered via the mouth in anesthetized, apneic adult subjects without muscle paralysis. Additional studies are needed to establish whether using this breathing technique during emergency situations will improve patient outcomes.

  20. Impaired release of antimicrobial peptides into nasal fluid of hyper-IgE and CVID patients.

    PubMed

    Cederlund, Andreas; Olliver, Marie; Rekha, Rokeya Sultana; Lindh, Monica; Lindbom, Lennart; Normark, Staffan; Henriques-Normark, Birgitta; Andersson, Jan; Agerberth, Birgitta; Bergman, Peter

    2011-01-01

    Patients with primary immunodeficiency (PID) often suffer from frequent respiratory tract infections. Despite standard treatment with IgG-substitution and antibiotics many patients do not improve significantly. Therefore, we hypothesized that additional immune deficits may be present among these patients. To investigate if PID patients exhibit impaired production of antimicrobial peptides (AMPs) in nasal fluid and a possible link between AMP-expression and Th17-cells. Nasal fluid, nasopharyngeal swabs and peripheral blood mononuclear cells (PBMCs) were collected from patients and healthy controls. AMP levels were measured in nasal fluid by Western blotting. Nasal swabs were cultured for bacteria. PBMCs were stimulated with antigen and the supernatants were assessed for IL-17A release by ELISA. In healthy controls and most patients, AMP levels in nasal fluid were increased in response to pathogenic bacteria. However, this increase was absent in patients with common variable immunodeficiency (CVID) and Hyper-IgE syndrome (HIES), despite the presence of pathogenic bacteria. Furthermore, stimulation of PBMCs revealed that both HIES and CVID patients exhibited an impaired production of IL-17A. CVID and HIES patients appear to have a dysregulated AMP response to pathogenic bacteria in the upper respiratory tract, which could be linked to an aberrant Th17 cell response. © 2011 Cederlund et al.

  1. Detection of Sleep Disordered Breathing and Its Central/Obstructive Character Using Nasal Cannula and Finger Pulse Oximeter

    PubMed Central

    Sommermeyer, Dirk; Zou, Ding; Grote, Ludger; Hedner, Jan

    2012-01-01

    Study Objective: To assess the accuracy of novel algorithms using an oximeter-based finger plethysmographic signal in combination with a nasal cannula for the detection and differentiation of central and obstructive apneas. The validity of single pulse oximetry to detect respiratory disturbance events was also studied. Methods: Patients recruited from four sleep laboratories underwent an ambulatory overnight cardiorespiratory polygraphy recording. The nasal flow and photoplethysmographic signals of the recording were analyzed by automated algorithms. The apnea hypopnea index (AHIauto) was calculated using both signals, and a respiratory disturbance index (RDIauto) was calculated from photoplethysmography alone. Apnea events were classified into obstructive and central types using the oximeter derived pulse wave signal and compared with manual scoring. Results: Sixty-six subjects (42 males, age 54 ± 14 yrs, body mass index 28.5 ± 5.9 kg/m2) were included in the analysis. AHImanual (19.4 ± 18.5 events/h) correlated highly significantly with AHIauto (19.9 ± 16.5 events/h) and RDIauto (20.4 ± 17.2 events/h); the correlation coefficients were r = 0.94 and 0.95, respectively (p < 0.001) with a mean difference of −0.5 ± 6.6 and −1.0 ± 6.1 events/h. The automatic analysis of AHIauto and RDIauto detected sleep apnea (cutoff AHImanual ≥ 15 events/h) with a sensitivity/specificity of 0.90/0.97 and 0.86/0.94, respectively. The automated obstructive/central apnea indices correlated closely with manually scoring (r = 0.87 and 0.95, p < 0.001) with mean difference of −4.3 ± 7.9 and 0.3 ± 1.5 events/h, respectively. Conclusions: Automatic analysis based on routine pulse oximetry alone may be used to detect sleep disordered breathing with accuracy. In addition, the combination of photoplethysmographic signals with a nasal flow signal provides an accurate distinction between obstructive and central apneic events during sleep. Citation: Sommermeyer D; Zou D; Grote L

  2. Impact of airborne particle size, acoustic airflow and breathing pattern on delivery of nebulized antibiotic into the maxillary sinuses using a realistic human nasal replica.

    PubMed

    Leclerc, Lara; Pourchez, Jérémie; Aubert, Gérald; Leguellec, Sandrine; Vecellio, Laurent; Cottier, Michèle; Durand, Marc

    2014-09-01

    Improvement of clinical outcome in patients with sinuses disorders involves targeting delivery of nebulized drug into the maxillary sinuses. We investigated the impact of nebulization conditions (with and without 100 Hz acoustic airflow), particle size (9.9 μm, 2.8 μm, 550 nm and 230 nm) and breathing pattern (nasal vs. no nasal breathing) on enhancement of aerosol delivery into the sinuses using a realistic nasal replica developed by our team. After segmentation of the airways by means of high-resolution computed tomography scans, a well-characterized nasal replica was created using a rapid prototyping technology. A total of 168 intrasinus aerosol depositions were performed with changes of aerosol particle size and breathing patterns under different nebulization conditions using gentamicin as a marker. The results demonstrate that the fraction of aerosol deposited in the maxillary sinuses is enhanced by use of submicrometric aerosols, e.g. 8.155 ± 1.476 mg/L of gentamicin in the left maxillary sinus for the 2.8 μm particles vs. 2.056 ± 0.0474 for the 550 nm particles. Utilization of 100-Hz acoustic airflow nebulization also produced a 2- to 3-fold increase in drug deposition in the maxillary sinuses (e.g. 8.155 ± 1.476 vs. 3.990 ± 1.690 for the 2.8 μm particles). Our study clearly shows that optimum deposition was achieved using submicrometric particles and 100-Hz acoustic airflow nebulization with no nasal breathing. It is hoped that our new respiratory nasal replica will greatly facilitate the development of more effective delivery systems in the future.

  3. [Aerosol deposition in nasal passages of burrowing and ground rodents when breathing dust-laden air].

    PubMed

    Moshkin, M P; Petrovskiĭ, D V; Akulov, A E; Romashchenko, A V; Gerlinskaia, L A; Muchnaia, M I; Ganimedov, V L; Sadovskiĭ, A S; Savelov, A A; Koptiug, I V; Troitskiĭ, S Iu; Bukhtiiarov, V I; Kolchanov, N A; Sagdeev, R Z; Fomin, V M

    2014-01-01

    In subterranean rodents, which dig down the passages with frontal teeth, adaptation to the underground mode of life presumes forming of mechanisms that provide protection against inhaling dust particles of different size when digging. One of such mechanisms can be specific pattern of air flow organization in the nasal cavity. To test this assumption, comparative study of geometry and aerodynamics of nasal passages has been conducted with regard to typical representative of subterranean rodents, the mole vole, and a representative of ground rodents, the house mouse. Numerical modeling of air flows and deposition of micro- and nanoparticle aerosols indicates that sedimentation of model particles over the whole surface of nasal cavity is higher in mole vole than in house mouse. On the contrary, particles deposition on the surface of olfactory epithelium turns out to be substantially less in the burrowing rodent as compared to the ground one. Adaptive significance of the latter observation has been substantiated by experimental study on the uptake ofnanoparticles of hydrated manganese oxide MnO x (H2O)x and Mn ions from nasal cavity into brain. It has been shown with use of magnetic resonance tomography method that there is no difference between studied species with respect to intake of particles or ions by olfactory bulb when they are introduced intranasally. Meanwhile, when inhaling nanoparticle aerosol of MnCl2, deposition of Mn in mouse's olfactory bulbs surpasses markedly that in vole's bulbs. Thereby, the morphology of nasal passages as a factor determining the aerodynamics of upper respiratory tract ensures for burrowing rodents more efficient protection of both lungs and brain against inhaled aerosols than for ground ones.

  4. Anatomical Details of the Rabbit Nasal Passages and Their Implications in Breathing, Air Conditioning, and Olfaction.

    PubMed

    Xi, Jinxiang; Si, Xiuhua A; Kim, Jongwon; Zhang, Yu; Jacob, Richard E; Kabilan, Senthil; Corley, Richard A

    2016-07-01

    The rabbit is commonly used as a laboratory animal for inhalation toxicology tests and detail knowledge of the rabbit airway morphometry is needed for outcome analysis or theoretical modeling. The objective of this study is to quantify the morphometric dimension of the nasal airway of a New Zealand white rabbit and to relate the morphology and functions through analytical and computational methods. Images of high-resolution MRI scans of the rabbit were processed to measure the axial distribution of the cross-sectional areas, perimeter, and complexity level. The lateral recess, which has functions other than respiration or olfaction, was isolated from the nasal airway and its dimension was quantified separately. A low Reynolds number turbulence model was implemented to simulate the airflow, heat transfer, vapor transport, and wall shear stress. Results of this study provide detailed morphological information of the rabbit that can be used in the studies of olfaction, inhalation toxicology, drug delivery, and physiology-based pharmacokinetics modeling. For the first time, we reported a spiral nasal vestibule that splits into three paths leading to the dorsal meatus, maxilloturbinate, and ventral meatus, respectively. Both non-dimensional functional analysis and CFD simulations suggested that the airflow in the rabbit nose is laminar and the unsteady effect is only significantly during sniffing. Due to the large surface-to-volume ratio, the maxilloturbinate is highly effective in warming and moistening the inhaled air to body conditions. The unique anatomical structure and respiratory airflow pattern may have important implications for designing new odorant detectors or electronic noses. Anat Rec, 299:853-868, 2016. © 2016 Wiley Periodicals, Inc.

  5. Anatomical Details of the Rabbit Nasal Passages and Their Implications in Breathing, Air Conditioning, and Olfaction

    PubMed Central

    Si, Xiuhua April; Kim, JongWon; Zhang, Yu; Jacob, Richard E.; Kabilan, Senthil; Corley, Richard A.

    2016-01-01

    The rabbit is commonly used as a laboratory animal for inhalation toxicology tests and detail knowledge of the rabbit airway morphometry is needed for outcome analysis or theoretical modeling. The objective of this study is to quantify the morphometric dimension of the nasal airway of a New Zealand white rabbit and to relate the morphology and functions through analytical and computational methods. Images of high-resolution MRI scans of the rabbit were processed to measure the axial distribution of the cross-sectional areas, perimeter, and complexity level. The lateral recess, which has functions other than respiration or olfaction, was isolated from the nasal airway and its dimension was quantified separately. A low Reynolds number turbulence model was implemented to simulate the airflow, heat transfer, vapor transport, and wall shear stress. Results of this study provide detailed morphological information of the rabbit that can be used in the studies of olfaction, inhalation toxicology, drug delivery, and physiology-based pharmacokinetics modeling. For the first time, we reported a spiral nasal vestibule that splits into three paths leading to the dorsal meatus, maxilloturbinate, and ventral meatus, respectively. Both non-dimensional functional analysis and CFD simulations suggested that the airflow in the rabbit nose is laminar and the unsteady effect is only significantly during sniffing. Due to the large surface-to-volume ratio, the maxilloturbinate is highly effective in warming and moistening the inhaled air to body conditions. The unique anatomical structure and respiratory airflow pattern may have important implications for designing new odorant detectors or electronic noses. PMID:27145450

  6. The Effect of Nasal Septal Perforation and its Treatment on Objective Sleep and Breathing Parameters.

    PubMed

    Boynuegri, Suleyman; Cayonu, Melih; Tuna, Evrim Unsal; Kurukahvecioglu, Selma; Ozcan, Kursat Murat; Turkay, Burak; Cingi, Cemal

    2016-02-15

    BACKGROUND Nasal septal perforation (NSP) may alter nasal airflow patterns and physiology. To the best of our knowledge, no studies in the English literature have investigated the effect of NSP and its treatment on polysomnographic parameters. In this study, we aimed to investigate polysomnographic parameters in patients with NSP as well as changes in those parameters after treatment of NSP. MATERIAL AND METHODS Nineteen patients diagnosed with NSP were included in the study. All patients had baseline and post-procedure polysomnographies (PSG) after insertion of silicone septal button for closure of NSP. RESULTS Both median AHI [5.30 (14.40) vs. 2.40 (14.50)] and median supine AHI [10.00 (42.10) vs. 6.60 (37.00)] decreased after correction of the perforation. There was a large reduction in median supine AHI in patients with a perforation size >66 mm2 [10.10 (34.15) vs. 1.60 (28.30)]. CONCLUSIONS We conclude that NSP did not cause any deterioration in objective sleep parameters as determined by PSG, other than a decrease in REM sleep duration and an increase in supine AHI. Correction of NSP did not affect REM duration and supine AHI decreased after treatment.

  7. Breathing-Impaired Speech after Brain Haemorrhage: A Case Study

    ERIC Educational Resources Information Center

    Heselwood, Barry

    2007-01-01

    Results are presented from an auditory and acoustic analysis of the speech of an adult male with impaired prosody and articulation due to brain haemorrhage. They show marked effects on phonation, speech rate and articulator velocity, and a speech rhythm disrupted by "intrusive" stresses. These effects are discussed in relation to the speaker's…

  8. Breathing-Impaired Speech after Brain Haemorrhage: A Case Study

    ERIC Educational Resources Information Center

    Heselwood, Barry

    2007-01-01

    Results are presented from an auditory and acoustic analysis of the speech of an adult male with impaired prosody and articulation due to brain haemorrhage. They show marked effects on phonation, speech rate and articulator velocity, and a speech rhythm disrupted by "intrusive" stresses. These effects are discussed in relation to the speaker's…

  9. Sleep-related breathing disorders. 5. Nasal continuous positive airway pressure treatment for obstructive sleep apnoea.

    PubMed

    Grunstein, R R

    1995-10-01

    CPAP should be considered the first line of treatment in patients with moderate to severe obstructive sleep apnoea. In our centre in Sydney this generally means patients with more than 20 apnoea/hypopnoeas per hour with repeated dips in oxyhaemoglobin saturation and usually some symptomatology. Despite this first line role of nasal CPAP, recent objective studies question whether earlier enthusiastic reports on adherence to CPAP are correct. The role of technical innovations in new CPAP machines in improving usage remains to be tested. The "drop out" rate from physician selection for a CPAP trial to highly compliant user is certainly more than 50% of patients. What happens to these patients? Data from some studies suggest that surgical treatments are used, at least in the USA, but in all probability many of these patients remain untreated. The challenge in the next decade is either to improve CPAP devices to increase usage in this group or to develop other treatment options. The role of intensive inhospital "acclimatisation" to CPAP also has yet to be objectively tested. It is unclear whether "intelligent" CPAP will make huge inroads in increasing the number of patients who accept CPAP trials, prescriptions, or compliance. It will have minimal impact on patients with mask problems or claustrophobia or those who feel that CPAP is inconvenient. There is a high likelihood that it will reduce technologist workload during CPAP titration studies. "Intelligent" CPAP may help to reduce total overnight mouth leakage and therefore reduce nasal side effects. The current expense of developing such devices will mean that they are unlikely to supersede much cheaper standard "one pressure" CPAP machines in the next few years.

  10. Detection of sleep disordered breathing and its central/obstructive character using nasal cannula and finger pulse oximeter.

    PubMed

    Sommermeyer, Dirk; Zou, Ding; Grote, Ludger; Hedner, Jan

    2012-10-15

    To assess the accuracy of novel algorithms using an oximeter-based finger plethysmographic signal in combination with a nasal cannula for the detection and differentiation of central and obstructive apneas. The validity of single pulse oximetry to detect respiratory disturbance events was also studied. Patients recruited from four sleep laboratories underwent an ambulatory overnight cardiorespiratory polygraphy recording. The nasal flow and photoplethysmographic signals of the recording were analyzed by automated algorithms. The apnea hypopnea index (AHI(auto)) was calculated using both signals, and a respiratory disturbance index (RDI(auto)) was calculated from photoplethysmography alone. Apnea events were classified into obstructive and central types using the oximeter derived pulse wave signal and compared with manual scoring. Sixty-six subjects (42 males, age 54 ± 14 yrs, body mass index 28.5 ± 5.9 kg/m(2)) were included in the analysis. AHI(manual) (19.4 ± 18.5 events/h) correlated highly significantly with AHI(auto) (19.9 ± 16.5 events/h) and RDI(auto) (20.4 ± 17.2 events/h); the correlation coefficients were r = 0.94 and 0.95, respectively (p < 0.001) with a mean difference of -0.5 ± 6.6 and -1.0 ± 6.1 events/h. The automatic analysis of AHI(auto) and RDI(auto) detected sleep apnea (cutoff AHI(manual) ≥ 15 events/h) with a sensitivity/specificity of 0.90/0.97 and 0.86/0.94, respectively. The automated obstructive/central apnea indices correlated closely with manually scoring (r = 0.87 and 0.95, p < 0.001) with mean difference of -4.3 ± 7.9 and 0.3 ± 1.5 events/h, respectively. Automatic analysis based on routine pulse oximetry alone may be used to detect sleep disordered breathing with accuracy. In addition, the combination of photoplethysmographic signals with a nasal flow signal provides an accurate distinction between obstructive and central apneic events during sleep.

  11. An adaptive breath sampler for use with human subjects with an impaired respiratory function.

    PubMed

    Basanta, M; Koimtzis, T; Singh, D; Wilson, I; Thomas, C L P

    2007-02-01

    An adaptive sampler for collecting 2.5 dm(3) samples of exhaled air from human subjects with an impaired respiratory function is described. Pressure in the upper respiratory tract is continuously monitored and the data used to control an automated system to collect select portions of the expired breathing cycle onto a mixed bed Tenax(trade mark) and Carbotrap(trade mark) adsorbent trap for analysis by GC-MS. The sampling approach is intended for use in metabolomic profiling of volatiles in human breath at concentrations greater than microg m(-3). The importance of experimental reproducibility in metabolomic data is emphasised and consequently a high purity air supply is used to maintain a stable exogenous volatile organic compound profile at concentrations in the range 5 to 30 microg m(-3). The results of a 90 day stability study showed that exogenous VOCs were maintained at significantly lower levels (40 times lower for isopropyl alcohol) and with significantly higher reproducibility (80 times lower standard deviation for isopropyl alcohol) than would have been be the case if ambient air had been used. The sampling system was evaluated with healthy controls alongside subjects with chronic obstructive pulmonary disease. Subjects were able to breathe normally with control subjects observed to breathe at a rate of 9 to 17 breaths per minute, compared to 16 to 30 breaths per minute for subjects with COPD. This study presents, for the first time, observations and estimates of intra-subject breath sample reproducibility from human subjects. These reproducibility studies indicated that VOCs in exhaled breath exhibit a variety of dynamic behaviours, with some species recovered with a RSD <30%, while other species were observed to have significantly more variable concentrations, 30 to 130% RSD. The approach was also demonstrated to reliably differentiate the differences in the VOC profiles between alveolar and dead space air.

  12. [pH values in the pharynx of the patients presenting with compromised nasal breathing of inflammatory and non-inflammatory genesis concomitant with gastroesophageal reflux disease].

    PubMed

    Subbotina, M V; Temnikova, I V; Onuchina, E V

    2015-01-01

    The objective of the present study was to estimate the influence of gastroesophageal reflux disease (GERD) on the pH values in the pharynx and nose. It included 87 patients at the age varying from 18 to 81 years admitted to the Irkutsk-based Railway Clinical Hospital and allocated to four groups. Group 1 was comprised of 25 patients presenting with gastroesophageal reflux disease and chronic rhinosinusitis (CRS), group 2 consisted of 29 patients with CRS in the absence of GERD, group 3 included 22 patients with nasal septum deformations (NSD) and GERD, group 4 included 11 patients with NSD and motor rhinitis without GERD. The control group was formed from 10 volunteers. pH was measured by the contact method with the use ofEkokhim indicator paper. Gastroesophageal reflux disease was diagnosed following the recommendations of the Montreal consensus. It was shown that pH values in the pharynx of the patients with compromised nasal breathing of any origin in combination with GERD were lower than in the absence of GERD and in the healthy volunteers. The study groups did not differ in terms of pH values in the nasal cavity. It is concluded that pH values 4 or lower may serve as the criterion for pharyngo-laryngeal reflux (PLR) concomitant with HERD while pH 5 occurs more frequently in the patients with compromised nasal breathing of any etiology, regardless of the presence or absence of GERD.Disordered nasal breathing of any genesis in the patients presenting with gastroesophageal reflux disease was associated with the feeling of the lump in the throat, congestion of the respiratory tract and the nose, pain in the ears, cardialgia, and irregular heartbeat. It isrecommended to use pH measurements as a criterion for diagnostics of pharyngo-laryngeal reflux in the patients presenting with gastroesophageal reflux disease.

  13. Matrix Gla protein deficiency impairs nasal septum growth, causing midface hypoplasia.

    PubMed

    Marulanda, Juliana; Eimar, Hazem; McKee, Marc D; Berkvens, Michelle; Nelea, Valentin; Roman, Hassem; Borrás, Teresa; Tamimi, Faleh; Ferron, Mathieu; Murshed, Monzur

    2017-07-07

    Genetic and environmental factors may lead to abnormal growth of the orofacial skeleton, affecting the overall structure of the face. In this study, we investigated the craniofacial abnormalities in a mouse model for Keutel syndrome, a rare genetic disease caused by loss-of-function mutations in the matrix Gla protein (MGP) gene. Keutel syndrome patients show diffuse ectopic calcification of cartilaginous tissues and impaired midface development. Our comparative cephalometric analyses of micro-computed tomography images revealed a severe midface hypoplasia in Mgp(-/-) mice. In vivo reporter studies demonstrated that the Mgp promoter is highly active at the cranial sutures, cranial base synchondroses, and nasal septum. Interestingly, the cranial sutures of the mutant mice showed normal anatomical features. Although we observed a mild increase in mineralization of the spheno-occipital synchondrosis, it did not reduce the relative length of the cranial base in comparison with total skull length. Contrary to this, we found the nasal septum to be abnormally mineralized and shortened in Mgp(-/-) mice. Transgenic restoration of Mgp expression in chondrocytes fully corrected the craniofacial anomalies caused by MGP deficiency, suggesting a local role for MGP in the developing nasal septum. Although there was no up-regulation of markers for hypertrophic chondrocytes, a TUNEL assay showed a marked increase in apoptotic chondrocytes in the calcified nasal septum. Transmission electron microscopy confirmed unusual mineral deposits in the septal extracellular matrix of the mutant mice. Of note, the systemic reduction of the inorganic phosphate level was sufficient to prevent abnormal mineralization of the nasal septum in Mgp(-/-);Hyp compound mutants. Our work provides evidence that modulation of local and systemic factors regulating extracellular matrix mineralization can be possible therapeutic strategies to prevent ectopic cartilage calcification and some forms of congenital

  14. Low-dose oxytocin delivered intranasally with Breath Powered device affects social-cognitive behavior: a randomized four-way crossover trial with nasal cavity dimension assessment.

    PubMed

    Quintana, D S; Westlye, L T; Rustan, Ø G; Tesli, N; Poppy, C L; Smevik, H; Tesli, M; Røine, M; Mahmoud, R A; Smerud, K T; Djupesland, P G; Andreassen, O A

    2015-07-14

    Despite the promise of intranasal oxytocin (OT) for modulating social behavior, recent work has provided mixed results. This may relate to suboptimal drug deposition achieved with conventional nasal sprays, inter-individual differences in nasal physiology and a poor understanding of how intranasal OT is delivered to the brain in humans. Delivering OT using a novel 'Breath Powered' nasal device previously shown to enhance deposition in intranasal sites targeted for nose-to-brain transport, we evaluated dose-dependent effects on social cognition, compared response with intravenous (IV) administration of OT, and assessed nasal cavity dimensions using acoustic rhinometry. We adopted a randomized, double-blind, double-dummy, crossover design, with 16 healthy male adults completing four single-dose treatments (intranasal 8 IU (international units) or 24 IU OT, 1 IU OT IV and placebo). The primary outcome was social cognition measured by emotional ratings of facial images. Secondary outcomes included the pharmacokinetics of OT, vasopressin and cortisol in blood and the association between nasal cavity dimensions and emotional ratings. Despite the fact that all the treatments produced similar plasma OT increases compared with placebo, there was a main effect of treatment on anger ratings of emotionally ambiguous faces. Pairwise comparisons revealed decreased ratings after 8 IU OT in comparison to both placebo and 24 IU OT. In addition, there was an inverse relationship between nasal valve dimensions and anger ratings of ambiguous faces after 8-IU OT treatment. These findings provide support for a direct nose-to-brain effect, independent of blood absorption, of low-dose OT delivered from a Breath Powered device.

  15. Low-dose oxytocin delivered intranasally with Breath Powered device affects social-cognitive behavior: a randomized four-way crossover trial with nasal cavity dimension assessment

    PubMed Central

    Quintana, D S; Westlye, L T; Rustan, Ø G; Tesli, N; Poppy, C L; Smevik, H; Tesli, M; Røine, M; Mahmoud, R A; Smerud, K T; Djupesland, P G; Andreassen, O A

    2015-01-01

    Despite the promise of intranasal oxytocin (OT) for modulating social behavior, recent work has provided mixed results. This may relate to suboptimal drug deposition achieved with conventional nasal sprays, inter-individual differences in nasal physiology and a poor understanding of how intranasal OT is delivered to the brain in humans. Delivering OT using a novel ‘Breath Powered' nasal device previously shown to enhance deposition in intranasal sites targeted for nose-to-brain transport, we evaluated dose-dependent effects on social cognition, compared response with intravenous (IV) administration of OT, and assessed nasal cavity dimensions using acoustic rhinometry. We adopted a randomized, double-blind, double-dummy, crossover design, with 16 healthy male adults completing four single-dose treatments (intranasal 8 IU (international units) or 24 IU OT, 1 IU OT IV and placebo). The primary outcome was social cognition measured by emotional ratings of facial images. Secondary outcomes included the pharmacokinetics of OT, vasopressin and cortisol in blood and the association between nasal cavity dimensions and emotional ratings. Despite the fact that all the treatments produced similar plasma OT increases compared with placebo, there was a main effect of treatment on anger ratings of emotionally ambiguous faces. Pairwise comparisons revealed decreased ratings after 8 IU OT in comparison to both placebo and 24 IU OT. In addition, there was an inverse relationship between nasal valve dimensions and anger ratings of ambiguous faces after 8-IU OT treatment. These findings provide support for a direct nose-to-brain effect, independent of blood absorption, of low-dose OT delivered from a Breath Powered device. PMID:26171983

  16. The role of the nose in sleep-disordered breathing.

    PubMed

    Meen, Eric K; Chandra, Rakesh K

    2013-01-01

    Sleep-disordered breathing (SDB) is a spectrum of airway collapse, ranging from primary snoring to profound obstructive sleep apnea (OSA). Studies have shown an association between impaired nasal breathing and SDB; consequently, treatments of nasal obstruction are often used in an attempt to improve disease severity. The authors performed a review of the literature to determine the impact of nasal obstruction and the effectiveness of nonsurgical and surgical interventions on SDB. Relevant literature up to 2012 on the association between nasal obstruction and SDB and effectiveness of nonsurgical and surgical treatment of the nose in SDB were reviewed. The literature is mostly limited to uncontrolled case series in which patient groups, interventions, disease definitions, and outcome measures are not standardized. Nasal medications, including intranasal steroids and nasal decongestants, have not been shown to improve either snoring or OSA. Nasal dilators have no impact on OSA but may improve snoring. Surgery for nasal obstruction does not improve objective indicators of SDB but can improve subjective elements of disease, such as snoring, sleepiness, and quality of life. Nasal surgery can facilitate continuous positive airway pressure use in cases where nasal obstruction is the factor limiting compliance. Nasal obstruction plays a modulating, but not causative, role in SDB. Nasal interventions may improve subjective aspects of snoring and OSA but do not improve objective indicators of disease. Standardization of methods and higher evidence level studies will further clarify the benefit of nasal interventions in the treatment of SDB.

  17. [Nursing outcomes for ineffective breathing patterns and impaired spontaneous ventilation in intensive care].

    PubMed

    do Canto, Débora Francisco; Almeida, Miriam de Abreu

    2013-12-01

    This study aimed to validate the results of Nursing selected from the link NANDA-I-NOC (Nursing Outcomes Classification--NANDA--International) for diagnosis Ineffective Breathing Pattern and Impaired Spontaneous Ventilation in adult intensive care unit. This is a content validation study conducted in a university hospital in southern Brazil with 15 expert nurses with clinical experience and knowledge of the ratings. The instruments contained five-point Likert scales to rate the importance of each outcome (1st step) and indicator (Step 2) for the diagnoses studied. We calculated weighted averages for each outcome/indicator, considering) 1 = 0. 2 = 0.25, 3 = 0.50 4 = 0.75 and 5 = 1. The outcomes suggested by the NOC with averages above 0.8 were considered validated as well as the indicators. The results Respiratory State--airway permeability (Ineffective Breathing Patterns) and 11 indicators, and Response to mechanical ventilation: adult (Impaired Spontaneous Ventilation) with 26 indicators were validated.

  18. Deep Breathing Improves End-Tidal Carbon Dioxide Monitoring of an Oxygen Nasal Cannula-Based Capnometry Device in Subjects Extubated After Abdominal Surgery.

    PubMed

    Takaki, Shunsuke; Mizutani, Kenji; Fukuchi, Moeka; Yoshida, Tasuku; Idei, Masahumi; Matsuda, Yuko; Yamaguchi, Yoshikazu; Miyashita, Tetsuya; Nomura, Takeshi; Yamaguchi, Osamu; Goto, Takahisa

    2017-01-01

    Capnometry detects hypoventilation earlier than pulse oximetry while supplemental oxygen is being administered. We compared the end-tidal CO2 (PETCO2 ) measured using a newly developed oxygen nasal cannula with a CO2-sampling port and the PaCO2 in extubated subjects after abdominal surgery. We also investigated whether the difference between PaCO2 and PETCO2 is affected by resting, by spontaneous breathing with the mouth consciously closed, and by deep breathing with the mouth closed. Adult post-abdominal surgery subjects admitted to the ICU were enrolled. After extubation, oxygen was supplied at 4 L/min using a capnometry-type oxygen cannula. The breathing frequency, PETCO2 , and PaCO2 were measured after 30 min of oxygen supplementation. PETCO2 was continuously measured during rest, during breathing with the mouth consciously closed, and during deep breathing with the mouth closed. The difference between PETCO2 and PaCO2 during various breathing patterns was analyzed using the Bland-Altman method. Twenty subjects were included. The bias ± SD (limits of agreement) for breathing frequency measured by capnometry compared with those obtained by direct measurement was 0.4 ± 3.6 (-6.7 to 7.4). In PETCO2 compared with PaCO2 , the biases (limits of agreement) were 14.8 ± 8.2 (-1.3 to 30.9) at rest, 10.2 ± 6.4 (-2.3 to 22.7) with the mouth closed, and 7.7 ± 5.6 (-3.2 to 18.6) for deep breathing with the mouth closed. PETCO2 determined using the capnometry device yielded unreliable and widely ranging values under various breathing patterns. However, deep breathing with the mouth closed decreased the difference between PETCO2 and PaCO2 , as compared with other breathing patterns. PETCO2 measurements under deep breathing with mouth closed with a capnometry-type oxygen cannula improved the prediction of the absolute value of PaCO2 in extubated post-abdominal surgical subjects without respiratory dysfunction. Copyright © 2017 by Daedalus Enterprises.

  19. The effect of high flow nasal cannula therapy on the work of breathing in infants with bronchiolitis.

    PubMed

    Pham, Trang M T; O'Malley, Lee; Mayfield, Sara; Martin, Simon; Schibler, Andreas

    2015-07-01

    The main physiological impact of high flow nasal cannula (HFNC) therapy is presumed to be a decrease in work of breathing (WOB). To assess this, diaphragmatic electrical activity and esophageal pressure changes were measured off then on HFNC delivered at 2 L/kg/min, in 14 infants with bronchiolitis and 14 cardiac infants. Electrical activity of the diaphragm (Edi) was measured using an Edi catheter with calculations of signal peak (EdiMAX ) and amplitude (EdiAMPL ). Pressure-rate and pressure-time products (PRP, PTP) were calculated from analyses of esophageal pressure. Changes in end-expiratory lung volume were measured using respiratory inductance plethysmography (RIPEEL ). The EdiMAX and EdiAMPL were significantly higher in infants with bronchiolitis than in cardiac infants (P < 0.05). Within the bronchiolitis group, both were significantly reduced between HFNC states from 27.9 µV [20.4, 35.4] to 21.0 µV [14.8, 27.2] and from 25.1 µV [18.0, 32.2] to 19.2 µV [13.3, 25.1], respectively (mean, 95% CI, P < 0.05). A less prominent offload of the diaphragm was observed in cardiac infants (P < 0.05). WOB decreased in both groups with a significant reduction of PRP and PTP (P < 0.05). RIPEEL increased significantly in bronchiolitis only (P < 0.05). HFNC offloads the diaphragm and reduces the WOB in bronchiolitis. A similar effect was demonstrated in cardiac infants, a group without signs of airway-obstruction. © 2014 Wiley Periodicals, Inc.

  20. Standardization procedure for the nasal nitric oxide measurement method using Niox MINO® and the tidal-breathing technique with velum-closure.

    PubMed

    Gelardi, M; Abbattista, G; Quaranta, V N; Quaranta, N; Seccia, V; Buttafava, S; Frati, F; Ciprandi, G

    2016-01-01

    Nitric oxide (NO) is a molecule that performs many functions in the human body. The entire respiratory tract can produce NO, but the highest production occurs in the upper respiratory tract, in the paranasal sinuses in particular. The aim of the present study was to assess a new nasal NO (nNO) measurement method using the Niox MINO Nasal® device (Aerocrine AB, Solna, Sweden) and a special procedure, in order to compare the nNO values obtained in 32 healthy subjects with the values found in the international literature. The measured normal nNO values were equal to 426.76±143.27 ppb, with a 95% confidence interval [160.22-733.30]. Males had an average nNO value equal to 446.76±133.63 [178.64 – 714.02], whereas in females the average value was 403.80±154.90 [94.00-713.60]. This study allows us to confirm that we have been able to establish the normal range of nitric oxide quantity produced in the nasal/sinus cavities of healthy individuals using the Niox MINO Nasal® device and tidal-breathing with velum-closure manoeuvre.

  1. Breathing resistance and ultrafine particle deposition in nasal-laryngeal airways of a newborn, an infant, a child, and an adult.

    PubMed

    Xi, Jinxiang; Berlinski, Ariel; Zhou, Yue; Greenberg, Bruce; Ou, Xiawei

    2012-12-01

    As a human grows from birth to adulthood, both airway anatomy and breathing conditions vary, altering the deposition rate and pattern of inhaled aerosols. However, deposition studies have typically focused on adult subjects, results of which may not be readily extrapolated to children. This study numerically evaluated the age-related effects on the airflow and aerosol dynamics in image-based nose-throat models of a 10-day-old newborn, a 7-month-old infant, a 5-year-old child, and a 53-year-old adult. Differences in airway physiology, breathing resistance, and aerosol filtering efficiency among the four models were quantified and compared. A high-fidelity fluid-particle transport model was employed to simulate the multi-regime airflows and particle transport within the nasal-laryngeal airways. Ultrafine particles were evaluated under breathing conditions ranging from sedentary to heavy activities. Results of this study indicate that the nasal-laryngeal airways at different ages, albeit differ significantly in morphology and dimension, do not significantly affect the total deposition fractions or maximum local deposition enhancement for ultrafine aerosols. Further, the deposition partitioning in the sub-regions of interest is different among the four models. Results of this study corroborate the use of the in vivo-based diffusion parameter (D(0.5)Q(-0.28)) over the replica-based parameter in correlating nasal-laryngeal depositions of ultrafine aerosols. Improved correlations have been developed for the four age groups by implementing this in vivo-based diffusion parameter as well as the Cunningham correction factor.

  2. Association between Sleep-Disordered Breathing and Neuropsychological Performance in Older Adults with Mild Cognitive Impairment.

    PubMed

    Terpening, Zoe; Lewis, Simon J G; Yee, Brendon J; Grunstein, Ron R; Hickie, Ian B; Naismith, Sharon L

    2015-01-01

    Sleep-disordered breathing in middle-age and older adults has been shown to be linked to a range of neuropsychological deficits, but the extent to which these relationships are evident in older people 'at risk' of developing dementia in unknown. In this study, we aimed to determine whether changes in sleep-disordered breathing and sleep fragmentation during nocturnal sleep were related to neuropsychological dysfunction in patients with mild cognitive impairment. Forty-six patients with MCI (mean age = 66.1 y, sd = 8.4) and 40 age-matched healthy controls (mean age = 63.5 y, sd = 8.9) underwent psychiatric, medical, and neuropsychological assessment, in addition to overnight polysomnography and self-report questionnaires. Measures of hypoxemia, sleep fragmentation, and sleep quality were derived including the apnoea-hypopnea index, oxygen desaturation index, percentage of total sleep time spent below 90% oxygen saturation, arousal index, sleep efficiency, and wake after sleep onset. Patients with MCI did not differ from healthy aging on any measure of sleep-disordered breathing or sleep fragmentation. In MCI, processing speed was negatively correlated with greater sleep time spent below 90% oxygen saturation and a higher apnoea-hypopnea index. In contrast, in the healthy aging, processing speed was negatively correlated with an increased oxygen desaturation index and the arousal index. Sleep-disordered breathing is evident in both healthy aging and MCI with associated decrements in processing speed. Future research is needed to determine the unique and synergistic effects of these differential associations, their potential to inform disease trajectory, and possible therapeutic interventions.

  3. Breathing life into dinosaurs: tackling challenges of soft-tissue restoration and nasal airflow in extinct species.

    PubMed

    Bourke, Jason M; Porter, W M Ruger; Ridgely, Ryan C; Lyson, Tyler R; Schachner, Emma R; Bell, Phil R; Witmer, Lawrence M

    2014-11-01

    The nasal region plays a key role in sensory, thermal, and respiratory physiology, but exploring its evolution is hampered by a lack of preservation of soft-tissue structures in extinct vertebrates. As a test case, we investigated members of the "bony-headed" ornithischian dinosaur clade Pachycephalosauridae (particularly Stegoceras validum) because of their small body size (which mitigated allometric concerns) and their tendency to preserve nasal soft tissues within their hypermineralized skulls. Hypermineralization directly preserved portions of the olfactory turbinates along with an internal nasal ridge that we regard as potentially an osteological correlate for respiratory conchae. Fossil specimens were CT-scanned, and nasal cavities were segmented and restored. Soft-tissue reconstruction of the nasal capsule was functionally tested in a virtual environment using computational fluid dynamics by running air through multiple models differing in nasal soft-tissue conformation: a bony-bounded model (i.e., skull without soft tissue) and then models with soft tissues added, such as a paranasal septum, a scrolled concha, a branched concha, and a model combining the paranasal septum with a concha. Deviations in fluid flow in comparison to a phylogenetically constrained sample of extant diapsids were used as indicators of missing soft tissue. Models that restored aspects of airflow found in extant diapsids, such as appreciable airflow in the olfactory chamber, were judged as more likely. The model with a branched concha produced airflow patterns closest to those of extant diapsids. These results from both paleontological observation and airflow modeling indicate that S. validum and other pachycephalosaurids could have had both olfactory and respiratory conchae. Although respiratory conchae have been linked to endothermy, such conclusions require caution in that our re-evaluation of the reptilian nasal apparatus indicates that respiratory conchae may be more widespread

  4. The effects of nasal irritant induced responses on breathing and cough in anaesthetized and conscious animal models.

    PubMed

    Biringerova, Z; Gavliakova, S; Brozmanova, M; Tatar, M; Hanuskova, E; Poliacek, I; Plevkova, J

    2013-12-01

    There is little evidence to support the down-regulation of coughing from the nose. The cough response to citric acid (CA) was studied in anesthetized and conscious guinea pigs after nasal pretreatment with saline, 1% DMSO, allylisothiocyanate (TRPA1 agonist) and allylisothiocyanate +AP-18 (TRPA1 antagonist). Cough was induced by adding citric acid (CA) to the tracheal perfusion in anaesthetized animals, or by inhaling 0.4M CA in conscious animals. The cough response was counted from the dose response curves, airflow traces and cough sound analysis. In conscious animals, nasal allylisothiocyanate induced reproducible, dose dependent nasal symptoms and a significant drop in respiratory rate. Cough induced by CA was suppressed after nasal allylisothiocyanate (p<0.05), and this effect was prevented by AP-18 (1mM). In anaesthetized animals, nasal allylisothiocyanate induced a significant drop in respiratory rate. Cough induced subsequently by CA was suppressed when compared to baseline and vehicle responses (p<0.05). The reasons for the suppression of CA induced cough by TRPA1 agonist applied to the nose are not clear and remain to be elucidated. Copyright © 2013 Elsevier B.V. All rights reserved.

  5. Neostigmine but not sugammadex impairs upper airway dilator muscle activity and breathing

    PubMed Central

    Eikermann, M.; Zaremba, S.; Malhotra, A.; Jordan, A. S.; Rosow, C.; Chamberlin, N. L.

    2008-01-01

    Background Cholinesterase inhibitor-based reversal agents, given in the absence of neuromuscular block, evoke a partial upper airway obstruction by decreasing skeletal upper airway muscle function. Sugammadex reverses neuromuscular block by encapsulating rocuronium. However, its effects on upper airway integrity and breathing are unknown. Methods Fifty-one adult male rats were anaesthetized with isoflurane, tracheostomized, and a femoral artery and vein were cannulated. First, we compared the efficacy of sugammadex 15 mg kg−1 and neostigmine 0.06 mg kg−1 to reverse respiratory effects of rocuronium-induced partial paralysis [train-of-four ratio (T4/T1)=0.5]. Subsequently, we compared the safety of sugammadex and neostigmine given after recovery of the T4/T1 to 1, by measuring phasic genioglossus activity and breathing. Results During partial paralysis (T4/T1=0.5), time to recovery of minute volume to baseline values was 10.9 (2), 75.8 (18), and 153 (54) s with sugammadex, neostigmine, and placebo, respectively (sugammadex was significantly faster than neostigmine and placebo, P<0.05). Recovery of T4/T1 was also faster for sugammadex than neostigmine and placebo. Neostigmine administration after complete recovery of T4/T1 decreased upper airway dilator muscle activity to 64 (30)% of baseline and decreased tidal volume (P<0.05 for both variables), whereas sugammadex had no effect on either variable. Conclusions In contrast to neostigmine, which significantly impairs upper airway dilator muscle activity when given after recovery from neuromuscular block, a reversal dose of sugammadex given under the same conditions does not affect genioglossus muscle activity and normal breathing. Human studies will be required to evaluate the clinical relevance of our findings. PMID:18559352

  6. Neostigmine but not sugammadex impairs upper airway dilator muscle activity and breathing.

    PubMed

    Eikermann, M; Zaremba, S; Malhotra, A; Jordan, A S; Rosow, C; Chamberlin, N L

    2008-09-01

    Cholinesterase inhibitor-based reversal agents, given in the absence of neuromuscular block, evoke a partial upper airway obstruction by decreasing skeletal upper airway muscle function. Sugammadex reverses neuromuscular block by encapsulating rocuronium. However, its effects on upper airway integrity and breathing are unknown. Fifty-one adult male rats were anaesthetized with isoflurane, tracheostomized, and a femoral artery and vein were cannulated. First, we compared the efficacy of sugammadex 15 mg kg(-1) and neostigmine 0.06 mg kg(-1) to reverse respiratory effects of rocuronium-induced partial paralysis [train-of-four ratio (T4/T1)=0.5]. Subsequently, we compared the safety of sugammadex and neostigmine given after recovery of the T4/T1 to 1, by measuring phasic genioglossus activity and breathing. During partial paralysis (T4/T1=0.5), time to recovery of minute volume to baseline values was 10.9 (2), 75.8 (18), and 153 (54) s with sugammadex, neostigmine, and placebo, respectively (sugammadex was significantly faster than neostigmine and placebo, P<0.05). Recovery of T4/T1 was also faster for sugammadex than neostigmine and placebo. Neostigmine administration after complete recovery of T4/T1 decreased upper airway dilator muscle activity to 64 (30)% of baseline and decreased tidal volume (P<0.05 for both variables), whereas sugammadex had no effect on either variable. In contrast to neostigmine, which significantly impairs upper airway dilator muscle activity when given after recovery from neuromuscular block, a reversal dose of sugammadex given under the same conditions does not affect genioglossus muscle activity and normal breathing. Human studies will be required to evaluate the clinical relevance of our findings.

  7. Influence of the respiratory cycle structure on the flow field in human nasal cavity at a fixed level of breath depth

    NASA Astrophysics Data System (ADS)

    Bosykh, L. Yu.; Ganimedov, V. L.; Muchnaya, M. I.; Sadovskii, A. S.

    2016-10-01

    The evolution of air flow field in the human nasal cavity has studied during the respiratory cycle. Real tomographic scans of the adult without abnormalities in the upper airway have been used to construct the geometric model. Quiet breathing mode is selected: the duration of the respiratory cycle is 4.3 sec and the depth of breathing is 600 ml, which provides pulmonary ventilation at 8.4 liters of air per minute. The system of Navier - Stokes equations was used to describe the flow. Laminar flow regime was postulated. The Lagrange approach was used for calculation of submicron particles motion. The numerical solution was built on the basis of gas-dynamic solver FLUENT of software package ANSYS 12. Calculations were made for two cases in which the same value of the integral characteristic (the depth of breathing) was reached, but which had different kind of boundary conditions on the exit. In the first case, the velocity was assumed symmetrical with respect to inhalation - exhalation and was approximated by sinusoid. In the second case, the velocity as a function of time is determined by processing of the real person spirogram. For the both variants the flow fields were obtained and compared. Analysis of the results showed that in non-stationary case the use of symmetric boundary condition leads to an underestimation of respiratory effort for the implementation of the required depth of breathing. In cyclic flow the flow fields in acceleration and deceleration phases are, basically, the same as in the corresponding steady flow. At the same time taking into account of non-symmetry of respiratory cycle influences on deposition pattern of particles significantly.

  8. Autonomic Markers of Impaired Glucose Metabolism: Effects of Sleep-Disordered Breathing

    PubMed Central

    Wang, Wenli; Redline, Susan; Khoo, Michael C. K.

    2012-01-01

    Background The association between diabetes and abnormalities in autonomic function is well-known, but it is not clear if this association can be extended to subjects with prediabetic impaired glucose metabolism (IGM). Sleep-disordered breathing (SDB), which commonly occurs in this population, is often overlooked. We sought to determine how autonomic function, monitored in an overnight sleep study setting, may be impaired in subjects with IGM and/or SDB. Methods Polysomnograms (PSGs) selected from the Cleveland Family Study database were categorized into four groups: normal, SDB (respiratory disturbance index > 5/h), IGM, and both SDB and IGM. Impaired glucose metabolism was defined as an oral glucose tolerance test (OGTT) level > 140 mg/dl. Time-domain and frequency-domain indices of heart rate variability were used to quantify autonomic impairment. Baroreflex sensitivity determined using pulse transit time (BRSPTT), an indirect measure of baroreflex sensitivity based on spontaneous pulse transit time fluctuations, was used as a surrogate measure of baroreflex sensitivity. Results Based on 31 PSGs from subjects (16 males, 15 females) ages 20.8–61.2 years, both SDNN and BRSPTT were found to be 20-25% lower in SDB and ~40% lower in IGM and SDB + IGM as compared to subjects without either condition. In analyses of continuous measures, mean standard deviation of 5 min R–R intervals (SDNN) and BRSPTT were found to be negatively correlated with OGTT following adjustment for age and body mass index. Oral glucose tolerance test and age were the two most significant factors for predicting SDNN and BRSPTT. Conclusions Our analyses suggest that cardiac autonomic control is impaired in IGM, regardless of whether SDB is present. The abnormal autonomic function involves degradation of baroreflex regulation. PMID:23063043

  9. Skeletal effects of RME in the transverse and vertical dimensions of the nasal cavity in mouth-breathing growing children.

    PubMed

    Cappellette, Mario; Nagai, Lucia Hatsue Yamamoto; Gonçalves, Raquel Mori; Yuki, Aparecida Keiko; Pignatari, Shirley Shizue Nagata; Fujita, Reginaldo Raimundo

    2017-01-01

    Maxillary constriction is a dentoskeletal deformity characterized by discrepancy in maxilla/mandible relationship in the transverse plane, which may be associated with respiratory dysfunction. The objective of this study was to evaluate the skeletal effects of RME on maxillary and nasal transverse dimensions and compare the differences between males and females. Sixty-one mouth-breathers patients with skeletal maxillary constriction (35 males and 26 females, mean age 9.6 years) were included in the study. Posteroanterior (PA) radiographs were taken before expansion (T1) and 3 months after expansion (T2). Data obtained from the evaluation of T1 and T2 cephalograms were tested for normality with the Kolmogorov-Smirnov method. The Student's t-test was performed for each measurement to determine sex differences. RME produced a significant increase in all linear measurements of maxillary and nasal transverse dimensions. No significant differences were associated regarding sex. The RME produced significant width increases in the maxilla and nasal cavity, which are important for treatment stability, improving respiratory function and craniofacial development.

  10. Skeletal effects of RME in the transverse and vertical dimensions of the nasal cavity in mouth-breathing growing children

    PubMed Central

    Cappellette, Mario; Nagai, Lucia Hatsue Yamamoto; Gonçalves, Raquel Mori; Yuki, Aparecida Keiko; Pignatari, Shirley Shizue Nagata; Fujita, Reginaldo Raimundo

    2017-01-01

    ABSTRACT Introduction: Maxillary constriction is a dentoskeletal deformity characterized by discrepancy in maxilla/mandible relationship in the transverse plane, which may be associated with respiratory dysfunction. Objective: The objective of this study was to evaluate the skeletal effects of RME on maxillary and nasal transverse dimensions and compare the differences between males and females. Methods: Sixty-one mouth-breathers patients with skeletal maxillary constriction (35 males and 26 females, mean age 9.6 years) were included in the study. Posteroanterior (PA) radiographs were taken before expansion (T1) and 3 months after expansion (T2). Data obtained from the evaluation of T1 and T2 cephalograms were tested for normality with the Kolmogorov-Smirnov method. The Student’s t-test was performed for each measurement to determine sex differences. Results: RME produced a significant increase in all linear measurements of maxillary and nasal transverse dimensions. Conclusions: No significant differences were associated regarding sex. The RME produced significant width increases in the maxilla and nasal cavity, which are important for treatment stability, improving respiratory function and craniofacial development. PMID:28902251

  11. Anesthesia and increased hypercarbic drive impair the coordination between breathing and swallowing

    PubMed Central

    D'Angelo, Olivia M.; Diaz-Gil, Daniel; Nunn, Danuza; Simons, Jeroen C.P.; Gianatasio, Chloe; Mueller, Noomi; Meyer, Matthew J.; Pierce, Eric; Rosow, Carl; Eikermann, Matthias

    2017-01-01

    Background Coordination between breathing and swallowing helps prevent aspiration of foreign material into the respiratory tract. We examined the effects of anesthesia, and hypercapnia on swallowing-breathing coordination. Methods In a randomized controlled cross-over study, general anesthesia with propofol or sevoflurane was titrated using an up-down method to identify the threshold for suppression of the motor response to electrical stimulation of the forearm. Additional measurements included bispectral index, genioglossus electromyogram, ventilation (pneumotachometer), and hypopharyngeal pressure. During wakefulness and at each level of anesthetic, carbon dioxide was added to increase its end tidal pressure by 4 and 8 mmHg. A swallow was defined as increased genioglossus activity with deglutition apnea and an increase in hypopharyngeal pressure. Spontaneous swallows were categorized as physiological (during expiration or followed by expiration), or pathological (during inspiration or followed by an inspiration). Results A total of 224 swallows were analyzed. Anesthesia increased the proportion of pathological swallows (25.9% versus 4.9%), and decreased the number of swallows per hour (1.7 ± 3.3 versus 28.0 ± 22.3) compared to wakefulness. During anesthesia, hypercapnia decreased hypopharyngeal pressure during inspiration (-14.1±3.7 versus -8.7±2 mmHg), and increased minute ventilation the proportion of pathological swallows (19.1% versus 12.3%), and the number of swallows per hour (5.5 ±17.0. versus 1.3 ± 5.5). Conclusions Anesthesia impaired the coordination between swallowing and respiration. Mild hypercapnia increased the frequency of swallowing during anesthesia and the likelihood of pathological swallowing. During anesthesia, the risk for aspiration may be further increased when ventilatory drive is stimulated. PMID:25275368

  12. Sleep-disordered breathing, impaired cardiac adrenergic innervation and prognosis in heart failure.

    PubMed

    Scala, Oriana; Paolillo, Stefania; Formisano, Roberto; Pellegrino, Teresa; Rengo, Giuseppe; Gargiulo, Paola; De Michele, Fausto; Starace, Antonio; Rapacciuolo, Antonio; Parisi, Valentina; Prastaro, Maria; Piscopo, Valentina; Dellegrottaglie, Santo; Bruzzese, Dario; De Martino, Fabiana; Parente, Antonio; Leosco, Dario; Trimarco, Bruno; Cuocolo, Alberto; Perrone-Filardi, Pasquale

    2016-06-23

    Unfavourable effects of sleep-disordered breathing (SDB) in heart failure (HF) are mainly mediated by impaired sympathetic activity. Few data are available on SDB and cardiac adrenergic impairment evaluated at myocardial level. The aim of the study was to assess the relationship between SDB, cardiac sympathetic innervation assessed by (123)I-metaiodobenzylguanidine ((123)I-MIBG) imaging and prognosis in HF. Observational, prospective study enrolling patients with HF and reduced systolic function. Patients underwent nocturnal cardiorespiratory monitoring to assess SDB presence by apnoea/hypopnoea index (AHI), and (123)I-MIBG imaging to calculate heart-to-mediastinum (H/M) ratios and washout rate. Patients were prospectively followed for 29±18 months for the combined endpoint of cardiovascular death and HF hospitalisation. Ninety-four patients (66.1±9.8 years; left ventricular ejection fraction 32±7%) were enrolled; 72 (77%) showed SDB and, compared with non-SDB, significantly reduced early (1.67±0.22 vs 1.77±0.13; p=0.019) and late H/M ratios (1.50±0.22 vs 1.61±0.23; p=0.038). Dividing patients into two groups according to SDB severity, patients with a moderate-severe disturbance (AHI >15; n=43) showed significantly worse survival for the composite study outcome (log-rank test, p=0.001) with respect to patients with mild or no disorder (AHI ≤15; n=51). Adding SDB variables to the already known prognostic role of (123)I-MIBG imaging, we observed a worse survival in patients with both SDB and H/M impairment. Patients with systolic HF and SDB show more impaired cardiac adrenergic innervation assessed by (123)I-MIBG imaging, and more adverse prognosis compared with HF patients without SDB. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Disorders of the nasal valve area

    PubMed Central

    Bloching, Marc Boris

    2008-01-01

    The nasal valve area is not a singular structure, but a complex three-dimensional construct consisting of several morphological structures. From the physiologic point of view, it is the place of maximum nasal flow resistance (“flow limiting segment”). Therefore, according to Poiseuille’s law, even minor constrictions of this area result in a clinically relevant impairment of nasal breathing for the patient. This narrow passage, also called “ostium internum nasi”, is formed by the mobile lateral nasal wall, the anterior septum with the swell body, the head of the inferior turbinate and the osseous piriform aperture. Within the framework of aetiology, static and dynamic disorders of the nasal valve area have to be distinguished since they result in different therapeutic measures. In the context of diagnosis, the exploration of the case history for assessing the patient’s extent of suffering and the clinical examination are very important. In addition to the presentation of the basics of disorders of the nasal valves, this paper focuses on the treatment of dynamic disorders that mainly constitute the more important therapeutic issue. In this context, we distinguish between stabilisation techniques through grafts or implants and stabilising suture techniques. Following a thorough analysis, the correction of static nasal valve disorders requires various plastic-reconstructive measures using transposition grafting and skin or composite grafts. PMID:22073083

  14. Initial stabilisation of preterm infants: a new resuscitation system with low imposed work of breathing for use with face mask or nasal prongs.

    PubMed

    Donaldsson, Snorri; Drevhammar, Thomas; Taittonen, Leena; Klemming, Stina; Jonsson, Baldvin

    2017-05-01

    T-piece resuscitation systems are pressure unstable and have high imposed work of breathing (iWOB). Pressure stable respiratory support with low iWOB might improve outcome. We have developed a new resuscitation system that can be used with nasal prongs or face mask. The aim of the study was to describe the in vitro performance of the new system and to perform a clinical feasibility trial of initial stabilisation of preterm infants. A mechanical lung model was used to determine iWOB at increasing levels of continuous positive airway pressure (CPAP). The feasibility trial included 36 infants (27-34 weeks of gestation), who were randomised into three groups (T-piece, new system with face mask or new system with prongs). Collected data included problems with usage, safety, time to stable breathing, need for positive pressure ventilation and intubation. In the mechanical lung model, the new system reduced iWOB with 91.5% (mask) and 86.6% (medium prongs) compared with Neopuff (4 cm CPAP, p<0.001). Informed consent was obtained from 45 patients, 39 were randomised and 36 needed support. Randomisation resulted in an imbalance: The group of new system infants had lower gestational age compared with the T-piece group. Thirteen patients needed positive pressure ventilation (median 20 cm H2O). One infant was intubated. The study did not reveal problems with the equipment or safety. Compared with T-piece systems, the new system had a marked reduction in iWOB in bench tests. The feasibility trial did not reveal problems with usability or safety. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. Hand-held tidal breathing nasal nitric oxide measurement--a promising targeted case-finding tool for the diagnosis of primary ciliary dyskinesia.

    PubMed

    Marthin, June Kehlet; Nielsen, Kim Gjerum

    2013-01-01

    Nasal nitric oxide (nNO) measurement is an established first line test in the work-up for primary ciliary dyskinesia (PCD). Tidal breathing nNO (TB-nNO) measurements require minimal cooperation and are potentially useful even in young children. Hand-held NO devices are becoming increasingly widespread for asthma management. Therefore, we chose to assess whether hand-held TB-nNO measurements reliably discriminate between PCD, and Healthy Subjects (HS) and included Cystic Fibrosis (CF) patients as a disease control group known to have intermediate nNO levels. In this cross sectional, single centre, single occasion, proof-of-concept study in children and adults with PCD and CF, and in HS we compared feasibility, success rates, discriminatory capacity, repeatability and agreement between a hand-held electrochemical device equipped with a nNO software application sampling at flow rates 2 ml/s or 5 ml/s, and two stationary chemiluminescence devices, applying both tidal breathing and velum closure techniques. Measurements were done in 16 PCD patients, 21 patients with CF and 20 HS aged between 3.8 and 60.9 years. Hand-held TB-nNO showed high success rate (96.5-100%) vs. velum closure nNO techniques (70.2-89.5%). Hand-held TB-nNO sampling at flow rate 5 ml/s showed equally high discriminative power (PCD vs. HS [p<0.0001] and PCD vs. CF [p<0.0001]) and reaching close to 100% sensitivity and specificity, superior repeatability (CV% = 10%) and equal limits of agreement compared to TB-nNO by stationary devices and even compared to velum closure sampling. Hand-held TB-nNO discriminates significantly between PCD, CF and HS and shows promising potential as a widespread targeted case-finding tool for PCD, although further studies are warranted before implementation.

  16. Respiratory monitoring system based on the nasal pressure technique for the analysis of sleep breathing disorders: Reduction of static and dynamic errors, and comparisons with thermistors and pneumotachographs

    NASA Astrophysics Data System (ADS)

    Alves de Mesquita, Jayme; Lopes de Melo, Pedro

    2004-03-01

    Thermally sensitive devices—thermistors—have usually been used to monitor sleep-breathing disorders. However, because of their long time constant, these devices are not able to provide a good characterization of fast events, like hypopneas. Nasal pressure recording technique (NPR) has recently been suggested to quantify airflow during sleep. It is claimed that the short time constants of the devices used to implement this technique would allow an accurate analysis of fast abnormal respiratory events. However, these devices present errors associated with nonlinearities and acoustic resonance that could reduce the diagnostic value of the NPR. Moreover, in spite of the high scientific and clinical potential, there is no detailed description of a complete instrumentation system to implement this promising technique in sleep studies. In this context, the purpose of this work was twofold: (1) describe the development of a flexible NPR device and (2) evaluate the performance of this device when compared to pneumotachographs (PNTs) and thermistors. After the design details are described, the system static accuracy is evaluated by a comparative analysis with a PNT. This analysis revealed a significant reduction (p<0.001) of the static error when system nonlinearities were reduced. The dynamic performance of the NPR system was investigated by frequency response analysis and time constant evaluations and the results showed that the developed device response was as good as PNT and around 100 times faster (τ=5,3 ms) than thermistors (τ=512 ms). Experimental results obtained in simulated clinical conditions and in a patient are presented as examples, and confirmed the good features achieved in engineering tests. These results are in close agreement with physiological fundamentals, supplying substantial evidence that the improved dynamic and static characteristics of this device can contribute to a more accurate implementation of medical research projects and to improve the

  17. Changes in lung volume and upper airway using MRI during application of nasal expiratory positive airway pressure in patients with sleep-disordered breathing.

    PubMed

    Braga, C W; Chen, Q; Burschtin, O E; Rapoport, D M; Ayappa, I

    2011-11-01

    Nasal expiratory positive airway pressure (nEPAP) delivered with a disposable device (Provent, Ventus Medical) has been shown to improve sleep-disordered breathing (SDB) in some subjects. Possible mechanisms of action are 1) increased functional residual capacity (FRC), producing tracheal traction and reducing upper airway (UA) collapsibility, and 2) passive dilatation of the airway by the expiratory pressure, carrying over into inspiration. Using MRI, we estimated change in FRC and ventilation, as well as UA cross-sectional area (CSA), in awake patients breathing on and off the nEPAP device. Ten patients with SDB underwent nocturnal polysomnography and MRI with and without nEPAP. Simultaneous images of the lung and UA were obtained at 6 images/s. Image sequences were obtained during mouth and nose breathing with and without the nEPAP device. The nEPAP device produced an end-expiratory pressure of 4-17 cmH(2)O. End-tidal Pco(2) rose from 39.7 ± 5.3 to 47.1 ± 6.0 Torr (P < 0.01). Lung volume changes were estimated from sagittal MRI of the right lung. Changes in UA CSA were calculated from transverse MRI at the level of the pharynx above the epiglottis. FRC determined by MRI was well correlated to FRC determined by N(2) washout (r = 0.76, P = 0.03). nEPAP resulted in a consistent increase in FRC (46 ± 29%, P < 0.001) and decrease in ventilation (50 ± 15%, P < 0.001), with no change in respiratory frequency. UA CSA at end expiration showed a trend to increase. During wakefulness, nEPAP caused significant hyperinflation, consistent with an increase in tracheal traction and a decrease in UA collapsibility. Direct imaging effects on the UA were less consistent, but there was a trend to dilatation. Finally, we showed significant hypoventilation and rise in Pco(2) during use of the nEPAP device during wakefulness and sleep. Thus, at least three mechanisms of action have the potential to contribute to the therapeutic effect of nEPAP on SDB.

  18. Sleep and neuromuscular disease: bilevel positive airway pressure by nasal mask as a treatment for sleep disordered breathing in patients with neuromuscular disease

    PubMed Central

    Guilleminault, C.; Philip, P.; Robinson, A.

    1998-01-01

    their masks. Three patients with myotonic dystrophy presented continued daytime somnolence despite apparent adequate treatment of their sleep disordered breathing. This required the addition of stimulant medication to their regimen. During this time three additional subjects had to be switched to nasal mask intermittent positive pressure ventilation delivered by traditional volume cycled home ventilator (volume controlled NIPPV).
CONCLUSIONS—Bilevel positive airway pressure delivered by nasal mask may be used successfully to treat sleep disordered breathing associated with neuromuscular disease. This device can be employed to assist nocturnal ventilation by either the spontaneous or timed mode. In the United States it is less expensive and easier to institute than volume controlled NIPPV and may be as efficacious as this mode if close surveillance and regular re-evaluation of the patient's status is maintained.

 PMID:9703177

  19. [Complications and sequelae after nasal trauma].

    PubMed

    Calderón, R; Miralles, G; Rodríguez Urcelay, P; Berenguer, B; González Meli, B; Enríquez de Salamanca, J; Cervera, J

    2007-04-01

    Septal haematoma after nasal trauma is a complication that can lead to septal abscess if unrecognized or early intervention is not performed. It can cause compression and thereby necrosis that evolve to a septal abscess in which cultures reveal saprophyte bacteria. Cartilage necrosis and destruction can produce impaired breathing and aesthetic deformities with collapse of the dorsum and the tip of the nose. We present a 10 year old masculine infant, that suffered a nasal fracture with a septal haematoma that remained undiagnosed. The patient developed a septal abscess that required drainage and resulted in nasal sequelae with collapse of dorsum and cranial displacement of tip and columella. Functional and aesthetic reconstruction was performed using rib cartilage grafts. No complications occurred. Functional and aesthetic improvement was observed. Result after 2 months of follow-up is considered favourable.

  20. Nasal Anatomy

    MedlinePlus

    ... Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult ... Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure Statement Printer Friendly ...

  1. Hand-Held Tidal Breathing Nasal Nitric Oxide Measurement – A Promising Targeted Case-Finding Tool for the Diagnosis of Primary Ciliary Dyskinesia

    PubMed Central

    Marthin, June Kehlet; Nielsen, Kim Gjerum

    2013-01-01

    Background Nasal nitric oxide (nNO) measurement is an established first line test in the work-up for primary ciliary dyskinesia (PCD). Tidal breathing nNO (TB-nNO) measurements require minimal cooperation and are potentially useful even in young children. Hand-held NO devices are becoming increasingly widespread for asthma management. Therefore, we chose to assess whether hand-held TB-nNO measurements reliably discriminate between PCD, and Healthy Subjects (HS) and included Cystic Fibrosis (CF) patients as a disease control group known to have intermediate nNO levels. Methods In this cross sectional, single centre, single occasion, proof-of-concept study in children and adults with PCD and CF, and in HS we compared feasibility, success rates, discriminatory capacity, repeatability and agreement between a hand-held electrochemical device equipped with a nNO software application sampling at flow rates 2 ml/s or 5 ml/s, and two stationary chemiluminescence devices, applying both tidal breathing and velum closure techniques. Results Measurements were done in 16 PCD patients, 21 patients with CF and 20 HS aged between 3.8 and 60.9 years. Hand-held TB-nNO showed high success rate (96.5–100%) vs. velum closure nNO techniques (70.2–89.5%). Hand-held TB-nNO sampling at flow rate 5 ml/s showed equally high discriminative power (PCD vs. HS [p<0.0001] and PCD vs. CF [p<0.0001]) and reaching close to 100% sensitivity and specificity, superior repeatability (CV% = 10%) and equal limits of agreement compared to TB-nNO by stationary devices and even compared to velum closure sampling. Conclusion Hand-held TB-nNO discriminates significantly between PCD, CF and HS and shows promising potential as a widespread targeted case-finding tool for PCD, although further studies are warranted before implementation. PMID:23437356

  2. Clinical estimation of mouth breathing.

    PubMed

    Fujimoto, Sachiko; Yamaguchi, Kazunori; Gunjigake, Kaori

    2009-11-01

    Breathing mode was objectively determined by monitoring airflow through the mouth, measuring nasal resistance and lip-seal function, and collecting information via questionnaire on the patient's etiology and symptoms of mouth breathing. The expiratory airflow through the mouth was detected with a carbon dioxide sensor for 30 minutes at rest. Fifteen men and 19 women volunteers (mean age, 22.4 +/- 2.5 years) were classified as nasal breathers, complete mouth breathers, or partial mouth breathers based on the mean duration of mouth breathing. Nasal resistance, lip-sealing function, and the subjective symptoms of mouth breathing ascertained by questionnaire were statistically compared by using 1-way and 2-way analysis of variance (ANOVA) and the chi-square test in the breathing groups. Nasal resistance was significantly (P <0.05) greater for the mouth breathers than for the nasal breathers, and significantly (P <0.05) greater for the partial mouth breathers than for the complete mouth breathers. There were no significant differences in the subjective responses to questions about mouth breathing among the 3 groups. Detecting airflow by carbon dioxide sensor can discriminate breathing mode. Degree of nasal resistance and subjective symptoms of mouth breathing do not accurately predict breathing mode.

  3. Are Nocturnal Breathing, Sleep, and Cognitive Performance Impaired at Moderate Altitude (1,630-2,590 m)?

    PubMed Central

    Latshang, Tsogyal D.; Lo Cascio, Christian M.; Stöwhas, Anne-Christin; Grimm, Mirjam; Stadelmann, Katrin; Tesler, Noemi; Achermann, Peter; Huber, Reto; Kohler, Malcolm; Bloch, Konrad E.

    2013-01-01

    Study Objectives: Newcomers at high altitude (> 3,000 m) experience periodic breathing, sleep disturbances, and impaired cognitive performance. Whether similar adverse effects occur at lower elevations is uncertain, although numerous lowlanders travel to moderate altitude for professional or recreational activities. We evaluated the hypothesis that nocturnal breathing, sleep, and cognitive performance of lowlanders are impaired at moderate altitude. Design: Randomized crossover trial. Setting: University hospital at 490 m, Swiss mountain villages at 1,630 m and 2,590 m. Participants: Fifty-one healthy men, median (quartiles) age 24 y (20-28 y), living below 800 m. Interventions: Studies at Zurich (490 m) and during 4 consecutive days at 1,630 m and 2,590 m, respectively, 2 days each. The order of altitude exposure was randomized. Polysomnography, psychomotor vigilance tests (PVT), the number back test, several other tests of cognitive performance, and questionnaires were evaluated. Measurements and Results: The median (quartiles) apnea-hypopnea index at 490 m was 4.6/h (2.3; 7.9), values at 1,630 and 2,590 m, day 1 and 2, respectively, were 7.0/h (4.1; 12.6), 5.4/h (3.5; 10.5), 13.1/h (6.7; 32.1), and 8.0/h (4.4; 23.1); corresponding values of mean nocturnal oxygen saturation were 96% (95; 96), 94% (93; 95), 94% (93; 95), 90% (89; 91), 91% (90; 92), P < 0.05 versus 490 m, all instances. Slow wave sleep on the first night at 2,590 m was 21% (18; 25) versus 24% (20; 27) at 490 m (P < 0.05). Psychomotor vigilance and various other measures of cognitive performance did not change significantly. Conclusions: Healthy men acutely exposed during 4 days to hypoxemia at 1,630 m and 2,590 m reveal a considerable amount of periodic breathing and sleep disturbances. However, no significant effects on psychomotor reaction speed or cognitive performance were observed. Clinical Trials Registration: Clinicaltrials.gov: NCT01130948. Citation: Latshang TD; Lo Cascio CM; Stöwhas AC

  4. The impact of later trading hours for hotels on levels of impaired driver road crashes and driver breath alcohol levels.

    PubMed

    Chikritzhs, Tanya; Stockwell, Tim

    2006-09-01

    To examine the impact of later trading hours for licensed hotels in Perth, Western Australia on levels of associated impaired driver road crashes and driver breath alcohol levels (BALs). Police data on the "last place of drinking" for impaired drivers involved in road crashes and their corresponding BALs were examined to identify those associated with Perth hotels between 1 July 1990 and 30 June 1997. During this period, 43 (23%) of the 186 hotels meeting study criteria were granted an Extended Trading Permit for 1 a.m. closing (ETP hotels), while the rest continued to close at midnight (non-ETP hotels). Time-series analyses employing multiple linear regressions were applied to determine whether an association existed between the introduction of extended trading and (i) monthly levels of impaired driver road crashes associated with ETP hotels and (ii) driver BALs associated with ETP hotels. Trends associated with non-ETP hotels were included as controls and possible confounders were considered. After controlling for the trend in crash rates associated with non-ETP hotels and the introduction of mobile police breath testing stations to Perth freeways, a significant increase in monthly crash rates for ETP hotels was found. This relationship was largely accounted for by higher volumes of high-alcohol content beer, wine and spirits purchased by ETP hotels. No relation was found between driver BALs and the introduction of ETPs. Late trading was associated with increased levels of impaired driver road crashes and alcohol consumption, particularly high-risk alcoholic beverages. Greater numbers of patrons and characteristics specific to clientele of hotels which applied for late trading hours (i.e. younger age, greater propensity to drunk-drive, preference for high-risk beverages) were suggested as having contributed to this increase.

  5. The effect of nasal tramazoline with dexamethasone in obstructive sleep apnoea patients.

    PubMed

    Koutsourelakis, Ioannis; Minaritzoglou, Aliki; Zakynthinos, Georgios; Vagiakis, Emmanouil; Zakynthinos, Spyros

    2013-10-01

    Although there is a strong correlation between oral/oro-nasal breathing and apnoea/hypopnoea index in patients with obstructive sleep apnoea and normal nasal resistance at wakefulness, it remains unknown whether the pharmacological prevention of potential nasal obstruction during sleep could decrease oral/oro-nasal breathing and increase nasal breathing and subsequently decrease the apnoea/hypopnoea index. This study evaluated the effect of a combination of a nasal decongestant with corticosteroid on breathing route pattern and apnoea/hypopnoea index. 21 patients with obstructive sleep apnoea (mean apnoea/hypopnoea index 31.1 events per hour) and normal nasal resistance at wakefulness were enrolled in a randomised crossover trial of 1 weeks' treatment with nasal tramazoline and dexamethasone compared with 1 weeks' treatment with nasal placebo. At the start and end of each treatment period, patients underwent nasal resistance measurement and overnight polysomnography with attendant measurement of breathing route pattern. Nasal tramazoline with dexamethasone was associated with decrease in oral/oro-nasal breathing epochs and concomitant increase in nasal breathing epochs, and mean decrease of apnoea/hypopnoea index by 21%. The change in nasal breathing epochs was inversely related to the change in apnoea/hypopnoea index (Rs=0.78; p<0.001). In conclusion, nasal tramazoline with dexamethasone in OSA patients with normal nasal resistance at wakefulness can restore the preponderance of nasal breathing epochs and modestly improve apnoea/hypopnoea index.

  6. Intranasal trigeminal sensitivity: measurements before and after nasal surgery.

    PubMed

    Scheibe, M; Schulze, S; Mueller, C A; Schuster, B; Hummel, Thomas

    2014-01-01

    Nasal surgeries constitute an extensive manipulation of the nasal mucosa and therefore of structures related to trigeminal and olfactory sensitivity. While olfactory changes due to nasal surgery are relatively well investigated, there are only very few studies regarding trigeminal sensitivity. Aim of the present study was to investigate sensory changes after nasal surgery with special regard to the trigeminal sensitivity. In 38 patients prior to and around 12 weeks after nasal surgery the following psychophysical measures were performed: odor identification, odor discrimination, phenyl ethyl alcohol odor threshold, sensitivity to trigeminal stimuli, trigeminal detection thresholds and trigeminal pain thresholds. These results were compared to those of a control group (43 healthy volunteers). Psychophysical olfactory and trigeminal testing showed no major changes in patients after surgery compared to the control group. Independent from the time of measurement higher trigeminal detection thresholds were found in patients compared to healthy subjects, meaning that trigeminal thresholds were already increased before surgery. The present study revealed a decreased trigeminal sensitivity in patients already before surgery. It may be hypothesized that patients also exhibit a decreased sensitivity for nasal airflow, which may also contribute to the patients' impression of impaired nasal breathing.

  7. The impact of later trading hours for hotels (public houses) on breath alcohol levels of apprehended impaired drivers.

    PubMed

    Chikritzhs, Tanya; Stockwell, Tim

    2007-10-01

    To examine the impact of extended trading permits (ETPs) for licensed hotels in Perth, Western Australia on impaired driver breath alcohol levels (BALs) between July 1993 and June 1997. Forty-three hotels obtained ETPs allowing later closing hours and 130 maintained standard closing time (controls). Impaired driver BALs were linked to 'last place of drinking' hotels. Before and after period BALs of drivers who last drank at ETP or non-ETP hotels were compared by time of day of apprehension and sex, controlling for age. Impaired female drivers apprehended between 10.01 p.m. and 12 midnight (before closing time) had significantly lower BALs after drinking at ETP hotels. Male drivers aged 18-25 years and apprehended between 12.01 and 2.00 a.m. after drinking at ETP hotels had significantly higher BALs than drivers who drank at non-ETP hotels. At peak times for alcohol-related offences, late trading is associated with higher BALs among those drinkers most at risk of alcohol-related harm.

  8. Visual exploration of nasal airflow.

    PubMed

    Zachow, Stefan; Muigg, Philipp; Hildebrandt, Thomas; Doleisch, Helmut; Hege, Hans-Christian

    2009-01-01

    Rhinologists are often faced with the challenge of assessing nasal breathing from a functional point of view to derive effective therapeutic interventions. While the complex nasal anatomy can be revealed by visual inspection and medical imaging, only vague information is available regarding the nasal airflow itself: Rhinomanometry delivers rather unspecific integral information on the pressure gradient as well as on total flow and nasal flow resistance. In this article we demonstrate how the understanding of physiological nasal breathing can be improved by simulating and visually analyzing nasal airflow, based on an anatomically correct model of the upper human respiratory tract. In particular we demonstrate how various Information Visualization (InfoVis) techniques, such as a highly scalable implementation of parallel coordinates, time series visualizations, as well as unstructured grid multi-volume rendering, all integrated within a multiple linked views framework, can be utilized to gain a deeper understanding of nasal breathing. Evaluation is accomplished by visual exploration of spatio-temporal airflow characteristics that include not only information on flow features but also on accompanying quantities such as temperature and humidity. To our knowledge, this is the first in-depth visual exploration of the physiological function of the nose over several simulated breathing cycles under consideration of a complete model of the nasal airways, realistic boundary conditions, and all physically relevant time-varying quantities.

  9. Nasal polyps

    MedlinePlus

    ... get rid of nasal polyps. Nasal steroid sprays shrink polyps. They help clear blocked nasal passages and ... is stopped. Corticosteroid pills or liquid may also shrink polyps, and can reduce swelling and nasal congestion. ...

  10. Masticatory Changes in Oral Breath Secondary to Allergic Rhinitis: Integrative Review

    PubMed Central

    Bezerra, Luciana Ângelo; Silva, Hilton Justino da; Melo, Ana Carolina Cardoso de; Moraes, Klyvia Juliana Rocha de; Cunha, Renata Andrade da; Cunha, Daniele Andrade da; Medeiros, Décio

    2013-01-01

    Introduction The III Brazilian Consensus on Rhinitis (2012) defines allergic rhinitis as a nasal mucosa inflammation, mediated by immunoglobulin E, after exposure to allergens. The classic signs and symptoms of allergic rhinitis are nasal obstruction, watery rhinorrhea, sneezing, and nasal itching, often reversible either spontaneously or with treatment, and mouth breathing (breathing predominantly through the mouth, regardless of the cause, due to a nasal breathing impairment) in some cases. Objective To evaluate the literature on masticatory changes in children with mouth breathing due to allergic rhinitis. Methods We conducted a search of the past 10 years, at Bireme and MEDLINE databases, for articles that covered masticatory changes in children with mouth breathing secondary to allergic rhinitis. Results We found 1,986 articles, including 15 repeated in databases, but only two articles met the inclusion criteria fully. Discussion We found few studies to answer the question raised in this review, and those studies have some methodological limitations. Most articles claimed no have statistically significant differences in masticatory changes in this population. Conclusion A better controlled study (isolating diseases, exposure time), with a larger sample (sample calculation appropriate), would be necessary to examine such changes. PMID:25992077

  11. Masticatory changes in oral breath secondary to allergic rhinitis: integrative review.

    PubMed

    Bezerra, Luciana Ângelo; Silva, Hilton Justino da; Melo, Ana Carolina Cardoso de; Moraes, Klyvia Juliana Rocha de; Cunha, Renata Andrade da; Cunha, Daniele Andrade da; Medeiros, Décio

    2014-04-01

    Introduction The III Brazilian Consensus on Rhinitis (2012) defines allergic rhinitis as a nasal mucosa inflammation, mediated by immunoglobulin E, after exposure to allergens. The classic signs and symptoms of allergic rhinitis are nasal obstruction, watery rhinorrhea, sneezing, and nasal itching, often reversible either spontaneously or with treatment, and mouth breathing (breathing predominantly through the mouth, regardless of the cause, due to a nasal breathing impairment) in some cases. Objective To evaluate the literature on masticatory changes in children with mouth breathing due to allergic rhinitis. Methods We conducted a search of the past 10 years, at Bireme and MEDLINE databases, for articles that covered masticatory changes in children with mouth breathing secondary to allergic rhinitis. Results We found 1,986 articles, including 15 repeated in databases, but only two articles met the inclusion criteria fully. Discussion We found few studies to answer the question raised in this review, and those studies have some methodological limitations. Most articles claimed no have statistically significant differences in masticatory changes in this population. Conclusion A better controlled study (isolating diseases, exposure time), with a larger sample (sample calculation appropriate), would be necessary to examine such changes.

  12. Taste - impaired

    MedlinePlus

    ... longer. Causes of impaired taste include: Bell's palsy Common cold Flu and other viral infections Nasal infection, nasal ... your diet. For taste problems due to the common cold or flu, normal taste should return when the ...

  13. Assessment of olfactory nerve by SPECT-MRI image with nasal thallium-201 administration in patients with olfactory impairments in comparison to healthy volunteers.

    PubMed

    Shiga, Hideaki; Taki, Junichi; Washiyama, Kohshin; Yamamoto, Junpei; Kinase, Sakae; Okuda, Koichi; Kinuya, Seigo; Watanabe, Naoto; Tonami, Hisao; Koshida, Kichiro; Amano, Ryohei; Furukawa, Mitsuru; Miwa, Takaki

    2013-01-01

    The aim of this study was to assess whether migration of thallium-201 ((201)Tl) to the olfactory bulb were reduced in patients with olfactory impairments in comparison to healthy volunteers after nasal administration of (201)Tl. 10 healthy volunteers and 21 patients enrolled in the study (19 males and 12 females; 26-71 years old). The causes of olfactory dysfunction in the patients were head trauma (n = 7), upper respiratory tract infection (n = 7), and chronic rhinosinusitis (n = 7). (201)TlCl was administered unilaterally to the olfactory cleft, and SPECT-CT was conducted 24 h later. Separate MRI images were merged with the SPECT images. (201)Tl olfactory migration was also correlated with the volume of the olfactory bulb determined from MRI images, as well as with odor recognition thresholds measured by using T&T olfactometry. Nasal (201)Tl migration to the olfactory bulb was significantly lower in the olfactory-impaired patients than in healthy volunteers. The migration of (201)Tl to the olfactory bulb was significantly correlated with odor recognition thresholds obtained with T&T olfactometry and correlated with the volume of the olfactory bulb determined from MRI images when all subjects were included. Assessment of the (201)Tl migration to the olfactory bulb was the new method for the evaluation of the olfactory nerve connectivity in patients with impaired olfaction.

  14. Different aspects of respiration: relationships between the upper and lower respiratory tracts, and the middle ear cleft, nasal versus oral breathing.

    PubMed

    Collet, S; Vande Vannet, B; Watelet, J B; Gordts, F

    2012-01-01

    This paper outlines the normal functioning of the child's upper airway: defending the lower airway by means of air conditioning, filtration, initiation of inflammatory reactions or immune responses. We investigate the hypothetical mechanisms that explain the influence of, and interrelations between, mouth breathing and obstructive sleep apnoea on craniofacial development. We advise orthodontic diagnosis and/or intervention at a young age.

  15. Nasal airflow during respiratory cycle.

    PubMed

    Chung, Seung-Kyu; Son, Young Rak; Shin, Seok Jae; Kim, Sung-Kyun

    2006-01-01

    Knowledge on the airflow patterns in the nasal cavity is essential to understanding the function of the nasal cavity. This study has attempted to observe the breath cycle of nasal airflow during respiration at rest. We constructed a nasal cavity model by rapid prototyping using 1.25-mm-thick CT data and devised a piston pump driven by a cam, to simulate respiration at rest. The airflow was evaluated with particle image velocimetry and visualized in coronal reconstructed images. During the inspiration, a maximal velocity was observed at the valve area and the main stream occurred in the middle and superior airways. During the expiration, main stream was noted in the middle airway and was slow compared with the flow during inspiration. Vortexes were observed between inspiration and expiration. This result widens our knowledge of nasal airflow and this technique will allow a more physiological understanding of nasal operations.

  16. Nasal steroids in snorers can decrease snoring frequency: a randomized placebo-controlled crossover trial.

    PubMed

    Koutsourelakis, Ioannis; Keliris, Anastasios; Minaritzoglou, Aliki; Zakynthinos, Spyros

    2015-04-01

    Although it is anecdotally known that nasal obstruction is associated with snoring, it remains unknown whether the application of nasal steroids could decrease oral/oro-nasal breathing and increase nasal breathing, and subsequently decrease snoring indices. This study evaluated the effect of nasal budesonide on breathing route pattern and snoring. Twenty-four snorers were enrolled in a randomized, double-blind, crossover trial of 1-week treatment with nasal budesonide compared with 1-week intervention with nasal placebo. At the start and end of each treatment period, patients underwent nasal resistance measurement and overnight polysomnography with concomitant measurement of breathing route pattern and snoring. Twelve patients were randomly assigned to a 1-week treatment with nasal budesonide, followed by 2-week washout period and a 1-week intervention with the nasal placebo; and 12 patients were randomly assigned to a 1-week intervention with nasal placebo, followed by 2-week washout period and a 1-week treatment with nasal budesonide. Nasal budesonide was associated with a decrease in oral/oro-nasal breathing epochs and concomitant increase in nasal breathing epochs, decrease of snoring frequency by [median (interquartile range)] 15.8% (11.2-18.8%), and an increase of rapid eye movement sleep; snoring intensity decreased only in patients with increased baseline nasal resistance by 10.6% (6.8-14.3%). The change in nasal breathing epochs was inversely related to the change in snoring frequency (Rs = 0.503; P < 0.001). Nasal budesonide in snorers can increase nasal breathing epochs, modestly decrease snoring frequency and increase rapid eye movement sleep. © 2014 European Sleep Research Society.

  17. Association of Sleep-Disordered Breathing With Cognitive Function and Risk of Cognitive Impairment: A Systematic Review and Meta-analysis.

    PubMed

    Leng, Yue; McEvoy, Claire T; Allen, Isabel E; Yaffe, Kristine

    2017-10-01

    Growing evidence suggests an association between sleep-disordered breathing (SDB) and cognitive decline in elderly persons. However, results from population-based studies have been conflicting, possibly owing to different methods to assess SDB or cognitive domains, making it difficult to draw conclusions on this association. To provide a quantitative synthesis of population-based studies on the relationship between SDB and risk of cognitive impairment. PubMed, EMBASE, and PsychINFO were systematically searched to identify peer-reviewed articles published in English before January 2017 that reported on the association between SDB and cognitive function. We included cross-sectional and prospective studies with at least 200 participants with a mean participant age of 40 years or older. Data were extracted independently by 2 investigators. We extracted and pooled adjusted risk ratios from prospective studies and standard mean differences from cross-sectional studies, using random-effect models. This meta-analysis followed the PRISMA guidelines and also adhered to the MOOSE guidelines. Cognitive outcomes were based on standard tests or diagnosis of cognitive impairment. Sleep-disordered breathing was ascertained by apnea-hypopnea index or clinical diagnosis. We included 14 studies, 6 of which were prospective, covering a total of 4 288 419 men and women. Pooled analysis of the 6 prospective studies indicated that those with SDB were 26% (risk ratio, 1.26; 95% CI, 1.05-1.50) more likely to develop cognitive impairment, with no evidence of publication bias but significant heterogeneity between studies. After removing 1 study that introduced significant heterogeneity, the pooled risk ratio was 1.35 (95% CI, 1.11-1.65). Pooled analysis of the 7 cross-sectional studies suggested that those with SDB had slightly worse executive function (standard mean difference, -0.05; 95% CI, -0.09 to 0.00), with no evidence of heterogeneity or publication bias. Sleep

  18. Factors related to quality of life and satisfaction with nasal appearance in patients treated for unilateral cleft lip and palate.

    PubMed

    Mani, Maria; Reiser, Erika; Andlin-Sobocki, Anna; Skoog, Valdemer; Holmström, Mats

    2013-07-01

    Objective : To identify factors related to quality of life (QoL) and satisfaction with nasal appearance among patients treated for unilateral cleft lip and palate (UCLP). Design : Cross-sectional population study with long-term follow-up. Patients/Settings : All patients with UCLP born between 1960 and 1987, treated at Uppsala University Hospital, were invited (n  =  109); 86 (79%) participated. Mean follow-up time was 35 years. Main Outcome Measures : Quality of life was measured with Short Form-36 (SF-36) and analyzed using mental and physical cluster scores (MCS and PCS). Nasal appearance was self-assessed with the "Satisfaction With Appearance" questionnaire and by panel judgment. Multivariate regression analyses explored endogenous factors (age, gender, infancy cleft width, nasal function, nasolabial appearance) and exogenous factors (marital status, number of children, education level, operation method, number of rhinoplasties performed). Results : A larger cleft width in infancy was associated with less satisfaction with nasal appearance as adults. A lower mental health QoL was associated with less satisfaction with nasal appearance. Despite female gender being linked to less satisfaction with nasal appearance, it was associated with higher mental health QoL. Higher resistance during nasal breathing was associated with lower physical health QoL. Conclusions : Gender and infant cleft width may affect QoL and satisfaction with nasal appearance among adults. They are potential predictive factors for satisfaction with nasal appearance and QoL during adulthood. The correlation of nasal function impairment and decreased physical health QoL underlines the importance of treatment of nasal symptoms in these patients.

  19. Decreased chewing activity during mouth breathing.

    PubMed

    Hsu, H-Y; Yamaguchi, K

    2012-08-01

    This study examined the effect of mouth breathing on the strength and duration of vertical effect on the posterior teeth using related functional parameters during 3 min of gum chewing in 39 nasal breathers. A CO(2) sensor was placed over the mouth to detect expiratory airflow. When no airflow was detected from the mouth throughout the recording period, the subject was considered a nasal breather and enrolled in the study. Electromyographic (EMG) activity was recorded during 3 min of gum chewing. The protocol was repeated with the nostrils occluded. The strength of the vertical effect was obtained as integrated masseter muscle EMG activity, and the duration of vertical effect was also obtained as chewing stroke count, chewing cycle variation and EMG activity duration above baseline. Baseline activity was obtained from the isotonic EMG activity during jaw movement at 1.6 Hz without making tooth contact. The duration represented the percentage of the active period above baseline relative to the 3-min chewing period. Paired t-test and repeated analysis of variance were used to compare variables between nasal and mouth breathing. The integrated EMG activity and the duration of EMG activity above baseline, chewing stroke count and chewing cycle significantly decreased during mouth breathing compared with nasal breathing (P<0.05). Chewing cycle variance during mouth breathing was significantly greater than nasal breathing (P<0.05). Mouth breathing reduces the vertical effect on the posterior teeth, which can affect the vertical position of posterior teeth negatively, leading to malocclusion.

  20. Post Septorhinoplasty Custom-Made Unilateral Nasal Stent for Nasal Cleft Deformity

    PubMed Central

    Rathee, Manu; Bhoria, Mohaneesh; Boora, Priyanka

    2015-01-01

    Context: Nasal cleft deformity is a complicated problem. Utilization of nasal stent in post septorhinoplastyaims at establishing and maintaining airway patency, tissue position, and reduces tissue contracture after surgery. Case Report: A 16-year-old female patient presented with history of surgical reconstruction of congenital cleft lip and cleft palate with secondary septorhinoplasty of nasal cleft deformity. Patient was referred for nasal stent 1 week after septorhinoplasty. This case report provides a novel technique for fabrication of esthetic nasal stent after postseptorhinoplasty for secondary cleft nose deformity correction. Conclusion: This case report presents a simple, convenient technique for nasal stent fabrication for prevention of restenosis for cleft nose deformity post secondary septorhinoplasty. Provision of nasal stent allows breathing, maintains esthetics, comfort, nasal patency, and contour with minimal discomfort. PMID:25789253

  1. Bad Breath

    MedlinePlus

    ... Emergency Room? What Happens in the Operating Room? Bad Breath KidsHealth > For Kids > Bad Breath A A ... visit your dentist or doctor . continue What Causes Bad Breath? Here are three common causes of bad ...

  2. Nasal airway and septal variation in unilateral and bilateral cleft lip and palate.

    PubMed

    Starbuck, John M; Friel, Michael T; Ghoneima, Ahmed; Flores, Roberto L; Tholpady, Sunil; Kula, Katherine

    2014-10-01

    Cleft lip and palate (CLP) affects the dentoalveolar and nasolabial facial regions. Internal and external nasal dysmorphology may persist in individuals born with CLP despite surgical interventions. 7-18 year old individuals born with unilateral and bilateral CLP (n = 50) were retrospectively assessed using cone beam computed tomography. Anterior, middle, and posterior nasal airway volumes were measured on each facial side. Septal deviation was measured at the anterior and posterior nasal spine, and the midpoint between these two locations. Data were evaluated using principal components analysis (PCA), multivariate analysis of variance (MANOVA), and post-hoc ANOVA tests. PCA results show partial separation in high dimensional space along PC1 (48.5% variance) based on age groups and partial separation along PC2 (29.8% variance) based on CLP type and septal deviation patterns. MANOVA results indicate that age (P = 0.007) and CLP type (P ≤ 0.001) significantly affect nasal airway volume and septal deviation. ANOVA results indicate that anterior nasal volume is significantly affected by age (P ≤ 0.001), whereas septal deviation patterns are significantly affected by CLP type (P ≤ 0.001). Age and CLP type affect nasal airway volume and septal deviation patterns. Nasal airway volumes tend to be reduced on the clefted sides of the face relative to non-clefted sides of the face. Nasal airway volumes tend to strongly increase with age, whereas septal deviation values tend to increase only slightly with age. These results suggest that functional nasal breathing may be impaired in individuals born with the unilateral and bilateral CLP deformity.

  3. Respiratory mode, nasal patency and palatine dimensions.

    PubMed

    Trevisan, Maria Elaine; Bellinaso, José Humberto; Pacheco, Andrielle de Bitencourt; Augé, Luciana Barros; Silva, Ana Maria Toniolo da; Corrêa, Eliane Castilhos Rodrigues

    2015-01-01

    To investigate the influence of breathing mode and nasal patency in the dimensions of the hard palate by comparing mouth breathing (MB) and nasal breathing (NB) adults. Seventy-seven individuals, distributed into the MB group (n=38) and the NB group (n=39), of both genders and aged between 18 and 30 years old, took part in the study. The respiratory mode diagnosis was based on anamnesis, physical characteristics, and otorhinolaryngological examination. The volunteers were evaluated in terms of nasal patency, with a peak nasal inspiratory flow (PNIF) meter, and obstruction symptoms, by a Nasal Obstruction Symptom Evaluation (NOSE) scale, and had their transversal and vertical hard palate dimensions measured with a digital caliper in plaster models. Comparing both groups, the MB group presented significantly higher values in the NOSE scale, lower values in the PNIF, lower values in the transversal distance of the palate in the intercanine region, and significantly higher values in the vertical distance in the regions of the first and second premolars and molars. There was a negative correlation between PNIF and NOSE, and a positive correlation between PNIF and transversal distance of the palate in the region of the first premolars. MB adults presented reduced nasal patency and a higher degree of nasal obstruction symptoms. The hard palate was morphologically narrower and deeper in adults with the MB mode compared to the NB mode. Moreover, it was concluded that the smaller the nasal patency, the greater the obstruction symptoms and the narrower the hard palate.

  4. Pathophysiology of nasal congestion

    PubMed Central

    Naclerio, Robert M; Bachert, Claus; Baraniuk, James N

    2010-01-01

    Nasal congestion is a common symptom in rhinitis (both allergic and nonallergic), rhinosinusitis and nasal polyposis. Congestion can also be caused by physical obstruction of nasal passages and/or modulation of sensory perception. Mucosal inflammation underlies many of the specific and interrelated factors that contribute to nasal congestion, as well as other symptoms of both allergic rhinitis and rhinosinusitis. A wide range of biologically active agents (eg, histamine, tumor necrosis factor-α, interleukins, cell adhesion molecules) and cell types contribute to inflammation, which can manifest as venous engorgement, increased nasal secretions and tissue swelling/edema, ultimately leading to impaired airflow and the sensation of nasal congestion. Inflammation-induced changes in the properties of sensory afferents (eg, expression of peptides and receptors) that innervate the nose can also contribute to altered sensory perception, which may result in a subjective feeling of congestion. Increased understanding of the mechanisms underlying inflammation can facilitate improved treatment selection and the development of new therapies for congestion. PMID:20463823

  5. Impact of airflow communication between nasal cavities on nasal ventilation.

    PubMed

    Zhou, Bing; Huang, Qian; Cui, Shunjiu; Liu, Yingxi; Han, Demin

    2013-01-01

    To investigate the impact of airflow communication between bilateral nostril sides on nasal ventilation. In addition, we try to validate the efficacy of the Draf III procedure from the aerodynamics perspective. One health model and two disease models were constructed. These included 2 patients with nasal septum perforation and 1 patient who received the Draf III procedure. With the computational fluid dynamics method, indices such as airflow velocity and wall shear stress in the nasal cavity were detected and compared among the 3 subjects. The main pathway for airflow in the nasal cavity is the common meatus. Little airflow exchange occurred in the patient who underwent the Draf III procedure, and the wall shear stress around the communication site was as low as in the adjacent areas. However, when airflow communication occurred in the lower part of the nasal cavity, the airflow velocity and wall shear stress were obviously altered, and the ventilation function of the nasal cavity was impaired. Airflow communication in the upper part of the nasal cavity has little impact on nasal ventilation. Nonetheless, airflow communication occurring in the lower part of the nasal cavity disturbs the overall airflow distribution and a repair procedure is necessary. © 2013 S. Karger AG, Basel.

  6. Human respiratory deposition of particles during oronasal breathing

    NASA Astrophysics Data System (ADS)

    Swift, David L.; Proctor, Donald F.

    Deposition of particles in the tracheobronchial and pulmonary airways is computed as a function of particle size, correcting for deposition in the parallel nasal and oral airways with oronasal breathing. Thoracic deposition is lower at all sizes for oronasal breathing than for mouth breathing via tube, and is negligible for aerodynamic equivalent diameters of 10 μm or larger.

  7. Effects of nasal pathologies on obstructive sleep apnea.

    PubMed

    Enoz, Murat

    2007-01-01

    Increased airway resistance can induce snoring and sleep apnea, and nasal obstruction is a common problem in snoring and obstructive sleep apnea (OSA) patients. Many snoring and OSA patients breathe via the mouth during sleep. Mouth breathing may contribute to increased collapsibility of the upper airways due to decreased contractile efficiency of the upper airway muscles as a result of mouth opening. Increased nasal airway resistance produces turbulent flow in the nasal cavity, induces oral breathing, promotes oscillation of the pharyngeal airway and can cause snoring.

  8. Air-conditioning in the human nasal cavity.

    PubMed

    Elad, David; Wolf, Michael; Keck, Tilman

    2008-11-30

    Healthy humans normally breathe through their nose even though its complex geometry imposes a significantly higher resistance in comparison with mouth breathing. The major functional roles of nasal breathing are defense against infiltrating particles and conditioning of the inspired air to nearly alveolar conditions in order to maintain the internal milieu of the lung. The state-of-the-art of the existing knowledge on nasal air-conditioning will be discussed in this review, including in vivo measurements in humans and computational studies on nasal air-conditioning capacity. Areas where further studies will improve our understanding and may help medical diagnosis and intervention in pathological states will be introduced.

  9. Nasal polyposis

    PubMed Central

    Brown, Gerald A.

    1969-01-01

    A review of 313 cases of nasal polyposis indicates that there is a high incidence of recurrence in this disease. Other nasal pathology affects a significant number of these patients. Simple surgical removal of the polypi by a transnasal route is the common mode of treatment. PMID:4187956

  10. Pediatric sleep-disordered breathing: New evidence on its development.

    PubMed

    Guilleminault, Christian; Akhtar, Farah

    2015-12-01

    Sleep-disordered breathing (SDB) in children could be resolved by adenotonsillectomy (T&A). However, incomplete results are often noted post-surgery. Because of this partial resolution, long-term follow-up is needed to monitor for reoccurrence of SDB, which may be diagnosed years later through reoccurrence of complaints or in some cases, through systematic investigations. Children undergoing T&A often have small upper airways. Genetics play a role in the fetal development of the skull, the skull base, and subsequently, the size of the upper airway. In non-syndromic children, specific genetic mutations are often unrecognized early in life and affect the craniofacial growth, altering functions such as suction, mastication, swallowing, and nasal breathing. These developmental and functional changes are associated with the development of SDB. Children without genetic mutations but with impairment of the above said functions also develop SDB. When applied early in life, techniques involved in the reeducation of these functions, such as myofunctional therapy, alter the craniofacial growth and the associated SDB. This occurs as a result of the continuous interaction between cartilages, bones and muscles involved in the growth of the base of the skull and the face. Recently collected data show the impact of the early changes in craniofacial growth patterns and how these changes lead to an impairment of the developmental functions and consequent persistence of SDB. The presence of nasal disuse and mouth breathing are abnormal functions that are easily amenable to treatment. Understanding the dynamics leading to the development of SDB and recognizing factors affecting the craniofacial growth and the resulting functional impairments, allows appropriate treatment planning which may or may not include T&A. Enlargement of lymphoid tissue may actually be a consequence as opposed to a cause of these initial dysfunctions.

  11. Early Onset of Efficacy and Consistency of Response Across Multiple Migraine Attacks From the Randomized COMPASS Study: AVP-825 Breath Powered(®) Exhalation Delivery System (Sumatriptan Nasal Powder) vs Oral Sumatriptan.

    PubMed

    Silberstein, Stephen; Winner, Paul K; McAllister, Peter J; Tepper, Stewart J; Halker, Rashmi; Mahmoud, Ramy A; Siffert, Joao

    2017-06-01

    To further characterize the clinical utility of AVP-825 based on additional prespecified outcomes and post hoc analyses of COMPASS, a Phase 3 comparative efficacy trial of AVP-825 vs 100 mg oral sumatriptan (NCT01667679). AVP-825 was approved in January 2016 by the US Food and Drug Administration under the name ONZETRA(®) Xsail(®) (sumatriptan nasal powder) for the acute treatment of migraine with or without aura in adults. AVP-825 is a delivery system that uses a patient's own breath to deliver low-dose sumatriptan powder to the upper posterior regions of the nasal cavity beyond the narrow nasal valve, areas lined with vascular mucosa conducive to rapid drug absorption into the systemic circulation. The recommended dose of AVP-825 is 22 mg sumatriptan powder administered as one 11 mg nosepiece in each nostril, which delivers approximately 15-16 mg of sumatriptan intranasally. The COMPASS trial compared AVP-825 22-100 mg oral sumatriptan across multiple migraine attacks for efficacy, safety, and tolerability endpoints. COMPASS was a randomized, multicenter, double-dummy, crossover, multiattack, comparative efficacy study with two 12-week double-blind periods. Patients with 2-8 migraine attacks/month were randomized 1:1 to AVP-825 (22 mg) plus oral placebo or an identical placebo delivery system plus 100 mg oral sumatriptan for the first period, and then patients switched treatments for the second period. Patients treated up to 5 qualifying migraines per period within 1 h of onset, even if the intensity of the attack was mild. Results from the primary endpoint (SPID-30, defined as the sum of pain intensity differences from dosing to 30 minutes), key secondary efficacy endpoints and safety assessments have been reported in the primary publication (Tepper et al., 2015). This article reports additional prespecified outcomes, including the SPID-30 for attacks treated when baseline severity was mild vs moderate/severe, measures of sustained response and consistency of

  12. Objective Measure of Nasal Air Emission Using Nasal Accelerometry.

    PubMed

    Cler, Meredith J; Lien, Yu-An S; Braden, Maia N; Mittelman, Talia; Downing, Kerri; Stepp, Cara E

    2016-10-01

    This article describes the development and initial validation of an objective measure of nasal air emission (NAE) using nasal accelerometry. Nasal acceleration and nasal airflow signals were simultaneously recorded while an expert speech language pathologist modeled NAEs at a variety of severity levels. In addition, microphone and nasal accelerometer signals were collected during the production of /pɑpɑpɑpɑ/ speech utterances by 25 children with and without cleft palate. Fourteen inexperienced raters listened to the microphone signals from the pediatric speakers and rated the samples for the severity of NAE using direct magnitude estimation. Mean listener ratings were compared to a novel quantitative measurement of NAE derived from the nasal acceleration signals. Correlation between the nasal acceleration energy measure and the measured nasal airflow was high (r = .87). Correlation between the measure and auditory-perceptual ratings was moderate (r = .49). The measure presented here is quantitative and noninvasive, and the required hardware is inexpensive ($150). Future studies will include speakers with a wider range of NAE severity and etiology, including cleft palate, hearing impairment, or dysarthria. Further development will also involve validation of the measure against airflow measures across subjects.

  13. Objective Measure of Nasal Air Emission Using Nasal Accelerometry

    PubMed Central

    Cler, Meredith J.; Lien, Yu-An S.; Braden, Maia N.; Mittelman, Talia; Downing, Kerri

    2016-01-01

    Purpose This article describes the development and initial validation of an objective measure of nasal air emission (NAE) using nasal accelerometry. Method Nasal acceleration and nasal airflow signals were simultaneously recorded while an expert speech language pathologist modeled NAEs at a variety of severity levels. In addition, microphone and nasal accelerometer signals were collected during the production of /pɑpɑpɑpɑ/ speech utterances by 25 children with and without cleft palate. Fourteen inexperienced raters listened to the microphone signals from the pediatric speakers and rated the samples for the severity of NAE using direct magnitude estimation. Mean listener ratings were compared to a novel quantitative measurement of NAE derived from the nasal acceleration signals. Results Correlation between the nasal acceleration energy measure and the measured nasal airflow was high (r = .87). Correlation between the measure and auditory-perceptual ratings was moderate (r = .49). Conclusion The measure presented here is quantitative and noninvasive, and the required hardware is inexpensive ($150). Future studies will include speakers with a wider range of NAE severity and etiology, including cleft palate, hearing impairment, or dysarthria. Further development will also involve validation of the measure against airflow measures across subjects. PMID:27618145

  14. Breathing difficulty

    MedlinePlus

    ... pulmonary disease (COPD), such as chronic bronchitis or emphysema Other lung disease Pneumonia Pulmonary hypertension Problems with ... of breath; Breathlessness; Difficulty breathing; Dyspnea Images Lungs Emphysema References Kraft M. Approach to the patient with ...

  15. Breathing Problems

    MedlinePlus

    ... getting enough air. Sometimes you can have mild breathing problems because of a stuffy nose or intense ... panic attacks Allergies If you often have trouble breathing, it is important to find out the cause.

  16. Hypoxia depresses nitric oxide output in the human nasal airways.

    PubMed

    Haight, J S; Qian, W; Daya, H; Chalmers, P; Zamel, N

    2000-03-01

    The role of oxygen in the nasal air on nasal nitric oxide (NO) output was studied in 13 adult volunteers. Nasal NO was measured while air containing oxygen (0%-100% in nitrogen) was aspirated through the nasal airway before and after the topical application of xylometazoline. The mean nasal NO output of the untreated nose was 507.8 +/- 161.9 nL/min (mean +/- SD) when 21% oxygen was aspirated through the nasal cavities in series and remained unaltered by 100% O2 (P = .79). Below 10% oxygen the reduction in nasal NO output correlated positively and significantly with the decrease in oxygen concentration (r2 = 0.14). NO output was 245.2 +/- 153.4 nL/min at 0% oxygen, a significant decline from 21% oxygen (P < .0001). Nasal vasoconstriction induced by xylometazoline and alterations in the blood oxygen content by a maximal breath-holding or breathing 100% oxygen did not alter nasal NO in hypoxia (P = .41). Nasal NO output is markedly depressed in hypoxia and is oxygen dependent at concentrations of less than 10%. Approximately 50% of nasally generated NO is produced from oxygen in nasal air or regulated by it.

  17. Sensing the effects of mouth breathing by using 3-tesla MRI

    NASA Astrophysics Data System (ADS)

    Park, Chan-A.; Kang, Chang-Ki

    2017-06-01

    We investigated the effects of mouth breathing and typical nasal breathing on brain function by using blood-oxygenation-level-dependent (BOLD) functional magnetic resonance imaging (fMRI). The study had two parts: the first test was a simple contrast between mouth and nasal breathing, and the second test involved combined breathing modes, e.g., mouth inspiration and nasal expiration. Eleven healthy participants performed the combined breathing task while undergoing 3T fMRI. In the group-level analysis, contrast images acquired by using an individual participantlevel analysis were processed using the one-sample t test. We also conducted a region-of-interest analysis comparing signal intensity changes between the breathing modes; the region was selected using an automated anatomical labeling map. The results demonstrated that the BOLD signal in the hippocampus and brainstem was significantly decreased in mouth breathing relative to nasal breathing. On the other hand, both the precentral and postcentral gyri showed activation that was more significant in mouth breathing compared to nasal breathing. This study suggests that the BOLD activity patterns between mouth and nasal breathing may be induced differently, especially in the hippocampus, which could provide clues to explain the effects on brain cognitive function due to mouth breathing.

  18. Desmopressin Nasal

    MedlinePlus

    ... stop some types of bleeding in people with hemophilia (condition in which the blood does not clot ... When desmopressin nasal (Stimate®) is used to treat hemophilia and von Willebrand's disease, 1 to 2 spray(s) ...

  19. Objective monitoring of nasal patency and nasal physiology in rhinitis.

    PubMed

    Nathan, Robert A; Eccles, Ron; Howarth, Peter H; Steinsvåg, Sverre K; Togias, Alkis

    2005-03-01

    impaired mucociliary clearance and altered nasal responsiveness. Measures exist for the monitoring of these aspects of nasal dysfunction. Although measures of mucociliary clearance are simple to perform, they have a poor record of reproducibility. Their incorporation into clinical trials is thus questionable, although positive outcomes from therapeutic intervention have been reported. Measures of nasal responsiveness are at present largely confined to research studies investigating disease mechanisms in allergic and nonallergic rhinitis. The techniques are insufficiently standardized to be applied to multicenter clinical trials but could be used in limited-center studies to gain insight into the regulatory effects of different therapeutic modalities.

  20. Collection of breath for hydrogen estimation.

    PubMed

    Gardiner, A J; Tarlow, M J; Sutherland, I T; Sammons, H G

    1981-02-01

    The breath hydrogen test is used in gastroenterological investigation, particularly for sugar malabsorption, transit time, and the investigation of small-bowel bacterial overgrowth. Several methods of collecting breath from infants and children for hydrogen assay have been described. Four such techniques (postnasal catheter, nasal prong, Rahn-Otis end-tidal sampler, and modification of a party toy--the 'Wiggins's blowout') were compared with breath collection using the Haldane-Priestley tube. Multiple sampling of breath from 3 adults was performed after initial lactulose loads to increase breath hydrogen excretion. The variability between the different assay techniques was less than the inherent variability of repeated breath hydrogen assays using the same technique. Each technique is therefore adequate for breath hydrogen collection; we recommend the Rahn-Otis end-tidal sampler in young infants and children, and the Haldane-Priestley tube in older children, since these were most acceptable to the children and their parents.

  1. Lamaze Breathing

    PubMed Central

    Lothian, Judith A.

    2011-01-01

    Lamaze breathing historically is considered the hallmark of Lamaze preparation for childbirth. This column discusses breathing in the larger context of contemporary Lamaze. Controlled breathing enhances relaxation and decreases perception of pain. It is one of many comfort strategies taught in Lamaze classes. In restricted birthing environments, breathing may be the only nonpharmacological comfort strategy available to women. Conscious breathing and relaxation, especially in combination with a wide variety of comfort strategies, can help women avoid unnecessary medical intervention and have a safe, healthy birth. PMID:22379360

  2. Nasalance in Cochlear Implantees

    PubMed Central

    Sreedevi, N; Lepcha, Anjali; Mathew, John

    2015-01-01

    Objectives Speech intelligibility is severely affected in children with congenital profound hearing loss. Hypernasality is a problem commonly encountered in their speech. Auditory information received from cochlear implants is expected to be far superior to that from hearing aids. Our study aimed at comparing the percentages of nasality in the speech of the cochlear implantees with hearing aid users and also with children with normal hearing. Methods Three groups of subjects took part in the study. Groups I and II comprised 12 children each, in the age range of 4-10 years, with prelingual bilateral profound hearing loss, using multichannel cochlear implants and digital hearing aids respectively. Both groups had received at least one year of speech therapy intervention since cochlear implant surgery and hearing aid fitting respectively. The third group consisted of age-matched and sex-matched children with normal hearing. The subjects were asked to say a sentence which consisted of only oral sounds and no nasal sounds ("Buy baby a bib"). The nasalance score as a percentage was calculated. Results Statistical analysis revealed that the children using hearing aids showed a high percentage of nasalance in their speech. The cochlear implantees showed a lower percentage of nasalance compared to children using hearing aids, but did not match with their normal hearing peers. Conclusion The quality of speech of the cochlear implantees was superior to that of the hearing aid users, but did not match with the normal controls. The study suggests that acoustic variables still exist after cochlear implantation in children, with hearing impairments at deviant levels, which needs attention. Further research needs to be carried out to explore the effect of the age at implantation as a variable in reducing nasality in the speech and attaining normative values in cochlear implantees, and also between unilateral versus bilateral implantees. PMID:26330912

  3. Nasal airflow and brain activity: is there a link?

    PubMed

    Price, A; Eccles, R

    2016-09-01

    Over the past few decades, evidence has emerged suggesting that nasal airflow asymmetry and brain asymmetry are linked. The nose exhibits asymmetrical airflow, with the dominant airflow alternating from one nasal passage to the other over a period of hours. Some authors have suggested a correlation between cerebral hemisphere dominance and nostril dominance. Others have proposed an association between rhythmic fluctuations in nasal airflow and corresponding fluctuations in cerebral hemisphere activity. Based on ancient yoga breathing techniques, newer evidence suggests that altering nasal airflow can influence brain activity, with reports of improved cognitive function caused by unilateral forced nostril breathing. It seems that a nasal airflow stimulus may have an activating effect on the brain, as it has also been shown to trigger seizure activity in epileptic patients. This article explores these theories in detail, reviews the evidence, and presents new models linking nasal airflow and brain activity.

  4. Dynamic Changes in Heart Rate Variability and Nasal Airflow Resistance during Nasal Allergen Provocation Test.

    PubMed

    Seppänen, Tiina M; Alho, Olli-Pekka; Seppänen, Tapio

    2016-01-01

    Allergic rhinitis is a major chronic respiratory disease and an immunoneuronal disorder. We aimed at providing further knowledge on the function of the neural system in nasal allergic reaction. Here, a method to assess simultaneously the nasal airflow resistance and the underlying function of autonomic nervous system (ANS) is presented and used during the nasal provocation of allergic and nonallergic subjects. Continuous nasal airflow resistance and spectral heart rate variability parameters show in detail the timing and intensity differences in subjects' reactions. After the provocation, the nasal airflow resistance of allergic subjects showed a positive trend, whereas LF/HF (Low Frequency/High Frequency) ratio and LF power showed a negative trend. This could imply a gradual sympathetic withdrawal in allergic subjects after the allergen provocation. The groups differed significantly by these physiological descriptors. The proposed method opens entirely new opportunities to research accurately concomitant changes in nasal breathing function and ANS.

  5. Dynamic Changes in Heart Rate Variability and Nasal Airflow Resistance during Nasal Allergen Provocation Test

    PubMed Central

    Seppänen, Tiina M.; Alho, Olli-Pekka; Seppänen, Tapio

    2016-01-01

    Allergic rhinitis is a major chronic respiratory disease and an immunoneuronal disorder. We aimed at providing further knowledge on the function of the neural system in nasal allergic reaction. Here, a method to assess simultaneously the nasal airflow resistance and the underlying function of autonomic nervous system (ANS) is presented and used during the nasal provocation of allergic and nonallergic subjects. Continuous nasal airflow resistance and spectral heart rate variability parameters show in detail the timing and intensity differences in subjects' reactions. After the provocation, the nasal airflow resistance of allergic subjects showed a positive trend, whereas LF/HF (Low Frequency/High Frequency) ratio and LF power showed a negative trend. This could imply a gradual sympathetic withdrawal in allergic subjects after the allergen provocation. The groups differed significantly by these physiological descriptors. The proposed method opens entirely new opportunities to research accurately concomitant changes in nasal breathing function and ANS. PMID:27196870

  6. Breathing mode influence on craniofacial development and head posture.

    PubMed

    Chambi-Rocha, Annel; Cabrera-Domínguez, Mª Eugenia; Domínguez-Reyes, Antonia

    2017-08-14

    The incidence of abnormal breathing and its consequences on craniofacial development is increasing, and is not limited to children with adenoid faces. The objective of this study was to evaluate the cephalometric differences in craniofacial structures and head posture between nasal breathing and oral breathing children and teenagers with a normal facial growth pattern. Ninety-eight 7-16 year-old patients with a normal facial growth pattern were clinically and radiographically evaluated. They were classified as either nasal breathing or oral breathing patients according to the predominant mode of breathing through clinical and historical evaluation, and breathing respiratory rate predomination as quantified by an airflow sensor. They were divided in two age groups (G1: 7-9) (G2: 10-16) to account for normal age-related facial growth. Oral breathing children (8.0±0.7 years) showed less nasopharyngeal cross-sectional dimension (MPP) (p=0.030), whereas other structures were similar to their nasal breathing counterparts (7.6±0.9 years). However, oral breathing teenagers (12.3±2.0 years) exhibited a greater palate length (ANS-PNS) (p=0.049), a higher vertical dimension in the lower anterior face (Xi-ANS-Pm) (p=0.015), and a lower position of the hyoid bone with respect to the mandibular plane (H-MP) (p=0.017) than their nasal breathing counterparts (12.5±1.9 years). No statistically significant differences were found in head posture. Even in individuals with a normal facial growth pattern, when compared with nasal breathing individuals, oral breathing children present differences in airway dimensions. Among adolescents, these dissimilarities include structures in the facial development and hyoid bone position. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  7. Nasal ventilation is more effective than combined oral-nasal ventilation during induction of general anesthesia in adult subjects.

    PubMed

    Liang, Yafen; Kimball, William R; Kacmarek, Robert M; Zapol, Warren M; Jiang, Yandong

    2008-06-01

    The authors hypothesized that nasal mask ventilation may be more effective than combined oral-nasal mask ventilation during induction of general anesthesia. They tested this hypothesis by comparing the volume of carbon dioxide removed per breath with nasal versus combined oral-nasal mask ventilation in nonparalyzed, apneic, adult subjects during induction of general anesthesia. Fifteen adult subjects receiving general anesthesia were ventilated first with a combined oral-nasal mask and then with only a nasal mask. The patient's head was maintained in a neutral position, without head extension or lower jaw thrust. Respiratory parameters were recorded simultaneously from both the nasal and oral masks regardless of ventilation approach. The volume of carbon dioxide removed per breath during nasal mask ventilation (median, 5.0 ml; interquartile range, 3.4-8.8 ml) was significantly larger than that during combined oral-nasal mask ventilation (median, 0.0 ml; interquartile range, 0.0-0.4 ml; P = 0.001); even the peak inspiratory airway pressure during nasal ventilation (16.7 +/- 2.7 cm H2O) was lower than that during combined oral-nasal ventilation (24.5 +/- 4.7 cm H2O; P = 0.002). The expiratory tidal volume during nasal ventilation (259.8 +/- 134.2 ml) was also larger than that during combined oral-nasal ventilation (98.9 +/- 103.4 ml; P = 0.003). Nasal mask ventilation was more effective than combined oral-nasal mask ventilation in apneic, nonparalyzed, adult subjects during induction of general anesthesia. The authors suggest that nasal mask ventilation, rather than full facemask ventilation, be considered during induction of anesthesia.

  8. Nasal deposition in infants and children.

    PubMed

    Zhou, Yue; Guo, Mindy; Xi, Jinxiang; Irshad, Hammad; Cheng, Yung-Sung

    2014-04-01

    The variability of particle deposition in infant and child nasal airways is significant due to the airway geometry and breathing rate. Estimation of particle deposition in the nasal airway of this age group is necessary, especially for inhalation drug delivery application. Previous studies on nasal aerosol deposition were focused mostly on adult. A few empirical equations were also developed to calculate nasal deposition in different age groups of children. However, those studies have their limitations. The aim of this study is to find a simple way to calculate the nasal aerosol deposition in all age groups. An in vitro test of micrometer particle deposition in nasal airways for three different ages of infants and children is conducted. An adult nasal replica is also studied as a comparison. Monodisperse oleic acid aerosols ranging in size between 2 and 28 μm are delivered into the replica at the rest condition. This size range covers the deposition efficiency up to around 100%. This study also compares results from our previous deposition tests with a 5-year-old replica. Nasal deposition of micrometer aerosols in small children and infants is higher than that in adults under equivalent breathing conditions, e.g., sitting awake in this study. Combining the data set of infants, children, and adults, we found the deposition in the nasal airway strongly depends on the particle size and pressure drop. The particle deposition can be calculated based on a single empirical equation in all age groups. The intersubject variability within the same age group was not addressed in this study. An empirical equation for all age groups is developed. From this equation, particle deposition efficiency in the nasal airway can best be estimated with input data of particle size and pressure drop of the airway.

  9. How to Use Nasal Pump Sprays

    MedlinePlus

    Using Nasal Pump SpraysBlow your nose gently before using the spray. Prime the pump bottle by spraying it into the air a ... Breathe in quickly while squeezing down on the pump bottle one time. Repeat in other nostril. Do ...

  10. Nasal nitric oxide in infants before and after extubation.

    PubMed

    Chang, Chun-Cheng; Lien, Shao-Hung; Liu, Tao-Yuan; Hua, Yi-Ming; Lee, Chuen-Ming; Yuh, Yeong-Seng

    2008-11-01

    The endogenous production of nitric oxide (NO) in the upper airways is known to be high, but reports of the exact level vary, especially in newborn infants. Currently there is still no standard methodology for nasal NO measurements in neonates. In this study, we compared the levels of NO from the nasal cavity, and from the lower respiratory tracts in intubated infants together with the differences in nasal NO before and after extubation. A total of 35 intubated infants were enrolled in the study. The sampling was conducted with a fast-response chemoluminescence analyzer using the on-line tidal breathing techniques. The levels of NO in the nasal cavity were sampled using two different methods, namely nasal catheterization (Group 1), and nasal occlusion (Group 2). In both groups, the NO levels in the nasal cavity were found to be significantly higher than in the lower airway (P < 0.001). After extubation, the concentration of nasal NO in Group 1 was found to be significantly lower than before extubation (P < 0.05). There was no difference found between the levels of nasal NO in Group 2 before and after extubation (P = 0.95). Generally speaking, the concentrations of nasal NO in Group 2 were significantly higher than in Group 1 after extubation (P < 0.05). For the sample that used nasal occlusion, the nasal NO levels were more stable before and after extubation and the concentration was not affected by the breathing pattern or crying. The infants were more comfortable as well. We therefore conclude that nasal occlusion is a better method for measuring the levels of nasal NO in infants and neonates. (c) 2008 Wiley-Liss, Inc.

  11. Nasal nitric oxide: a comparison of measurement techniques.

    PubMed

    Silkoff, P E; Chatkin, J; Qian, W; Chakravorty, S; Gutierrez, C; Furlott, H; McClean, P; Rai, S; Zamel, N; Haight, J

    1999-01-01

    Nasal nitric oxide measurement may be a surrogate marker of upper airway inflammation. There is, however, no standardized measurement technique; and this led us to examine measurement techniques for acceptability and reproducibility. In five subjects we examined the flow dependence of nasal NO. In 13 healthy volunteers, nasal NO was measured on-line by five methods: 1) Tidal nasal and oral breathing: NO sampling during exclusive nasal followed by exclusive oral tidal breathing; 2) Fixed flow exhalation: NO sampling during exclusive nasal followed by exclusive oral exhalation at 100 mL/second from total lung capacity; 3) Nasal-oral aspiration: air aspirated from the mouth via both nares at 100 mL/second with glottis closure; 4) Aspiration from one nares: air aspirated from one nares at 3.3 mL/second using nitric oxide analyzer sample line with velum closure; 5) Nasal Insufflation: NO sampled at one nares as air insufflated into the other nares at a flow of 100 mL/second with velum closure. Acceptability of all methods was assessed by subjects and technicians. Nasal NO concentration showed a significant inverse correlation with transnasal flow rate. All methods showed excellent reproducibility as assessed by the intraclass correlation coefficient except tidal breathing, which showed highly variable breath-to-breath NO levels, although mean breath values were reproducible. Mean nasal NO concentrations with methods 1, 2, 3, 4, and 5 were 32.1, 50.2, 62.8, 1381, and 60.0 ppb, respectively. Velum closure was not always achieved in methods 4 and 5, whereas methods 1 and 2 required separate nasal and oral procedures. Method 5 had reduced acceptability. NO concentrations were similar with methods that used the same airflow (2, 3, and 5). Nasal NO can be sampled in different ways with excellent reproducibility. In view of the flow dependence of nasal NO, it is vital to use a constant flow rate, and lower airway NO contribution must be excluded or subtracted. The fixed flow

  12. [Exhaled and nasal nitric oxide in patients with Japanese cedar pollinosis and effects of nasal steroids].

    PubMed

    Miyazaki, Y

    1999-12-01

    Nitric oxide (NO) is produced by the action of NO synthase (NOS) using L-arginine as a substrate in various cells and found in air exhaled by humans. Previous studies suggest that almost all exhaled NO is derived from the upper airways and increases in patients with untreated asthma and allergic rhinitis. Exhaled NO is inhibited by treatment with inhalation of steroids that may be caused by inhibition of inducible nitric oxide synthase (iNOS). The purpose of this study is to determine whether exhaled and nasal NO increases in patients with Japanese cedar pollinosis compared with nonallergic healthy subjects, and whether it is affected by treatment with nasal steroids. Furthermore, we investigated its relation to nasal function and allergic rhinitis. 10 patients with Japanese cedar pollinosis and 5 healthy normal subjects were tested. All subjects had no history of respiratory infection for at least 2 weeks and did not smoke. Exhaled NO was collected in a sampling bag from oral and nasal breathing, and nasal NO was sampled directly from the nasal cavity. Both were measured by a chemiluminescence NO analyzer, ML9841, at a detection limit of 1 part per billion (ppb). Subjects used nasal steroids for 2 weeks and were measured similarly afterwards. NO concentrations in nasal air and air exhaled from the nose in patients with Japanese cedar pollinosis (277.9 +/- 59.5 ppb, 34.4 +/- 3.9 ppb, n = 10) were higher than the normal subjects (153.3 +/- 30.6 ppb, 19.9 +/- 3.4 ppb, n = 5) (p < 0.05). NO exhaled from the mouth was not significantly different between patients (20.5 +/- 4.9 ppb) and normal subjects (23.7 +/- 2.6 ppb). In patients with Japanese cedar pollinosis, the concentration of nasal NO and nasal exhaled NO were significantly decreased after treatment with nasal steroids (144.0 +/- 21.0 ppb, 26.1 +/- 3.0 ppb) (p < 0.01, p < 0.05), but there was no change in oral exhaled NO (17.2 +/- 3.3 ppb). In normal subjects, oral (22.5 +/- 5.3 ppb), nasal exhaled NO (19

  13. Automatic Recognition of Breathing Route During Sleep Using Snoring Sounds

    NASA Astrophysics Data System (ADS)

    Mikami, Tsuyoshi; Kojima, Yohichiro

    This letter classifies snoring sounds into three breathing routes (oral, nasal, and oronasal) with discriminant analysis of the power spectra and k-nearest neighbor method. It is necessary to recognize breathing route during snoring, because oral snoring is a typical symptom of sleep apnea but we cannot know our own breathing and snoring condition during sleep. As a result, about 98.8% classification rate is obtained by using leave-one-out test for performance evaluation.

  14. Neuropsychiatric symptoms, quality of sleep and quality of life in patients diagnosed with nasal septal deviation.

    PubMed

    Fidan, Tülin; Fidan, Vural; Ak, Mehmet; Sütbeyaz, Yavuz

    2011-01-01

    This study aims to evaluate the psychiatric symptoms, quality of sleep, quality of life and the predictive factors affecting quality of sleep in patients diagnosed with nasal septal deviation (NSD). Forty male patients (mean age 22.3±1.4 years; range 21 to 26 years) who admitted to the otorhinolaryngology (ORL) clinic of the Ağrı Military Hospital and diagnosed with NSD as a result of a through ORL examination between February 2009 and April 2009 and 36 healthy volunteer (mean age 21.7±1.0 years; range 21 to 25 years) controls, were included in this study. Pre- and postoperative evaluations were performed using the Quality of Life Scale (Short Form-36/SF-36), the Pittsburgh Sleep Quality Index (PSQI) and the Symptom Check List Revised (SCL-90-R). All patients and controls completed pre- and postoperative evaluations. No complications occurred. There was a statistically significant difference between the groups in the quality of sleep measures, in the SCL-90-R subscales of somatization, obsession, interpersonal sensitivity, depression, anxiety, phobic anxiety, hostility, paranoid thought, and psychoticism, additional scales and in physical health dimension of SF-36 Quality of Life Scale. Psychiatric symptoms are more common in patients with nasal septal deviation when compared to healthy controls. The impairments in nasal breathing in patients with NSD may cause a decline in the physical dimension of quality of life and a marked impairment in sleep quality.

  15. Bad Breath

    MedlinePlus

    ... and soda poor dental hygiene (say: HI-jeen), meaning not brushing and flossing regularly smoking and other tobacco use Poor oral hygiene leads to bad breath because when food particles are left in your mouth, they can rot ...

  16. Bad Breath

    MedlinePlus

    ... for lunch. But certain strong-smelling foods like onions and garlic can cause bad breath. So can ... leave behind strong smells, like cabbage, garlic, raw onions, and coffee. If you’re trying to lose ...

  17. Breath odor

    MedlinePlus

    ... drain their stomach. The breath may have an ammonia-like odor (also described as urine-like or " ... Is there a specific odor (such as fish, ammonia, fruit, feces, or alcohol)? Have you recently eaten ...

  18. Mouth leak with nasal continuous positive airway pressure increases nasal airway resistance.

    PubMed

    Richards, G N; Cistulli, P A; Ungar, R G; Berthon-Jones, M; Sullivan, C E

    1996-07-01

    Nasal congestion, dry nose and throat, and sore throat affect approximately 40% of patients using nasal continuous positive airway pressure (CPAP). The mechanisms causing nasal symptoms are unclear, but mouth leaks causing high unidirectional nasal airflow may be important. We conducted a study to investigate the effects of mouth leak and the influence of humidification on nasal resistance in normal subjects. Nasal resistance was measured with posterior rhinomanometry in six normal subjects who deliberately produced a mouth leak for 10 min while using nasal CPAP. Nasal resistance was measured regularly for 20 min after the challenge. A series of tests were performed using air at differing temperatures and humidities. There was no change in nasal resistance when subjects breathed through their noses while on CPAP, but a mouth leak caused a large increase in resistance (at a flow of 0.5 L/s) from a baseline mean of 2.21 cm H2O/L/s to a maximum mean of 7.52 cm H2O/L/s at 1 min after the challenge. Use of a cold passover humidifier caused little change in the response (maximum mean: 8.27 cm H2O/L/s), but a hot water bath humidifier greatly attenuated the magnitude (maximum mean: 4.02 cm H2O/L/s) and duration of the response. Mouth leak with nasal CPAP leads to high unidirectional nasal airflow, which causes a large increase in nasal resistance. This response can be largely prevented by fully humidifying the inspired air.

  19. Oral breathing increases Pth and vocal effort by superficial drying of vocal fold mucosa.

    PubMed

    Sivasankar, Mahalakshmi; Fisher, Kimberly V

    2002-06-01

    Oral breathing superficially dehydrates the airway lumen by decreasing the depth of the sol layer in humans and animals. Conversely, nasal breathing can increase the humidity of inspired air. We compared the effects of short-term oral and nasal breathing on Pth and perceived vocal effort in 20 female subjects randomly assigned to two groups: oral breathing (N = 10, age 21-32 years); nasal breathing (N = 10, age 20-36 years). We hypothesized that short-term oral breathing, but not nasal breathing, would increase Pth, and that subjects would perceive this change as an increase in vocal effort. Following 15 minutes of oral breathing, Pth increased at comfortable and low pitch (p < 0.01) with 6 of 10 subjects reporting increased vocal effort. Nasal breathing reduced Pth at all three pitches (p < 0.01), and 7 of 10 subjects reported decreased vocal effort. Over all subjects, 49% of the variance in treatment-induced change in Pth was accounted for by change in vocal effort (R = 0.70). We posit that obligatory oral breathing places healthy subjects at risk for symptoms of increased vocal effort. The facilitatory role of superficial hydration on vocal fold oscillation should be considered in biomechanical models of phonation and in the clinical prevention of laryngeal dryness.

  20. Nasal ventilation.

    PubMed Central

    Simonds, A. K.

    1998-01-01

    Nasal intermittent positive pressure ventilation is likely to have an increasing role in the management of acute ventilatory failure, weaning, and chronic ventilatory problems. Further improvements in ventilator and mask design will be seen. Appropriate application is likely to reduce both mortality and admissions to intensive care, while domiciliary use can improve life expectancy and/or quality of life in chronic ventilatory disorders. As with any new technique, enthusiasm should not outweigh clear outcome information, and possible new indications should always be subject to careful assessment. Images Figure 2 PMID:9799887

  1. Impaired E Prostanoid2 Expression and Resistance to Prostaglandin E2 in Nasal Polyp Fibroblasts from Subjects with Aspirin-Exacerbated Respiratory Disease.

    PubMed

    Cahill, Katherine N; Raby, Benjamin A; Zhou, Xiaobo; Guo, Feng; Thibault, Derek; Baccarelli, Andreas; Byun, Hyang-Min; Bhattacharyya, Neil; Steinke, John W; Boyce, Joshua A; Laidlaw, Tanya M

    2016-01-01

    Recurrent, rapidly growing nasal polyps are hallmarks of aspirin-exacerbated respiratory disease (AERD), although the mechanisms of polyp growth have not been identified. Fibroblasts are intimately involved in tissue remodeling, and the growth of fibroblasts is suppressed by prostaglandin E2 (PGE2), which elicits antiproliferative effects mediated through the E prostanoid (EP)2 receptor. We now report that cultured fibroblasts from the nasal polyps of subjects with AERD resist this antiproliferative effect. Fibroblasts from polyps of subjects with AERD resisted the antiproliferative actions of PGE2 and a selective EP2 agonist (P < 0.0001 at 1 μM) compared with nasal fibroblasts from aspirin-tolerant control subjects undergoing polypectomy or from healthy control subjects undergoing concha bullosa resections. Cell surface expression of the EP2 receptor protein was lower in fibroblasts from subjects with AERD than in fibroblasts from healthy control subjects and aspirin-tolerant subjects (P < 0.01 for both). Treatment of the fibroblasts with trichostatin A, a histone deacetylase inhibitor, significantly increased EP2 receptor mRNA in fibroblasts from AERD and aspirin-tolerant subjects but had no effect on cyclooxygenase-2, EP4, and microsomal PGE synthase 1 (mPGES-1) mRNA levels. Histone acetylation (H3K27ac) at the EP2 promoter correlated strongly with baseline EP2 mRNA (r = 0.80; P < 0.01). These studies suggest that the EP2 promotor is under epigenetic control, and one explanation for PGE2 resistance in AERD is an epigenetically mediated reduction of EP2 receptor expression, which could contribute to the refractory nasal polyposis typically observed in this syndrome.

  2. Stereoscopic PIV measurements of flow in the nasal cavity with high flow therapy

    NASA Astrophysics Data System (ADS)

    Spence, C. J. T.; Buchmann, N. A.; Jermy, M. C.; Moore, S. M.

    2011-04-01

    Knowledge of the airflow characteristics within the nasal cavity with nasal high flow (NHF) therapy and during unassisted breathing is essential to understand the treatment's efficacy. The distribution and velocity of the airflow in the nasal cavity with and without NHF cannula flow has been investigated using stereoscopic particle image velocimetry at steady peak expiration and inspiration. In vivo breathing flows were measured and dimensionally scaled to reproduce physiological conditions in vitro. A scaled model of the complete nasal cavity was constructed in transparent silicone and airflow simulated with an aqueous glycerine solution. NHF modifies nasal cavity flow patterns significantly, altering the proportion of inspiration and expiration through each passageway and producing jets with in vivo velocities up to 17.0 ms-1 for 30 l/min cannula flow. Velocity magnitudes differed appreciably between the left and right sides of the nasal cavity. The importance of using a three-component measurement technique when investigating nasal flows has been highlighted.

  3. External nasal dilators: definition, background, and current uses

    PubMed Central

    Dinardi, Ricardo Reis; de Andrade, Cláudia Ribeiro; Ibiapina, Cássio da Cunha

    2014-01-01

    Our goal was to revise the literature about external nasal dilators (ENDs) as to their definition, history, and current uses. We reviewed journals in the PubMed and MEDLINE databases. The current uses hereby presented and discussed are physical exercise, nasal congestion and sleep, snoring, pregnancy, cancer, and healthy individuals. Numerous studies have shown that ENDs increase the cross-sectional area of the nasal valve, reducing nasal resistance and transnasal inspiratory pressure and stabilizing the lateral nasal vestibule, avoiding its collapse during final inspiration. These effects also facilitate breathing and are beneficial to patients with nasal obstruction. Furthermore, END use is simple, noninvasive, painless, affordable, and bears minimum risk to the user. Most studies have limited sample size and are mainly focused on physical exercise. In conclusion, ENDs seem useful, so further studies involving potential effects on the performance of physical tests and improvements in sleep quality are necessary, especially in children and teenagers. PMID:25419156

  4. How to breathe when you are short of breath

    MedlinePlus

    Pursed lip breathing; COPD - pursed lip breathing; Emphysema - pursed lip breathing; Chronic bronchitis - pursed lip breathing; Pulmonary fibrosis - pursed lip breathing; Interstitial lung disease - pursed lip breathing; Hypoxia - pursed lip breathing; ...

  5. Nasal sequelae of Treacher Collins syndrome.

    PubMed

    Plomp, Raul G; Mathijssen, Irene M J; Moolenburgh, Sanne E; van Montfort, Kees A G M; van der Meulen, Jacques J N M; Poublon, René M L

    2015-06-01

    This study aimed to determine external and endonasal deformity, and satisfaction with nasal functioning and appearance, in Treacher Collins syndrome. A cross-sectional cohort study was conducted. Eleven adult patients with Treacher Collins syndrome were compared with 151 controls in terms of satisfaction with nasal functioning and appearance by means of the Nasal Appearance and Function Evaluation Questionnaire. In all patients with Treacher Collins syndrome, external nasal deformities were scored on standardized digital photographs of the nose as rated independently by three experienced physicians. Endonasal deformity was determined by standardized nasal endoscopy. The patients were relatively satisfied with the various esthetic nasal subunits. The most significant functional problems were snoring (P = 0.001) and quality of phonation (P = 0.003). The main external nasal deformities were the dorsal hump (73%), external deviation (≤55%), the bifid or bulbous nasal tip (55%), and columellar septal luxation (55%). In 82% of the patients, a septal deviation was found, often associated with spurs. Satisfaction with esthetics of the nose was fair, but these patients suffer from the functional problems of snoring and impaired quality of phonation. A structured nasal ENT physical examination with nasal endoscopy might determine aspects requiring more attention during treatment. Septorhinoplasty can be performed at an adult age if there is a considerable esthetic wish of the patient and/or nasal obstruction combined with septal deviation. Attention should be paid to dorsal hump reduction, correction of the deviated external osseous framework, septoplasty, and correction of the nasal tip shape. 2b. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. Exhaled nitric oxide and nasal tryptase are associated with wheeze, rhinitis and nasal allergy in primary school children.

    PubMed

    De Prins, Sofie; Marcucci, Francesco; Sensi, Laura; Van de Mieroop, Els; Nelen, Vera; Nawrot, Tim S; Schoeters, Greet; Koppen, Gudrun

    2014-09-01

    Rhinitis and asthma are the most common respiratory diseases in children. We assessed whether airway inflammation markers were associated with nasal allergies and self-reported symptoms of wheeze and rhinitis in 130 children 6-12 year old in an epidemiological context. Independent of sex and age, the fraction of exhaled nitric oxide (FeNO) and nasal mast cell (MC) activation (tryptase ≥ 5 ng/mL) were positively associated with wheeze, rhinitis and with nasal allergy. Nasal eosinophil cationic protein (ECP) and exhaled breath condensate (EBC) markers (pH, 8-isoprostane, interleukin-1β) were not associated with symptoms or with nasal allergy. In conclusion, FeNO and nasal tryptase reflect allergic inflammation in the respiratory system.

  7. [Model of nasal cavity and paranasal sinuses created for studying the dynamics of the nasal airflow].

    PubMed

    Jiang, Guang-Li; Xu, Geng

    2008-09-01

    To create a model from an adult cadaver's nasal cavity and verify whether it can be used to study the airflow dynamics in the nasal cavity and paranasal sinuses. (1) The model was made by the material of transparent resin and Bengal gelatin according to a nasal cast of a cadaver. (2) The model was check by Acoustic Rhino-meter, CT scan and nasal endoscope, then compared with the normal. (3) To observe the smoke flow in the model and record it by a digital camera It was succeeded in creating a model of the nasal cavity and paranasal sinus. The model was good at simulation and transparency. The structure of the model, the cross-sectional areas of the nasal passage and the CT scan results of the model were similar to the normal. The airflows in the model could be recorded by a digital camera. It showed that there were two types of airflows in the nose. The majority of airflows were found in the common and middle nasal meatus, the little part of the airflows passed through the upper of the nose like a parabola. There was an increasing proportion of airflows in the olfactory region when elevated the airflow rates. A relatively large vortex formed in the upper part of the nose, just behind the nasal valve, and another one was in the pharynx nasals. (1) The transparent resin and Bengal gelatin are suitable for making the model of the nose. The model can be used to study the airflows dynamics of the nasal cavity and paranasal sinuses. (2) The majority of inspired airflows go straightly to the pharynx nasals through the combined middle and inferior airways, a little part of inspired airflows through the olfactory region like a parabola. (3) The inspired airflows first arrived at the front position of the middle and inferior turbinate. The airflows can go into the maxillary sinus, a vortex can be see in the maxillary sinus during breath.

  8. Muscle-building therapy in treatment of nasal valve collapse.

    PubMed

    Vaiman, Michael; Eviatar, Ephraim; Segal, Samuel

    2004-09-01

    The purpose of this paper is to describe the outcome of muscle-building therapy for nasal muscles in cases of nasal valve stenosis or collapse. The present study was performed to investigate the best way to combine transcutaneous and intranasal surface electromyography (sEMG) biofeedback training of muscles involved in nasal valve function with a home exercise program and electric stimulation of nasal muscles. A randomized pilot study of 3 groups of patients (n1=12, n2=12, n3=10; total 34 patients) presenting with symptoms of obstructed nasal breathing was conducted. All selected patients demonstrated nasal valve stenosis with a positive Cottler maneuver and clinically evident nasal valve collapse. Follow-up ranged from 8 to 12 months. Treatment for Group 1 included transcutaneous and intranasal electric stimulation of nasal muscles only. Treatment for Group 2 included biofeedback training and home exercise program of specific nasal movements, and treatment for Group 3 included surface and intranasal EMG biofeedback assisted specific strategies for nasal muscle education, home exercises and electric stimulation. All patients in these groups exhibited subjective improvement. For Group 3, in 80% the improvement was proved objectively; for Group 2, in 75% the improvement was proved objectively; for Group 1, in 58,33% the improvement was proved objectively. We found no significant difference between the results in Groups 3 and 2 and poorer results in Group 1. Relieve of nasal valve stenosis and collapse can be achieved with a complex muscle-building therapy as described. It helps a significant cohort of patients with symptoms of obstructed nasal breathing to avoid surgical intervention. Electric stimulation of the muscles does not contribute significantly in achieving of good results.

  9. Nasal obstructive disorders impair health-related quality of life in adolescents with persistent allergic rhinitis: A real-life study.

    PubMed

    Valls-Mateus, Meritxell; Marino-Sanchez, Franklin; Ruiz-Echevarría, Karen; Cardenas-Escalante, Paulina; Jiménez-Feijoo, Rosa; Blasco-Lozano, Jaime; Giner-Muñoz, María Teresa; Haag, Oliver; Alobid, Isam; Plaza Martin, Ana María; Mullol, Joaquim

    2017-08-01

    We previously reported a higher prevalence of nasal obstructive disorders (NOD) in pediatric patients with persistent allergic rhinitis (PER) not responding to medical treatment. The aim of this study was to determine the impact of NOD on quality of life (QoL) in this population. Real-life prospective study including 142 patients (41 children, 6-11 years old and 101 adolescents, 12-17 years old) with moderate and severe PER. After 2 months of medical treatment (intranasal steroids and antihistamines), patients were asked whether their symptoms had improved (yes/no) and classified accordingly in R, responders and NR, non-responders. Nasal symptoms (visual analog scale, VAS), NOD (nasal endoscopy), and QoL (PRQLQ, AdolQRLQ) were also assessed. Sixty-nine adolescents and 24 children were included in the NR group. NR presented worse QoL overall scores in adolescents (3.16±1.1 vs 1.63±0.99; P=.00001) and children (2.19±0.82 vs 1.51±0.77, P=.02). Medical treatment failure was associated with worse outcomes in QoL (adolescents OR: 1.6, P<.0001; children OR: 1.04, P=.036). Female adolescents presented worse QoL scores than males (3.19 vs 2.36, P=.001). The presence of obstructive septal deviation (OR: 1.02, P=.005), obstructive turbinate hyperplasia (OR: 1.03, P=.0006), and coexistence of both (OR=2.06, P=.001) was associated with worse QoL in adolescents. A strong and highly significant correlation was found between nasal symptoms VAS and QoL. The presence of NOD, particularly in adolescents, is associated with poor QoL outcomes. Assessment of NOD in pediatric PER should be considered an essential approach to determine the response to treatment and its impact on patient's QoL. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

  10. Comparison of cephalometric patterns in mouth breathing and nose breathing children.

    PubMed

    Chung Leng Muñoz, Isabel; Beltri Orta, Paola

    2014-07-01

    The aim of this study was to compare cephalometric values between nasal and oral breathing children and to measure the upper and lower airway space in both groups. The study was conducted on 118 pediatric patients, 51 girls and 67 boys, from the Dental Clinic of the Universidad Europea de Madrid. The age ranges of the sample were 6-12 years old. 53 of them were mouth breathers and 65 nose breathers. Lateral cephalometric radiographs were obtained for all of the subjects. The radiographs were analyzed and a cephalometric tracing was performed on each one. The mouth breathing children showed a more retruded mandible (SNB), and a greater inclination of the mandibular plane (NS-Go Gn) and occlusal plane (NS-O Pl.), than the nose breathing children (P<0.05). The mouth breathing group also had a higher frequency of having the hyoid bone in a more elevated position and the nasopharyngeal air space significantly smaller than the nasal breathing group (P<0.001). Mouth breathing children seem to have an increase in anterior lower facial height, the hyoid bone in a more elevated position and higher tendency towards having a class II malocclusion compared to nose breathing children. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Phonatory Effects of Airway Dehydration: Preliminary Evidence for Impaired Compensation to Oral Breathing in Individuals with a History of Vocal Fatigue

    ERIC Educational Resources Information Center

    Sivasankar, Mahalakshmi; Erickson, Elizabeth; Schneider, Sara; Hawes, Ashleigh

    2008-01-01

    Purpose: Airway drying is detrimental to phonation and is posited to exacerbate vocal fatigue. However, limited research has demonstrated the adverse phonatory effects of dehydration in speakers reporting vocal fatigue. We compared the negative phonatory consequences of short-term oral breathing at low, moderate, and high humidity in individuals…

  12. Phonatory Effects of Airway Dehydration: Preliminary Evidence for Impaired Compensation to Oral Breathing in Individuals with a History of Vocal Fatigue

    ERIC Educational Resources Information Center

    Sivasankar, Mahalakshmi; Erickson, Elizabeth; Schneider, Sara; Hawes, Ashleigh

    2008-01-01

    Purpose: Airway drying is detrimental to phonation and is posited to exacerbate vocal fatigue. However, limited research has demonstrated the adverse phonatory effects of dehydration in speakers reporting vocal fatigue. We compared the negative phonatory consequences of short-term oral breathing at low, moderate, and high humidity in individuals…

  13. Nasal cycle dominance and hallucinations in an adult schizophrenic female.

    PubMed

    Shannahoff-Khalsa, David; Golshan, Shahrokh

    2015-03-30

    Nasal dominance, at the onset of hallucinations, was studied as a marker of both the lateralized ultradian rhythm of the autonomic nervous system and the tightly coupled ultradian rhythm of alternating cerebral hemispheric dominance in a single case study of a schizophrenic female. Over 1086 days, 145 hallucination episodes occurred with left nostril dominance significantly greater than the right nostril dominant phase of the nasal cycle. A right nostril breathing exercise, that primarily stimulates the left hemisphere, reduces symptoms more quickly for hallucinations.

  14. The nose and sleep-disordered breathing.

    PubMed

    Pirsig, Wolfgang

    2003-06-01

    The influence of nasal obstruction on the pathogenesis of sleep-disordered breathing (SDB) has not yet been clearly defined. Similarly, a lack of data about the long-term effect of nasal surgery on snoring and obstructive sleep apnea keeps discussion of this topic controversial. This special issue of Sleep and Breathing presents four review articles that try to elucidate the complex interrelationship between the nose and SDB. An outstanding review article opens our eyes to the fascinating palette of the activities of nitric oxide, focusing on its inseparable connection to obstructive sleep apnea. Another summarizes data on the role of the nose in the pathophysiology of SDB and the slow progress concerning rhinologic treatments for SDB. The part of nose in the diagnostics of SDB is treated in a third article that also focuses on acoustic reflectometry as the newest technical development in the diagnostics of SDB. The last article elucidates the effect of nasal continuous positive airway pressure on the nasal passages including the authors' own data on the relatively poor long-term compliance of nasal continuous positive airway pressure.

  15. Nasal obstruction may alleviate bruxism related temporomandibular joint disorders.

    PubMed

    Bektas, Devrim; Cankaya, Mustafa; Livaoglu, Murat

    2011-02-01

    Temporomandibular disorder (TMD) is a collective term used to identify a group of musculoskeletal conditions of the temporomandibular region. Bruxism is a non-functional activity characterized by repeated tooth clenching or grinding in an unconscious manner. Over the time bruxism may lead to TMD by the uploading it causes. Nasal obstruction is a common complaint that necessitates mouth breathing when severe. The treatment of bruxism is frequently performed by oral appliances, which induce occlusal disengagement and relax jaw musculature and therefore reduce the force on the temporomandibular joint (TMJ). We believe that nasal obstruction may indirectly have a preemptive and therapeutic effect on sleep bruxism related TMD by causing mouth breathing.

  16. Nasalance, nasality, voice, and articulation after uvulopalatopharyngoplasty.

    PubMed

    Van Lierde, Kristiane M; Van Borsel, John; Moerman, Mieke; Van Cauwenberge, Paul

    2002-05-01

    The main purpose of the study was to determine the impact of uvulopalatopharyngoplasty (UPPP) on nasalance and nasality. It was hypothesized that nasalance would change from the presurgical to the postsurgical condition because the surgical protocol involves removal of palatal tissue. An additional objective of the study was to provide objective and subjective data about changes in voice and articulation after UPPP. Because the surgical procedure of UPPP does not involve laryngeal tissue, it was hypothesized that the voice characteristics remain relatively stable. Because of removal of effective velar length, articulation problems of the uvular /R/ can occur in the Dutch language. Prospective study in which 26 men were studied before (1 week before UPPP) and after (3 weeks after UPPP) surgery. The Nasometer was used to obtain nasalance scores. The mirror-fogging test, a perceptual evaluation of each subject's readings, and the Gutzmann and the Bzoch hypernasality tests were used for the assessment of nasality. For the assessment of articulation, a phonetic analysis was performed. Voice assessment included a perceptual rating of the voice and a determination of fundamental frequency. No significant differences were found between the conditions before and after surgery regarding nasalance (except for the vowel /i/), nasality, and voice. Regarding articulation, only 1 patient showed a derhotacized /R/. The findings of the study indicate that UPPP does not have an impact on nasality, voice, and articulation. Regarding nasalance, no significant nasalance change occurred after UPPP, except for the high vowel /i/.

  17. Coordination of Mastication, Swallowing and Breathing

    PubMed Central

    Matsuo, Koichiro; Palmer, Jeffrey B.

    2009-01-01

    Summary The pathways for air and food cross in the pharynx. In breathing, air may flow through either the nose or the mouth, it always flows through the pharynx. During swallowing, the pharynx changes from an airway to a food channel. The pharynx is isolated from the nasal cavity and lower airway by velopharyngeal and laryngeal closure during the pharyngeal swallow. During mastication, the food bolus accumulates in the pharynx prior to swallow initiation. The structures in the oral cavity, pharynx and larynx serve multiple functions in breathing, speaking, mastication and swallowing. Thus, the fine temporal coordination of feeding among breathing, mastication and swallowing is essential to provide proper food nutrition and to prevent pulmonary aspiration. This review paper will review the temporo-spatial coordination of the movements of oral, pharyngeal, and laryngeal structures during mastication and swallowing, and temporal coordination between breathing, mastication, and swallowing. PMID:20161022

  18. Humming greatly increases nasal nitric oxide.

    PubMed

    Weitzberg, Eddie; Lundberg, Jon O N

    2002-07-15

    The paranasal sinuses are major producers of nitric oxide (NO). We hypothesized that oscillating airflow produced by humming would enhance sinus ventilation and thereby increase nasal NO levels. Ten healthy subjects took part in the study. Nasal NO was measured with a chemiluminescence technique during humming and quiet single-breath exhalations at a fixed flow rate. NO increased 15-fold during humming compared with quiet exhalation. In a two-compartment model of the nose and sinus, oscillating airflow caused a dramatic increase in gas exchange between the cavities. Obstruction of the sinus ostium is a central event in the pathogenesis of sinusitis. Nasal NO measurements during humming may be a useful noninvasive test of sinus NO production and ostial patency. In addition, any therapeutic effects of the improved sinus ventilation caused by humming should be investigated.

  19. Nasal lift-nasal valve lift and nasal tip lift-preliminary results of a new technique using noninvasive self-retaining unidirectional nasal suspension with threads.

    PubMed

    Saban, Yves; Javier, De Benito; Massa, Michela

    2014-12-01

    In the context of nasal obstruction treatment, an alternative, no invasive technique is described. It consists in the suspension of the nasal valve or in the association of the suspension of the valve and rotation of the tip, through the placement of one or two absorbable threads, already known in aesthetic medicine. This technique allows to open the nasal valve and to correct the moderate closure of the nasolabial angle obtaining an immediate benefit of breathing. Functional improvement has been evaluated at regular intervals, that is, 1, 3, 6, and 12 months and then provided for every 6 months, through the use of a visual scale of 0/10 to 10/10. In our experience, the technique allows to obtain satisfactory results, avoiding more invasive techniques and postoperative recovery days.

  20. Changes in facial morphology after adenotonsillectomy in mouth-breathing children.

    PubMed

    Mattar, Sara E M; Valera, Fabiana C P; Faria, Gisele; Matsumoto, Miriam A N; Anselmo-Lima, Wilma T

    2011-09-01

    Morphological and dentofacial alterations have been attributed to impaired respiratory function. To examine the influence of mouth breathing (MB) on children facial morphology before and after adenoidectomy or adenotonsillectomy. Thirty-three MB children who restored nasal breathing (NB) after surgery and 22 NB children were evaluated. Both groups were submitted to lateral cephalometry, at time 1 (T1) before and at time 2 (T2) 28 months on average postoperatively. Comparison between the MB and NB groups at T1 showed that mouth breathers had higher inclination of the mandibular plane; more obtuse gonial angle; dolichofacial morphology; and a decrease in the total and inferior posterior facial heights. Twenty-eight months after the MB surgical intervention, they still presented a dolichofacial morphologic pattern. During this period, MB altered the face growth direction and decreased their mandible plane inclination, with reduction in the SN.GoGn, PP.MP, SNGn, and ArGo.GoMe parameters as well as an increase in BaN.PtGn. After the MB rehabilitation, children between 3 and 6 years old presented significant normalization in the mandibular growth direction, a decrease in the mandible inclination, and an increase in the posterior facial height. Instead, they still persisted with a dolichofacial pattern when compared with nasal breathers. 2011 The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.

  1. Unsteady flow in the nasal cavity with high flow therapy measured by stereoscopic PIV

    NASA Astrophysics Data System (ADS)

    Spence, C. J. T.; Buchmann, N. A.; Jermy, M. C.

    2012-03-01

    Nasal high flow (NHF) cannulae are used to deliver heated and humidified air to patients at steady flows ranging from 5 to 50 l/min. In this study, the flow velocities in the nasal cavity across the complete respiratory cycle during natural breathing and with NHF has been mapped in vitro using time-resolved stereoscopic particle image velocimetry (SPIV). An anatomically accurate silicone resin model of a complete human nasal cavity was constructed using CT scan data and rapid prototyping. Physiological breathing waveforms were reproduced in vitro using Reynolds and Womersley number matching and a piston pump driven by a ball screw and stepper motor. The flow pattern in the nasal cavity with NHF was found to differ significantly from natural breathing. Velocities of 2.4 and 3.3 ms-1 occurred in the nasal valve during natural breathing at peak expiration and inspiration, respectively; however, on expiration, the maximum velocity of 3.8 ms-1 occurred in the nasopharynx. At a cannula flow rate of 30 l/min, maximal velocities of 13.6 and 16.5 ms-1 at peak expiration and inspiration, respectively, were both located in the cannula jet within the nasal valve. Results are presented that suggest the quasi-steady flow assumption is invalid in the nasal cavity during natural breathing; however, it was valid with NHF. Cannula flow has been found to continuously flush the nasopharyngeal dead space, which may enhance carbon dioxide removal and increase oxygen fraction.

  2. The effect of vibrissae on subjective and objective measures of nasal obstruction.

    PubMed

    Stoddard, David G; Pallanch, John F; Hamilton, Grant S

    2015-01-01

    Nasal congestion and/or obstruction represents a prevalent and extensively studied problem. No published research exists that describes the impact of nasal hair (vibrissae) on nasal obstruction. To assess the impact of nasal vibrissae on subjective and objective measurements of nasal obstruction. In this prospective study, 30 healthy participants without nasal symptoms were assessed for baseline vibrissae density and were treated with a topical decongestant. The subjects were then asked to subjectively assess nasal breathing by using four questions from the Nasal Obstruction Symptom Evaluation instrument before undergoing rhinomanometry. Nasal vibrissae were then trimmed, and the participants repeated the subjective and objective assessments. Pre- and postintervention outcomes, including symptom scores, nasal airflow, and resistance, were compared by using statistical analysis. Statistically significant improvement was noted in subjects' nasal airway specific symptom scores and in objective measurements of their nasal airway. Patients with moderate or many vibrissae at baseline were noted to have greater likelihood of improvement in subjective and objective obstruction assessments than patients rated with few. In these 30 subjects, statistically significant improvement occurred in both subjective and objective assessments of nasal obstruction, particularly in patients with greater density of vibrissae. These findings support further study of the potential benefit of the reduction of vibrissae density in some patients with nasal obstruction.

  3. Measurement of nitric oxide in human exhaled breath

    SciTech Connect

    Gordon, S.M.; Spicer, C.W.; Ollison, W.M.

    1997-12-31

    This project was initiated to confirm the reliability of nitric oxide (NO) measurement in the breath matrix, using two different analytical techniques - ozone and luminol chemiluminescence - and to corroborate literature reports of elevated breath NO values. To measure peak oral and nasal NO levels, subjects performed slow vital capacity and breath holding maneuvers directly into the monitors through the mouth and the nose, respectively. Additional measurements were made using normal breathing techniques. Initial interferent tests indicate that measured NO signals are real and are not confounded by measurement artifacts. Similar results were obtained using the two independent analytical methods in dry or humid air. The NO signal was unaffected by maximum concentrations of potential breath interferents, such as sulfur compounds and alkenes. The measured breath NO concentrations were greater than typical room air levels and differed significantly with the breathing technique used. During these tests room air averaged 4-5 ppb NO. Peak oral NO levels were 4.3 {+-} 1.5 ppb during a slow vital capacity maneuver and 8.0 {+-} 5.0 ppb during a breath holding maneuver. By contrast, higher peak nasal NO levels were measured for both slow vital capacity (17.8 {+-} 7.8 ppb) and breath holding maneuvers (45.4 {+-} 29.5 ppb).

  4. Innovative management of nasal septal hematoma in an infant

    PubMed Central

    Sumitha, R.; Anandan, Ajay Kumar; Govarthanaraj, Aberna

    2015-01-01

    Nasal septal hematoma is a collection of blood between the cartilage or bone and mucoperichondrium or mucoperiosteum of the nose. This condition requires immediate surgical drainage to prevent complications. All patients need nasal packing postoperatively to prevent recurrence. This causes a lot of discomforts due to mouth breathing more in infants who are obligatory nose breathers. They can go for cyanosis in the postoperative period. Here, we discuss the case report of an infant who had tubular nasal pack with endotracheal tube postoperatively to maintain the patency of nose. PMID:26015758

  5. Innovative management of nasal septal hematoma in an infant.

    PubMed

    Sumitha, R; Anandan, Ajay Kumar; Govarthanaraj, Aberna

    2015-04-01

    Nasal septal hematoma is a collection of blood between the cartilage or bone and mucoperichondrium or mucoperiosteum of the nose. This condition requires immediate surgical drainage to prevent complications. All patients need nasal packing postoperatively to prevent recurrence. This causes a lot of discomforts due to mouth breathing more in infants who are obligatory nose breathers. They can go for cyanosis in the postoperative period. Here, we discuss the case report of an infant who had tubular nasal pack with endotracheal tube postoperatively to maintain the patency of nose.

  6. Deprojecting the nasal profile.

    PubMed

    Papel, I D; Mabrie, D C

    1999-02-01

    The nose is the most prominent aesthetic feature of the facial profile. Nasal length, tip rotation, and tip projection are integral aspects in analysis of the nasal profile. In most rhinoplasties the surgeon has the difficult task of increasing or maintaining tip projection of an underprojected or normally projected nasal tip. Less commonly, the rhinoplastic surgeon is presented with an overprojected nasal tip, and efforts are focused on deprojecting the nasal profile. In this article, the authors present a discussion of the overprojected tip, elucidating strategies of analysis, etiologies, and management of the nasal profile and give clinical examples.

  7. Nasal Injuries in Sports.

    PubMed

    Marston, Alexander P; O'Brien, Erin K; Hamilton, Grant S

    2017-04-01

    Nasal trauma is a common consequence of athletic competition. The nasal bones are the most commonly fractured facial bone and are particularly at risk during sports participation. Acute management of trauma to the nose includes thorough evaluation of all injuries and may require immediate management for repair of facial lacerations, epistaxis control, or septal hematoma drainage. Nasal fractures can often be addressed with closed reduction techniques; however, in the setting of complex nasal trauma, an open approach may be indicated. Using appropriate treatment techniques, posttraumatic nasal sequelae can be minimized; most patients report satisfactory long-term nasal form and function.

  8. Effects of septal perforation on nasal airflow: computer simulation study.

    PubMed

    Lee, H P; Garlapati, R R; Chong, V F H; Wang, D Y

    2010-01-01

    Nasal septal perforation is a structural or anatomical defect in the septum. The present study focused on the effects of septal perforation on nasal airflow and nasal patency, investigated using a computer simulation model. The effect of nasal septal perforation size on nasal airflow pattern was analysed using computer-generated, three-dimensional nasal models reconstructed using data from magnetic resonance imaging scans of a healthy human subject. Computer-based simulations using computational fluid dynamics were then conducted to determine nasal airflow patterns. The maximum velocity and wall shear stress were found always to occur in the downstream region of the septal perforation, and could potentially cause bleeding in that region, as previously reported. During the breathing process, there was flow exchange and flow reversal through the septal perforation, from the higher flow rate to the lower flow rate nostril side, especially for moderate and larger sized perforations. In the breathing process of patients with septal perforations, there is airflow exchange from the higher flow rate to the lower flow rate nostril side, especially for moderate and large sized perforations. For relatively small septal perforations, the amount of cross-flow is negligible. This cross-flow may cause the whistling sound typically experienced by patients.

  9. Measuring nasal nitric oxide in allergic rhinitis patients.

    PubMed

    Nesic, V S; Djordjevic, V Z; Tomic-Spiric, V; Dudvarski, Z R; Soldatovic, I A; Arsovic, N A

    2016-11-01

    This study aimed to compare two sampling methods for nasal nitric oxide in healthy individuals and allergic rhinitis patients, and to examine the within-subject reliability of nasal nitric oxide measurement. The study included 23 allergic rhinitis patients without concomitant asthma and 10 healthy individuals. For all participants, nitric oxide levels were measured non-invasively from the lungs through the mouth (i.e. the oral fractional exhaled nitric oxide) and the nose. Nasal nitric oxide was measured by two different methods: (1) nasal aspiration via one nostril during breath holding and (2) single-breath quiet exhalation against resistance through a tight facemask (i.e. the nasal fractional exhaled nitric oxide). Compared with healthy participants, allergic rhinitis patients had significantly higher average oral and nasal nitric oxide levels. All methods of nitric oxide measurement had excellent reliability. Nasal nitric oxide measurement is a useful and reliable clinical tool for diagnosing allergic rhinitis in patients without asthma in an out-patient setting.

  10. [Nasal sequels of unilateral clefts: analysis and management].

    PubMed

    Talmant, J-C; Talmant, J-Ch; Lumineau, J-P

    2007-09-01

    Usually, the nasal sequels of unilateral cleft patient are just considered as an esthetic problem to be addressed after the growth spurt of adolescence. This very narrow vision has led the cleft lip and palate treatment to a deadend. Actually, nasal sequels are the worst in terms of consequence on facial growth. 75% of complete unilateral cleft children are more oral than nasal breathers. Today, we know about the bad consequences of oral breathing on facial growth. It is not surprising to observe a high rate of small maxilla with cleft maxilla scars. In the fetus, the unilateral cleft nose deformities are well explained by the rupture of the facial envelope and the ventilatory dynamics of the amniotic fluid. Every step of the primary treatment threatens the nasal air way patency, whether when repairing lip and nose, suturing the hard palate that is the floor of the nose, or closing the alveolar cleft which controls the width of the piriform aperture. The functional and esthetic nasal sequels reflect the initial deformity, but are also the surgeon's skill and protocol choice. Before undertaking treatment, we must analyze the deformity at every level. Usually, the best option is to reopen the cleft completely to perform a combined revision of the lip, nose, and alveolar cleft after an adequate anterior maxillary expansion. If nasal breathing is necessary for an adequate facial growth, 25 years of experience showed us that it was very difficult to erase the cortical imprint of an early oral breathing pattern. So it is essential to establish a normal nasal breathing mode at the initial surgery. When the initial surgery is efficient and/or the secondary repair is successful, the final esthetic rhinoplasty, when indicated, is just performed for the sake of harmonization, with a classic internal approach and a few refinements.

  11. Changes in respiratory activity induced by mastication during oral breathing in humans.

    PubMed

    Daimon, Shigeru; Yamaguchi, Kazunori

    2014-06-01

    We examined the effect of oral breathing on respiratory movements, including the number of respirations and the movement of the thoracic wall at rest and while chewing gum. Forty normal nose breathers were selected by detecting expiratory airflow from the mouth using a CO2 sensor. Chest measurements were recorded using a Piezo respiratory belt transducer, and electromyographic (EMG) activity of the masseter and trapezius muscles were recorded at rest and while chewing gum during nasal or oral breathing. Oral breathing was introduced by completely occluding the nostrils with a nose clip. During oral breathing, the respiration rate was significantly lower while chewing gum than while at rest (P < 0.05). While chewing gum, the respiration rate was significantly lower during oral breathing than during nasal breathing (P < 0.05). During oral breathing, thoracic movement was significantly higher while chewing gum than while at rest (P < 0.05). Thoracic movement was significantly greater during oral breathing than during nasal breathing (P < 0.05). The trapezius muscle exhibited significant EMG activity when chewing gum during oral breathing. The activity of the trapezius muscle coincided with increased movement of the thoracic wall. Chewing food while breathing through the mouth interferes with and decreases the respiratory cycle and promotes unusual respiratory movement of the thoracic wall, which is directed by the activity of accessory muscles of respiration.

  12. Beclomethasone Nasal Spray

    MedlinePlus

    ... the lining of the nose) after nasal polyp removal surgery. Beclomethasone nasal spray should not be used ... room temperature and away from excess heat and moisture (not in the bathroom).Unneeded medications should be ...

  13. Triamcinolone Nasal Spray

    MedlinePlus

    ... itchy nose and itchy, watery eyes caused by hay fever or other allergies. Triamcinolone nasal spray should not ... germs.Triamcinolone nasal spray controls the symptoms of hay fever and allergies but does not cure these conditions. ...

  14. Acoustic rhinometry in mouth breathing patients: a systematic review.

    PubMed

    Melo, Ana Carolina Cardoso de; Gomes, Adriana de Oliveira de Camargo; Cavalcanti, Arlene Santos; Silva, Hilton Justino da

    2015-01-01

    When there is a change in the physiological pattern of nasal breathing, mouth breathing may already be present. The diagnosis of mouth breathing is related to nasal patency. One way to access nasal patency is by acoustic rhinometry. To systematically review the effectiveness of acoustic rhinometry for the diagnosis of patients with mouth breathing. Electronic databases LILACS, MEDLINE via PubMed and Bireme, SciELO, Web of Science, Scopus, PsycInfo, CINAHL, and Science Direct, from August to December 2013, were consulted. 11,439 articles were found: 30 from LILACS, 54 from MEDLINE via Bireme, 5558 from MEDLINE via PubMed, 11 from SciELO, 2056 from Web of Science, 1734 from Scopus, 13 from PsycInfo, 1108 from CINAHL, and 875 from Science Direct. Of these, two articles were selected. The heterogeneity in the use of equipment and materials for the assessment of respiratory mode in these studies reveals that there is not yet consensus in the assessment and diagnosis of patients with mouth breathing. According to the articles, acoustic rhinometry has been used for almost twenty years, but controlled studies attesting to the efficacy of measuring the geometry of nasal cavities for complementary diagnosis of respiratory mode are warranted. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  15. A study on the relationship between mouth breathing and facial morphological pattern.

    PubMed

    Bianchini, Ana Paula; Guedes, Zelita Caldeira Ferreira; Vieira, Marilena Manno

    2007-01-01

    Breathing is responsible for facial and cranial morphology development. investigate in order to see if there is any relationship between oral breathing and facial type. 119 male and female teenagers, with ages ranging between 15 and 18 years. The sample was separated in two groups: A-50 teenage oral breathers, 28 males and 22 females; and group B- 69 teenage nasal breathers, 37 males and 32 females. The sample was collected at the Centro de Atendimento e Apoio ao Adolescente do Departamento de Pediatria da UNIFESP/ EPM. We evaluated breathing and facial measures. by means of anthropometric indexes we classified facial types and associated them with the persons breathing type, Hypereuriprosopic (Total=0; oral breathers 0%; nasal breathers 0%; Euriprosopic (Total=14; oral breathers 2.52%, nasal breathers 9.24%;Mesoprosope (Total=20; oral breathers 19.32%; nasal breathers 21.01%, Leptoprosopic (Total=37; oral breathers 14.29%; nasal breathers 16.81%; Hyperleptoprosopic (Total =48; oral breathers 5.89% nasal breathers 10.92%). The mesoprosopic facial type was found in 48 teenagers (40.33%) of whom 25 (21.01%) were oral breathers and 23 (19.32%) were nasal breathers. it was not possible to prove the existence of an association between oral breathing and facial type.

  16. Impaired gastric emptying of a solid test meal in patients with Parkinson's disease using 13C-sodium octanoate breath test.

    PubMed

    Goetze, Oliver; Wieczorek, Joerg; Mueller, Thomas; Przuntek, Horst; Schmidt, Wolfgang E; Woitalla, Dirk

    2005-03-03

    Up to now gastric emptying in patients with Parkinson's disease was determined by radioscintigraphy. The 13C-sodium octanoate breath test (OBT) has been established for the non-invasive evaluation of gastric emptying with a solid test meal. The aim of the study was to evaluate the OBT in patients with Parkinson's disease and to investigate the prevalence of delayed gastric emptying for solids in PD and the relationship to clinical staging patterns. Twenty-two healthy subjects and 36 patients with different clinical stages of PD classified using Hoehn and Yahr (H&Y) and Unified Parkinson's Disease Rating Scale (UPDRS) were studied. Each fasting control and patient received a solid test meal (241 kcal) labelled with 100 mg of 13C-sodium octanoate. Breath samples were obtained before substrate administration and then in 15-min intervals over 4 h. The 13CO2/12CO2 ratio was determined in each breath sample as delta over baseline. Time to peak (t(peak)), gastric half emptying time (t1/2b), lag phase (t(lagb)) and gastric emptying coefficient (GEC) were calculated. Significant differences in t(peak), t1/2b, t(lagb) and GEC were found between patients and healthy volunteers (p<0.0001), with a 60% delay in gastric half emptying time in the patient group. Gastric half emptying time was different between clinical disease groups (H&Y 0-2 versus H&Y 2.5-5, p=0.001; UPDRS 0-30 versus UPDRS 61-92, p<0.05). The OBT detects a significant delay in gastric emptying of a solid test meal in patients with PD. Delayed gastric emptying for solids is associated with disease severity.

  17. Nasal Harmony in Aguaruna.

    ERIC Educational Resources Information Center

    Moon, Gui-Sun

    A discussion of the nasal harmony of Aguaruna, a language of the Jivaroan family in South America, approaches the subject from the viewpoint of generative phonology. This theory of phonology proposes an underlying nasal consonant, later deleted, that accounts for vowel nasalization. Complex rules that suppose a complex system of vowel and…

  18. Nasal Harmony in Aguaruna.

    ERIC Educational Resources Information Center

    Moon, Gui-Sun

    A discussion of the nasal harmony of Aguaruna, a language of the Jivaroan family in South America, approaches the subject from the viewpoint of generative phonology. This theory of phonology proposes an underlying nasal consonant, later deleted, that accounts for vowel nasalization. Complex rules that suppose a complex system of vowel and…

  19. Nasal septal hematoma.

    PubMed

    Ginsburg, C M

    1998-04-01

    Nasal septal hematoma is a rare but potentially serious complication of nasal trauma. Proper management consists of early recognition, prompt surgical evacuation of the hematoma, and antimicrobial therapy if a secondary nasal septal abscess is suspected. Clindamycin is recommended as initial therapy until the results of cultures and susceptibility studies are available.

  20. Nasal computed tomography.

    PubMed

    Kuehn, Ned F

    2006-05-01

    Chronic nasal disease is often a challenge to diagnose. Computed tomography greatly enhances the ability to diagnose chronic nasal disease in dogs and cats. Nasal computed tomography provides detailed information regarding the extent of disease, accurate discrimination of neoplastic versus nonneoplastic diseases, and identification of areas of the nose to examine rhinoscopically and suspicious regions to target for biopsy.

  1. Nasalance and nasality in children with cochlear implants and children with hearing aids.

    PubMed

    Baudonck, N; Van Lierde, K; D'haeseleer, E; Dhooge, I

    2015-04-01

    In prelingually deaf children, many speech production aspects including resonance, are known to be problematic. This study aimed to investigate nasality and nasalance in two groups of prelingually hearing impaired children, namely deaf children with a cochlear implant (CI) and moderate-to-severely hearing impaired hearing aid (HA) users. The results of both groups are compared with the results of normal hearing children. Besides, the impact of the degree of hearing loss was determined. 36 CI children (mean age: 9;0y), 25 HA children (mean age: 9;1y) and 26 NH children (mean age: 9;3y) were assessed using objective assessment techniques and perceptual evaluations in order to investigate the nasal resonance of the three groups. Ten HA children had thresholds above 70dB (range: 91dB-105dB) and fifteen below 70dB (range: 58dB-68dB). The Nasometer was used for registration of the nasalance values and nasality was perceptually evaluated by two experienced speech therapists using a nominal rating scale (consensus evaluation). For nasal stimuli, both CI children and HA children showed lower nasalance values in comparison with NH children. The opposite was observed for the oral stimuli. In both hearing impaired groups, cul-de-sac-resonance was observed on a significantly larger scale than in the NH group, and the HA children were judged to be significantly more hypernasal in comparison with NH children. Despite the fact that a substantial number of the CI and HA children demonstrate normal (nasal) resonance quality, this aspect of speech production is still at risk for hearing impaired children. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Postural alterations and pulmonary function of mouth-breathing children.

    PubMed

    Silveira, Waleska da; Mello, Fernanda Carvalho de Queiroz; Guimarães, Fernando Silva; Menezes, Sara Lucia Siveira de

    2010-01-01

    Mouth-breathing children have changes in their stomatognathic system, which result in head projection, stress increase in the scapular belt muscles and postural adaptations. Although thoracic shape and posture can influence ventilatory dynamics, we didn't find studies addressing pulmonary function of mouth-breathing children. this study aimed at analyzing the posture of mouth-breathing children, and studying the existence of correlations between posture and pulmonary volumes. prospective, observational and cross-sectional study, where the posture and pulmonary function of 17 mouth-breathing children and of 17 nasal-breathing children were evaluated by means of photogrammetry and forced spirometry. when compared to nasal-breathing, mouth-breathing subjects presented an increment in head projection and cervical lordosis, forwarded gravity center and reduced pulmonary volumes. There was an association between head projection and forced vital capacity, and between postural alterations and age. mouth-breathing children have postural alterations which increases with age and also reduced spirometry values. The vital capacity reduction correlates negatively with head projection.

  3. Rapid shallow breathing

    MedlinePlus

    Tachypnea; Breathing - rapid and shallow; Fast shallow breathing; Respiratory rate - rapid and shallow ... Shallow, rapid breathing has many possible medical causes, including: Asthma Blood clot in an artery in the lung Choking ...

  4. Breathing and Relaxation

    MedlinePlus

    ... Home Health Insights Stress & Relaxation Breathing and Relaxation Breathing and Relaxation Make an Appointment Ask a Question ... level is often dependent on his or her breathing pattern. Therefore, people with chronic lung conditions may ...

  5. Deep breathing after surgery

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000440.htm Deep breathing after surgery To use the sharing features on ... way to do so is by doing deep breathing exercises. Deep breathing keeps your lungs well-inflated ...

  6. A preoperative sleep study with nasal airway occlusion in pharyngeal flap surgery.

    PubMed

    Morita, Takeshi; Kurata, Kyosuke; Hiratsuka, Yasuyuki; Ito, Juichi

    2004-01-01

    Obstructive sleep apnea is a major complication of pharyngeal flap surgery. The purpose of the present study is to predict preoperatively the risk of upper airway obstruction after surgery. We performed an overnight sleep study preoperatively and postoperatively in 16 pediatric patients considered for pharyngeal flap surgery. Preoperative sleep study was done for two nights, once in normal breathing condition and once with complete nasal occlusion by packing of nostril with tampon gauze. In preoperative sleep recordings in normal breathing condition, all subjects had a normal apnea hypopnea index (AHI) less than 5/h. In preoperative recording with complete nasal occlusion, five patients exceeded 5/h in AHI. In particular, for two patients who had AHI higher than 15/h, we gave up a surgery in one case and performed pharyngeal flap operation for the other following a tracheotomy for severe disturbance of oral breathing. The remaining 14 subjects underwent surgery without airway obstructive complications. There was strong correlation between preoperative AHI with nasal tampon gauze and AHI at two weeks postoperatively (r = 0.88 P < .0001). There was no significant correlation between preoperative AHI in normal breathing condition and postoperative AHI (P > .05). These results exhibit preoperative sleep study with complete nasal airway occlusion represent postoperative breathing condition well during early postoperative period. Preoperative sleep study with complete nasal airway occlusion with nasal tampons could be useful for predicting the risk of upper airway obstruction secondary to pharyngeal flap surgery.

  7. Effect of treating severe nasal obstruction on the severity of obstructive sleep apnoea.

    PubMed

    McLean, H A; Urton, A M; Driver, H S; Tan, A K W; Day, A G; Munt, P W; Fitzpatrick, M F

    2005-03-01

    An association between mouth breathing during sleep and increased propensity for upper airway collapse is well documented, but the effect of treatment for nasal obstruction on mouth breathing during sleep and simultaneous obstructive sleep apnoea (OSA) severity has not been described previously. A randomised single blind placebo- and sham-controlled crossover study of treatment (topical decongestant and external dilator strip) for nasal obstruction was carried out in 10 patients (nine males; mean+/-SEM 46+/-5 yrs) with nasal obstruction and OSA. All patients had normal acoustic pharyngometry. The effect of treatment on nasal resistance, mouth breathing during sleep and OSA severity was quantified. Treatment of nasal obstruction was associated with a dramatic and sustained reduction in nasal resistance and the oral fraction of ventilation during sleep (mean (95% confidence interval) absolute reduction in oral fraction 30% (12-49)). Improvements in sleep architecture were observed during active treatment, and there was a modest reduction in OSA severity (change in apnoea-hypopnoea index 12 (3-22)). In conclusion, treating nasal obstruction reduced mouth breathing during sleep and obstructive sleep apnoea severity, but did not effectively alleviate obstructive sleep apnoea.

  8. [Smokers develop a nasal obstruction in supine position].

    PubMed

    Gudziol, H; Krause, J; Stadeler, M; Guntinas-Lichius, O

    2011-07-01

    We found in a previous study a healthy non-smoker nose does not develop obstruction lying in supine position . We examined whether a designated smoker nose behaves consistently. 39 healthy young smokers participated. The daily consumption was Ø 21 cigarettes. 9 test positions have been realized. Acoustic rhinometry was used for the estimation of nasal volumes and the nasal minimum cross-sectional areas as parameters for nasal respiration. Additionally, blood pressure and heart rate were measured to control the cardiovascular behavior. The total nasal volume decreased significantly lying down. Only one third of the volunteers noticed this obstruction. Going upstairs all measured parameters increased. 2 min later all rhinometric parameters, the diastolic blood pressure and heart rate had reached its baseline level. Systolic blood pressure took about 4 min. A cigarette smoke-induced nasal obstruction can be demonstrated during supine position using the acoustic rhinometry. One third of smokers noted a deterioration of nasal breathing. During stairs climbing the sympathic tone is increasing followed by nasal decongestion, raised blood pressure and heart rate. If smokers complaint of nasal obstruction in lying position - whether alert or during sleep - it is advisable to lift the bed-head. In medium term a therapy of chronic rhinitis with topical corticosteroids, in longer term a smoking cessation is recommended. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Oral breathing challenge in participants with vocal attrition.

    PubMed

    Sivasankar, Mahalakshmi; Fisher, Kimberly V

    2003-12-01

    Vocal folds undergo osmotic challenge by mouth breathing during singing, exercising, and loud speaking. Just 15 min of obligatory oral breathing, to dry the vocal folds, increases phonation threshold pressure (Pth) and expiratory vocal effort in healthy speakers (M. Sivasankar & K. Fisher, 2002). We questioned whether oral breathing is more detrimental to phonation in healthy participants with a history of temporary vocal attrition. The effects of a 15-min oral or nasal breathing challenge on Pth and perceived expiratory vocal effort were compared for participants reporting symptoms of vocal attrition (N = 18, ages 19-38 years) and normal controls (N = 20, ages 19-33 years). Post-challenge-prechallenge differences in Pth (deltaPth) and effort (deltaEffort) revealed that oral breathing, but not nasal breathing, increased Pth (p < .001 ) and effort (p < .001) at low, comfortable, and high pitch. deltaPth was significantly greater in participants with vocal attrition than in normal controls (p < .001). Nasal breathing reduced Pth for all controls but not for all participants reporting vocal attrition. deltaPth was significantly and linearly correlated with deltaEffort (rvocal attrition = .81, p < .001; rcontrol = .84, p < .001). We speculate that the greater increases in Pth in participants reporting vocal attrition may result from delayed or inadequate compensatory response to superficial laryngeal dehydration. Obligatory oral breathing may place voice users at risk for exacerbating vocal attrition. That sol layer depletion by obligatory oral breathing increased Pth and vocal effort provides support for the role of superficial hydration in maintaining ease of phonation.

  10. SNORAP: A Device for the Correction of Impaired Sleep Health by Using Tactile Stimulation for Individuals with Mild and Moderate Sleep Disordered Breathing.

    PubMed

    Yağanoğlu, Mete; Kayabekir, Murat; Köse, Cemal

    2017-09-01

    Sleep physiology and sleep hygiene play significant roles in maintaining the daily lives of individuals given that sleep is an important physiological need to protect the functions of the human brain. Sleep disordered breathing (SDB) is an important disease that disturbs this need. Snoring and Obstructive Sleep Apnea Syndrome (OSAS) are clinical conditions that affect all body organs and systems that intermittently, repeatedly, with at least 10 s or more breathing stops that decrease throughout the night and disturb sleep integrity. The aim of this study was to produce a new device for the treatment of patients especially with position and rapid eye movement (REM)-dependent mild and moderate OSAS. For this purpose, the main components of the device (the microphone (snore sensor), the heart rate sensor, and the vibration motor, which we named SNORAP) were applied to five volunteer patients (male, mean age: 33.2, body mass index mean: 29.3). After receiving the sound in real time with the microphone, the snoring sound was detected by using the Audio Fingerprint method with a success rate of 98.9%. According to the results obtained, the severity and the number of the snoring of the patients using SNORAP were found to be significantly lower than in the experimental conditions in the apnea hypopnea index (AHI), apnea index, hypopnea index, in supine position's AHI, and REM position's AHI before using SNORAP (Paired Sample Test, p < 0.05). REM sleep duration and nocturnal oxygen saturation were significantly higher when compared to the group not using the SNORAP (Paired Sample Test, p < 0.05).

  11. Nasal NO as a biomarker: don't say NO to the many challenges of translational medicine.

    PubMed

    Voynow, Judith A; Montpetit, Alison J

    2015-01-01

    This editorial summarizes the challenges of exhaled breath biomarker research particularly for nasal NO. We also introduce a new focus for Pediatric Pulmonology, a section on Translational Medicine. © 2014 Wiley Periodicals, Inc.

  12. Regional peak mucosal cooling predicts the perception of nasal patency.

    PubMed

    Zhao, Kai; Jiang, Jianbo; Blacker, Kara; Lyman, Brian; Dalton, Pamela; Cowart, Beverly J; Pribitkin, Edmund A

    2014-03-01

    Nasal obstruction is the principal symptom that drives patients with rhinosinus disease to seek medical treatment. However, patient perception of obstruction often bears little relationship to actual measured physical obstruction of airflow. This lack of an objective clinical tool hinders effective diagnosis and treatment. Previous work has suggested that the perception of nasal patency may involve nasal trigeminal activation by cool inspiratory airflow; we attempt to derive clinically relevant variables following this phenomenon. Prospective healthy cohort. Twenty-two healthy subjects rated unilateral nasal patency in controlled room air using a visual analog scale, followed by rhinomanometry, acoustic rhinometry, and butanol lateralization thresholds (BLTs). Each subject then immediately underwent a computed tomography scan, enabling the construction of a real-time computational fluid dynamics (CFD) nasal airway model, which was used to simulate nasal mucosa heat loss during steady resting breathing. Among all measured and computed variables, only CFD-simulated peak heat loss posterior to the nasal vestibule significantly correlated with patency ratings (r = -0.46, P < .01). Linear discriminant analysis predicted patency categories with 89% success rate, with BLT and rhinomanometric nasal resistance being two additional significant variables. As validation, CFD simulated nasal resistance significantly correlated with rhinomanometrically measured resistance (r = 0.41, P < .01). These results reveal that our noses are sensing patency via a mechanism involving localized peak nasal mucosal cooling. The analysis provides a strong rationale for combining the individualized CFD with other objective and neurologic measures to create a novel clinical tool to diagnose nasal obstruction and to predict and evaluate treatment outcomes. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  13. Regional Peak Mucosal Cooling Predicts the Perception of Nasal Patency

    PubMed Central

    Zhao, Kai; Jiang, Jianbo; Blacker, Kara; Lyman, Brian; Dalton, Pamela; Cowart, Beverly; Pribitkin, Edmund

    2013-01-01

    Objective Nasal obstruction is the principal symptom that drives patients with rhinosinus disease to seek medical treatment. However, patient perception of obstruction often bears little relationship to actual measured physical obstruction of airflow. This lack of an objective clinical tool hinders effective diagnosis and treatment. Previous work has suggested that the perception of nasal patency may involve nasal trigeminal activation by cool inspiratory airflow; we attempt to derive clinically relevant variables following this phenomenon. Study design Prospective healthy cohort. Methods Twenty-two healthy subjects rated unilateral nasal patency in controlled room air using a visual analog scale, followed by rhinomanometry, acoustic rhinometry and butanol lateralization thresholds (BLT). Each subject then immediately underwent a CT scan, enabling the construction of a “real-time” computational fluid dynamics (CFD) nasal airway model, which was used to simulate nasal mucosa heat loss during steady resting breathing. Results Among all measured and computed variables, only CFD-simulated peak heat loss posterior to the nasal vestibule significantly correlated with patency ratings (r=−0.46, p<0.01). Linear discriminant analysis predicted patency categories with 89% success rate, with BLT and rhinomanometric nasal resistance being two additional significant variables. As validation, CFD simulated nasal resistance significantly correlated with rhinomanometrically measured resistance (r=0.41, p<0.01). Conclusion These results reveal that our noses are sensing patency via a mechanism involving localized peak nasal mucosal cooling. The analysis provides a strong rationale for combining the individualized CFD with other objective and neurological measures to create a novel clinical tool to diagnose nasal obstruction and to predict and evaluate treatment outcomes. PMID:23775640

  14. Investigation of the vascular reaction of the nasal mucosa in cosmonauts

    NASA Technical Reports Server (NTRS)

    Yakovleva, I. Y.; Baranova, V. P.

    1982-01-01

    Rhinopneumometric examinations in 3 positions of the body were undertaken in 36 cosmonauts aged 25 to 45 years, 14 of whom participated in space flights of various lengths. The nasal vascular response standards were defined in persons of the group examined. A subjective characteristic of the nasal vascular, reactions arising during the flight is provided. Examinations of 14 people were performed before and after the space flight. The rise of intranasal resistance in the horizontal body position permits forecasting different degrees of nasal breathing disturbances during a period of acute adaptation to weightlessness owing to vasomotor alterations of the nasal mucous membrane.

  15. Methodological Issues of Sample Collection and Analysis of Exhaled Breath

    EPA Science Inventory

    Recommended standardized procedures have been developed for measurement of exhaled lower respiratory nitric oxide (NO) and nasal NO. It would be desirable to develop similar guidelines for the sampling of exhaled breath related to other compounds. For such systemic volatile o...

  16. Methodological Issues of Sample Collection and Analysis of Exhaled Breath

    EPA Science Inventory

    Recommended standardized procedures have been developed for measurement of exhaled lower respiratory nitric oxide (NO) and nasal NO. It would be desirable to develop similar guidelines for the sampling of exhaled breath related to other compounds. For such systemic volatile o...

  17. Measuring and Characterizing the Human Nasal Cycle

    PubMed Central

    Kahana-Zweig, Roni; Geva-Sagiv, Maya; Weissbrod, Aharon; Secundo, Lavi; Soroker, Nachum; Sobel, Noam

    2016-01-01

    Nasal airflow is greater in one nostril than in the other because of transient asymmetric nasal passage obstruction by erectile tissue. The extent of obstruction alternates across nostrils with periodicity referred to as the nasal cycle. The nasal cycle is related to autonomic arousal and is indicative of asymmetry in brain function. Moreover, alterations in nasal cycle periodicity have been linked to various diseases. There is therefore need for a tool allowing continuous accurate measurement and recording of airflow in each nostril separately. Here we provide detailed instructions for constructing such a tool at minimal cost and effort. We demonstrate application of the tool in 33 right-handed healthy subjects, and derive several statistical measures for nasal cycle characterization. Using these measures applied to 24-hour recordings we observed that: 1: subjects spent slightly longer in left over right nostril dominance (left = 2.63 ± 0.89 hours, right = 2.17 ± 0.89 hours, t(32) = 2.07, p < 0.05), 2: cycle duration was shorter in wake than in sleep (wake = 2.02 ± 1.7 hours, sleep = 4.5 ± 1.7 hours, (t(30) = 5.73, p < 0.0001). 3: slower breathing was associated with a more powerful cycle (the extent of difference across nostrils) (r = 0.4, p < 0.0001), and 4: the cycle was influenced by body posture such that lying on one side was associated with greater flow in the contralateral nostril (p < 0.002). Finally, we provide evidence for an airflow cycle in each nostril alone. These results provide characterization of an easily obtained measure that may have diagnostic implications for neurological disease and cognitive state. PMID:27711189

  18. Measuring and Characterizing the Human Nasal Cycle.

    PubMed

    Kahana-Zweig, Roni; Geva-Sagiv, Maya; Weissbrod, Aharon; Secundo, Lavi; Soroker, Nachum; Sobel, Noam

    2016-01-01

    Nasal airflow is greater in one nostril than in the other because of transient asymmetric nasal passage obstruction by erectile tissue. The extent of obstruction alternates across nostrils with periodicity referred to as the nasal cycle. The nasal cycle is related to autonomic arousal and is indicative of asymmetry in brain function. Moreover, alterations in nasal cycle periodicity have been linked to various diseases. There is therefore need for a tool allowing continuous accurate measurement and recording of airflow in each nostril separately. Here we provide detailed instructions for constructing such a tool at minimal cost and effort. We demonstrate application of the tool in 33 right-handed healthy subjects, and derive several statistical measures for nasal cycle characterization. Using these measures applied to 24-hour recordings we observed that: 1: subjects spent slightly longer in left over right nostril dominance (left = 2.63 ± 0.89 hours, right = 2.17 ± 0.89 hours, t(32) = 2.07, p < 0.05), 2: cycle duration was shorter in wake than in sleep (wake = 2.02 ± 1.7 hours, sleep = 4.5 ± 1.7 hours, (t(30) = 5.73, p < 0.0001). 3: slower breathing was associated with a more powerful cycle (the extent of difference across nostrils) (r = 0.4, p < 0.0001), and 4: the cycle was influenced by body posture such that lying on one side was associated with greater flow in the contralateral nostril (p < 0.002). Finally, we provide evidence for an airflow cycle in each nostril alone. These results provide characterization of an easily obtained measure that may have diagnostic implications for neurological disease and cognitive state.

  19. Treatment and prognosis of nasal polyps in cystic fibrosis.

    PubMed

    Stern, R C; Boat, T F; Wood, R E; Matthews, L W; Doershuk, C F

    1982-12-01

    Nasal polyposis complicated the course of fibrosis in 157 (26%) of 605 patients. Onset before age 5 years or after age 20 years was rare. Polyposis was the initial symptom of cystic fibrosis in 13 patients. Common symptoms included obstruction to nasal air flow, mouth breathing, epistaxis, and rhinorrhea. Intranasal and oral corticosteroids and antihistamines were ineffective in preventing recurrences but did occasionally afford symptomatic relief of obstruction. Nineteen (31%) of 62 patients who never had surgery had spontaneous and permanent disappearance of polyps. Simple polypectomy was an adequate procedure for patients with substantial nasal symptoms. There were no visual complications. Other surgical complications were rare. Children and adolescents with nasal polyps should have sweat tests by pilocarpine iontophoresis to rule out cystic fibrosis.

  20. [Nasal fractures in adults].

    PubMed

    Sjöstedt, Sannia; Larsen, Christian Grønhøj; Bilde, Anders; von Buchwald, Christian

    2016-03-07

    The risk of complications warrants treatment of most dislocated nasal fractures. Other injuries including other facial fractures and septal haematoma must be treated if present at the initial presentation. The usual treatment for a simple nasal fracture is closed reduction in local anaesthesia after five to seven days. Complicated cases require open reduction in general anaesthesia. Later revision of the deviated nose may become necessary in patients suffering from complications such as persistent nasal stenosis and/or deformity.

  1. Association between halitosis and mouth breathing in children

    PubMed Central

    Motta, Lara Jansiski; Bachiega, Joanna Carolina; Guedes, Carolina Cardoso; Laranja, Lorena Tristão; Bussadori, Sandra Kalil

    2011-01-01

    OBJECTIVE: To determine whether there is a correlation between halitosis and mouth breathing in children. STUDY DESIGN: Fifty-five children between 3 and 14 years of age were divided into two groups (nasal and mouth breathing) for the assessment of halitosis. A descriptive analysis was conducted on the degree of halitosis in each group. The chi-square test was used for comparison between groups, with a 5% level of significance. RESULTS: There was a significantly greater number of boys with the mouth-breathing pattern than girls. A total of 23.6% of the participants had no mouth odor, 12.7% had mild odor, 12.7% had moderate odor and 50.9% had strong odor. There was a statistically significant association between halitosis and mouth breathing. CONCLUSIONS: The occurrence of halitosis was high among the children evaluated, and there was a statistically significant association between halitosis and mouth breathing. PMID:21808855

  2. Association between halitosis and mouth breathing in children.

    PubMed

    Motta, Lara Jansiski; Bachiega, Joanna Carolina; Guedes, Carolina Cardoso; Laranja, Lorena Tristão; Bussadori, Sandra Kalil

    2011-01-01

    To determine whether there is a correlation between halitosis and mouth breathing in children. Fifty-five children between 3 and 14 years of age were divided into two groups (nasal and mouth breathing) for the assessment of halitosis. A descriptive analysis was conducted on the degree of halitosis in each group. The chi-square test was used for comparison between groups, with a 5% level of significance. There was a significantly greater number of boys with the mouth-breathing pattern than girls. A total of 23.6% of the participants had no mouth odor, 12.7% had mild odor, 12.7% had moderate odor and 50.9% had strong odor. There was a statistically significant association between halitosis and mouth breathing. The occurrence of halitosis was high among the children evaluated, and there was a statistically significant association between halitosis and mouth breathing.

  3. The supernumerary nasal tooth.

    PubMed

    Kirmeier, R; Truschnegg, A; Payer, M; Malyk, J; Daghighi, S; Jakse, N

    2009-11-01

    Teeth exceeding the normal dental complement that have erupted into the nasal cavity are a rare pathological entity. This case report describes a female patient with recurrent complaints and fetid discharge from the left nasal cavity. The suspected clinical diagnosis of a supernumerary nasal tooth was confirmed by computed tomography. After endoscopic removal, the tooth was examined using X-ray microtomography and thin-section preparations; these findings are presented for the first time. A literature search identified 25 supernumerary nasal teeth in 23 patients.

  4. Measuring Nasal Obstruction.

    PubMed

    Keeler, Jarrod; Most, Sam P

    2016-08-01

    The nose and the nasal airway is highly complex with intricate 3-dimensional anatomy, with multiple functions in respiration and filtration of the respired air. Nasal airway obstruction (NAO) is a complex problem with no clearly defined "gold-standard" in measurement. There are 3 tools for the measurement of NAO: patient-derived measurements, physician-observed measurements, and objective measurements. We continue to work towards finding a link between subjective and objective nasal obstruction. The field of evaluation and surgical treatment for NAO has grown tremendously in the past 4-5 decades and will continue to grow as we learn more about the pathophysiology and treatment of nasal obstruction.

  5. Affective brain areas and sleep disordered breathing

    PubMed Central

    Harper, Ronald M.; Kumar, Rajesh; Macey, Paul M.; Woo, Mary A.; Ogren, Jennifer A.

    2014-01-01

    The neural damage accompanying the hypoxia, reduced perfusion, and other consequences of sleep-disordered breathing found in obstructive sleep apnea, heart failure (HF), and congenital central hypoventilation syndrome (CCHS), appears in areas that serve multiple functions, including emotional drives to breathe, and involve systems that serve affective, cardiovascular, and breathing roles. The damage, assessed with structural magnetic resonance imaging (MRI) procedures, shows tissue loss or water content and diffusion changes indicative of injury, and impaired axonal integrity between structures; damage is preferentially unilateral. Functional MRI responses in affected areas also are time- or amplitude- distorted to ventilatory or autonomic challenges. Among the structures injured are the insular, cingulate, and ventral medial prefrontal cortices, as well as cerebellar deep nuclei and cortex, anterior hypothalamus, raphé, ventrolateral medulla, basal ganglia and, in CCHS, the locus coeruleus. Raphé and locus coeruleus injury may modify serotonergic and adrenergic modulation of upper airway and arousal characteristics. Since both axons and gray matter show injury, the consequences to function, especially to autonomic, cognitive, and mood regulation, are major. Several affected rostral sites, including the insular and cingulate cortices and hippocampus, mediate aspects of dyspnea, especially in CCHS, while others, including the anterior cingulate and thalamus, participate in initiation of inspiration after central breathing pauses, and the medullary injury can impair baroreflex and breathing control. The ancillary injury associated with sleep-disordered breathing to central structures can elicit multiple other distortions in cardiovascular, cognitive, and emotional functions in addition to effects on breathing regulation. PMID:24746053

  6. [The influence of breathing mode on the oral cavity].

    PubMed

    Surtel, Anna; Klepacz, Robert; Wysokińska-Miszczuk, Joanna

    2015-12-01

    Nose breathing is one of the key factors in the proper development and functioning of the oral cavity. The air passing through the nasal cavity is warmed and humidified while dust and other particulate matter is removed. It is also important as far as bone formation is concerned. The obstruction or congestions of the upper respiratory tract may negatively affect the correct and most optimal (nasal) respiratory tract. The switch from nasal to mouth breathing may lead to serious clinical consequences. Children with the clinical diagnosis of mouth breathing are usually pale, apathetic and they lack concentration and often get tired. Disorders resulting from hypoxy may also be the reason from sleep disturbances, such as frequent waking-up, nocturia, difficulties falling aslee. The main clinical manifestations of mouth breathing appear in the craniofacial structures. Mouth breathers frequently suffer from dental malocclusions and craniofacial bone abnormalities. Chronic muscle tension around the oral cavity could result in the widening of cranio-vertebral angle, posterior position of mandibula and narrow maxillary arch. Among dental alterations the most common are class II malocclusion (total or partial) with the protrusion of the anterior teeth, cross bite (unilateral or bilateral), anterior open bite and primary crowded teeth. Apart from malocclusion, chronic gingivitis, periodontitis, candida infections and halitosis are frequently present in mouth--breathing patients.

  7. Effect of nitric oxide inhibition on nasal airway resistance after nasal allergen challenge in allergic rhinitis.

    PubMed

    Maniscalco, M; Sofia, M; Carratù, L; Higenbottam, T

    2001-05-01

    Nitric oxide has been detected by chemiluminescence in the lumen of nasal airway, which is increased in nasal breathing in patients with seasonal rhinitis during a chronic exposure. The purpose of this study was to determinate the effect of a NO-synthase inhibitor NGL-arginine methyl ester (L-NAME) on nasal airway resistance (NAR) in patients with seasonal allergic rhinitis after an acute challenge to the allergen. Nitric oxide levels in the nose were measured by the chemiluminescence method in nine non-atopic volunteers and in seven patients with seasonal rhinitis at rest and after an acute challenge with the allergen. NAR were measured by active anterior rhinomanometry. Basal nasal NO concentration in allergic rhinitis was 496.5 +/- 151.4 parts per billion (ppb). (n = 7) and it was not significantly different from levels found in the control group: 458.4 +/- 105.9 ppb (n = 9). The topical administration of L-NAME in allergic rhinitis reduced the NO concentration (338.6 +/- 99.3 ppb, P < 0.001; n = 7). In the rhinitic patients the challenge with the allergen did not modify the nasal NO levels (504.5 +/- 138.5 ppb). The application of the allergen after the pretreatment with placebo caused a significant increase in NAR (from 0.32 +/- 0.11 Pa s cm-3 to 1.01 +/- 0.12 Pa s cm-3, P < 0.001; n = 7). Pre-treatment with L-NAME did not prevent the increase in NAR induced by allergen challenge (from 0.36 +/- 0.15 Pa s cm-3 to 1.06 +/- 0.26 Pa s cm-3). The results indicate that nasal administration of a NOS inhibitor L-NAME, at doses capable of decreasing nasal NO levels, has no effect on NAR and it does not prevent the NAR increase induced by an acute challenge with allergen in subjects with seasonal rhinitis.

  8. Nasal high flow reduces dead space.

    PubMed

    Möller, Winfried; Feng, Sheng; Domanski, Ulrike; Franke, Karl-Josef; Celik, Gülnaz; Bartenstein, Peter; Becker, Sven; Meyer, Gabriele; Schmid, Otmar; Eickelberg, Oliver; Tatkov, Stanislav; Nilius, Georg

    2017-01-01

    Recent studies show that nasal high flow (NHF) therapy can support ventilation in patients with acute or chronic respiratory disorders. Clearance of dead space has been suggested as being the key mechanism of respiratory support with NHF therapy. The hypothesis of this study was that NHF in a dose-dependent manner can clear dead space of the upper airways from expired air and decrease rebreathing. The randomized crossover study involved 10 volunteers using scintigraphy with (81m)Krypton ((81m)Kr) gas during a breath-holding maneuver with closed mouth and in 3 nasally breathing tracheotomized patients by volumetric capnography and oximetry through sampling CO2 and O2 in the trachea and measuring the inspired volume with inductance plethysmography following NHF rates of 15, 30, and 45 l/min. The scintigraphy revealed a decrease in (81m)Kr gas clearance half-time with an increase of NHF in the nasal cavities [Pearson's correlation coefficient cc = -0.55, P < 0.01], the pharynx (cc = -0.41, P < 0.01), and the trachea (cc = -0.51, P < 0.01). Clearance rates in nasal cavities derived from time constants and MRI-measured volumes were 40.6 ± 12.3 (SD), 52.5 ± 17.7, and 72.9 ± 21.3 ml/s during NHF (15, 30, and 45 l/min, respectively). Measurement of inspired gases in the trachea showed an NHF-dependent decrease of inspired CO2 that correlated with an increase of inspired O2 (cc = -0.77, P < 0.05). NHF clears the upper airways of expired air, which reduces dead space by a decrease of rebreathing making ventilation more efficient. The dead space clearance is flow and time dependent, and it may extend below the soft palate.

  9. Toxicology of the nasal passages

    SciTech Connect

    Barrow, C.S.

    1986-01-01

    Contents of this work include: Comparative Anatomy and Function of the Nasal Passages; Light Microscopic Examination of the Rat Nasal Passages: Preparation and Morphologic Features; Histopathology of Acute and Subacute Nasal Toxicity; Pathology of Chronic Nasal Toxic Responses Including Cancer; Responses of the Nasal Mucociliary Apparatus to Airborne Irritants; Effects of Chemical Exposure on Olfaction in Humans, Possible Consequences of Cytochrome P-450-Dependent Monooxygenases in Nasal Tissues.

  10. The effect of mouth breathing on chewing efficiency.

    PubMed

    Nagaiwa, Miho; Gunjigake, Kaori; Yamaguchi, Kazunori

    2016-03-01

    To examine the effect of mouth breathing on chewing efficiency by evaluating masticatory variables. Ten adult nasal breathers with normal occlusion and no temporomandibular dysfunction were selected. Subjects were instructed to bite the chewing gum on the habitual side. While breathing through the mouth and nose, the glucide elution from the chewing gum, number of chewing strokes, duration of chewing, and electromyography (EMG) activity of the masseter muscle were evaluated as variables of masticatory efficiency. The durations required for the chewing of 30, 60, 90, 120, 180, and 250 strokes were significantly (P < .05) longer while breathing through the mouth. There was no significant difference in the glucide elution rate (%) for each chewing stroke between nose and mouth breathings. The glucide elution rates for 1- and 3-minute chewing were significantly (P < .05) lower while breathing through the mouth. However, there was no significant difference in the glucide elution rate for 5-minute chewing between nose and mouth breathings. While chewing for 1, 3, and 5 minutes, the chewing stroke and EMG activity of the masseter muscle were significantly (P < .05) lower during mouth breathing. It takes a longer amount of time to complete chewing to obtain higher masticatory efficiency when breathing through the mouth. Therefore, mouth breathing will decrease the masticatory efficiency if the duration of chewing is restricted in everyday life.

  11. An investigation on airflow in disordered nasal cavity and its corrected models by tomographic PIV

    NASA Astrophysics Data System (ADS)

    Kim, S. K.; Chung, S. K.

    2004-06-01

    Knowledge of airflow characteristics in nasal cavities is essential to understand the physiology and pathology aspects of nasal breathing. Several studies have utilized physical models of the healthy nasal cavity to investigate the relationship between nasal anatomy and airflow. Since the final goal of these works is their contribution to the diagnosis and treatment of nasal diseases, therefore, the next step in this topic must be followed by the studies for disordered nasal cavities. In this paper, airflows in normal and abnormal nasal cavities and surgically created models, which simulate surgical treatment, are investigated experimentally by PIV. High-resolution computerized tomogram data and careful manipulation of the model surface by the ear, nose and throat doctor provide more sophisticated nasal cavity models. The correlation based correction PIV algorithm with window offset is used for PIV flow analysis. Average and RMS distributions in sagittal and coronal sections are obtained for inspiratory and expiratory nasal airflows. Comparisons in nasal airflows for both normal and abnormal cases are also examined. Airflow characteristics that are related to the abnormalities in the nasal cavity are proposed. In the case of simulations of surgical operations, velocity and RMS distributions in coronal section change locally, this may cause some difficulties in physiologic functions of noses and may hurt mucosal surface.

  12. Indirect open reduction through intercartilaginous incision and intranasal Kirschner wire splinting of comminuted nasal fractures.

    PubMed

    Burm, J S; Oh, S J

    1998-08-01

    The majority of nasal fractures have been managed by using closed reduction and intranasal packing. In comminuted nasal fractures, open reduction and internal fixation may be indicated for accurate reduction and rigid fixation, but it is a very aggressive procedure. We developed a new technique for comminuted nasal fractures: indirect open reduction and intranasal Kirschner wire splinting. A periosteal elevator is used to elevate the mucoperiosteum posterior to the nasal bone through intercartilaginous incision and to reduce accurately the nasal bone, at the same time detecting the fracture lines. The Kirschner wire is used to insert between the nasal bone and the mucoperiosteum and to splint rigidly the nasal bone. During the follow-up period of 5 weeks to 4 months, 23 of 27 patients (85 percent) had successful cosmetic results. Four patients had slight cosmetic deformity but did not request a late rhinoplasty. Nineteen patients had accurate reduction on a computed tomography scan. Ten patients had undercorrection of the nasal septum on a computed tomography scan, and three patients had significant septal deviation with airway obstruction. Indirect open reduction through intercartilaginous incision and intranasal Kirschner wire splinting is a reliable and useful method for the treatment of comminuted nasal fractures because it achieves accurate reduction and rigid, long intranasal support, can be done comfortably under local anesthesia, permits early nasal breathing postoperatively, has no external scar, and minimizes complications such as nasal bleeding, soft-tissue injury, infection, and recurrent displacement.

  13. Nasality in Taiwanese

    ERIC Educational Resources Information Center

    Pan, Ho-hsien

    2004-01-01

    This study used perceptual and articulatory data to investigate a language specific phonemic inventory, and allophonic rules for homorganic initial voiced stops versus homorganic nasal stops, and oral versus nasal vowels in Taiwanese. Four experiments were conducted: concept formation, gating, and two airflow studies. Results of a first nasal…

  14. Nasality in Taiwanese

    ERIC Educational Resources Information Center

    Pan, Ho-hsien

    2004-01-01

    This study used perceptual and articulatory data to investigate a language specific phonemic inventory, and allophonic rules for homorganic initial voiced stops versus homorganic nasal stops, and oral versus nasal vowels in Taiwanese. Four experiments were conducted: concept formation, gating, and two airflow studies. Results of a first nasal…

  15. Lining in nasal reconstruction.

    PubMed

    Haack, Sebastian; Fischer, Helmut; Gubisch, Wolfgang

    2014-06-01

    Restoring nasal lining is one of the essential parts during reconstruction of full-thickness defects of the nose. Without a sufficient nasal lining the whole reconstruction will fail. Nasal lining has to sufficiently cover the shaping subsurface framework. But in addition, lining must not compromise or even block nasal ventilation. This article demonstrates different possibilities of lining reconstruction. The use of composite grafts for small rim defects is described. The limits and technical components for application of skin grafts are discussed. Then the advantages and limitations of endonasal, perinasal, and hingeover flaps are demonstrated. Strategies to restore lining with one or two forehead flaps are presented. Finally, the possibilities and technical aspects to reconstruct nasal lining with a forearm flap are demonstrated. Technical details are explained by intraoperative pictures. Clinical cases are shown to illustrate the different approaches and should help to understand the process of decision making. It is concluded that although the lining cannot be seen after reconstruction of the cover it remains one of the key components for nasal reconstruction. When dealing with full-thickness nasal defects, there is no way to avoid learning how to restore nasal lining.

  16. Nasal dermoid sinus cyst.

    PubMed

    Cauchois, R; Laccourreye, O; Bremond, D; Testud, R; Küffer, R; Monteil, J P

    1994-08-01

    Nasal dermoid sinus cyst is one of the diagnoses of midline nasal masses in children. This retrospective study analyzes the various theories regarding the origin of this congenital abnormality, the differential diagnosis, and the value of magnetic resonance imaging, as well as the various surgical options available.

  17. Reconstructive procedures for disturbed functions within the upper airway: pharyngeal breathing/snoring

    PubMed Central

    Verse, Thomas

    2005-01-01

    Breathing disorders which have their origin within the pharynx mainly occur during sleep. These so-called obstructive sleep-related breathing disorders include three different disturbances which have to be distinguished properly: simple snoring, upper airway resistance syndrome (UARS) and obstructive sleep apnea (OSA). Each disturbance requires a different treatment. Simple snoring does not affect the physical health of the snorer himself, but often leads to social problems due to the annoying character of the breathing sounds. Appropriate treatment modalities are oral devices and transcutaneous or ttransmucosal electrical stimulation of the muscles of the floor of the mouth via surface electrodes. As reconstructive surgical procedures adenotomies, tonsillectomies, tonsillotomies, or adenotonsillectomies are successfully used in children. Moreover, in adults radiofrequency treatments of the tonsils, the soft palate and of the base of tongue, as well as uvulopalatopharyngoplasty (UPPP), laser-assisted uvulopalatoplasty (LAUP) and palatal implants are adequate treatments for simple snoring. Adequate therapies for UARS and mild OSA (less than 20 breathing events per hour of sleep) are oral appliances. Nasal continuos positive airway pressure (NCPAP) ventilation is a very successful treatment modality, but shows low compliance in these patients, as daytime symptoms like excessive sleepiness or or impaired cognitive functions are often unincisive in patients with mild OSA. Reconstructive procedures like UPPP, radiofrequency surgery of the tonsils or the base of tongue, hyoid suspension, mandibular osteotomy with genioglossus advancement (MO) are successful treatment options either as isolated procedures or in combination within so-called multi-level surgery concepts. Goldstandard for the treatment of moderate to severe OSA is the nCPAP ventilation. All patients should at least try this treatment modality. Only in the rare cases of nCPAP failure (2%) and in the

  18. Oral and oronasal breathing during continuous exercise produce similar responses to ozone inhalation

    SciTech Connect

    Adams, W.C.; Schelegle, E.S.; Shaffrath, J.D. )

    1989-09-01

    Breathing route has a profound effect on sulfur dioxide-induced pulmonary function response in human subjects. There is comparatively little evidence of the effects of oral, nasal, and oronasal breathing on ozone (O3)-induced responses in humans. In this study, six young adult males were exposed on five occasions to 0.40 parts per million (ppm) O3 while exercising continuously at one of two workloads (minute ventilation, VE, of approximately 30 and 75 l/min). The VE exposure time product was similar for all protocols. Four exposures were delivered randomly with a Hans-Rudolph respiratory valve attached to a silicone facemask, with breathing route effected with and without noseclip. A 2 x 2 analysis of variance revealed no statistically significant differences (p less than .05) across conditions in pulmonary function, exercise ventilatory pattern, or subjective symptoms responses. The fifth exposure, delivered via the same respiratory valve with mouthpiece, but without facemask, revealed significantly greater forced expiratory volume in 1 s (FEV1.0) impairment than that observed for the respiratory valve, facemask with noseclip exposure (-20.4% and -15.9%, respectively). The latter suggests partial O3 reactivity to the facemask and clean shaven facial surface of the subjects, although reduced oral scrubbing by mouthpiece-induced bypassing of the oral vestibule might account, in part, for this difference. Recent O3 uptake evidence from another laboratory, however, supports our conclusion that breathing route during moderate and heavy continuous exercise does not affect acute physiologic responses to 0.40 ppm O3.

  19. [Nasal allergenic provocation test].

    PubMed

    Becerril Angeles, M H; Pérez López, A; Azuara Pliego, E

    2000-01-01

    This is a method to evaluate both specific sensitivity to allergens in the nasal mucosa, IgE-mediated hypersensitivity, and antiinflammatory and antiallergic drugs efficacy, whose objectives are for research in diagnosis and treatment. The method is based in allergen extracts delivery in the nasal mucosa and the post-challenge measurement of rhinitis symptoms, vasoactive mediators release quantification and nasal obstruction degree evaluated by rhinomanometry. Nasal allergen challenge is a procedure of diagnostic and therapeutic evaluation usefulness, that must be performed in selected patients, in adequate facilities, by experts physicians, with standardised allergen dosages, in an specific nasal area, with objective measurements (rhinomanometry, mediators and secretions of the allergic response) and symptoms scoring that allow get reliable results in patients with allergic rhinitis under study.

  20. Nanoparticles for nasal vaccination.

    PubMed

    Csaba, Noemi; Garcia-Fuentes, Marcos; Alonso, Maria Jose

    2009-02-27

    The great interest in mucosal vaccine delivery arises from the fact that mucosal surfaces represent the major site of entry for many pathogens. Among other mucosal sites, nasal delivery is especially attractive for immunization, as the nasal epithelium is characterized by relatively high permeability, low enzymatic activity and by the presence of an important number of immunocompetent cells. In addition to these advantageous characteristics, the nasal route could offer simplified and more cost-effective protocols for vaccination with improved patient compliance. The use of nanocarriers provides a suitable way for the nasal delivery of antigenic molecules. Besides improved protection and facilitated transport of the antigen, nanoparticulate delivery systems could also provide more effective antigen recognition by immune cells. These represent key factors in the optimal processing and presentation of the antigen, and therefore in the subsequent development of a suitable immune response. In this sense, the design of optimized vaccine nanocarriers offers a promising way for nasal mucosal vaccination.

  1. Nasal nitric oxide is dependent on sinus obstruction in allergic rhinitis.

    PubMed

    Suojalehto, Hille; Vehmas, Tapio; Lindström, Irmeli; Kennedy, David W; Kilpeläinen, Maritta; Plosila, Tuomas; Savukoski, Sauli; Sipilä, Jukka; Varpula, Matti; Wolff, Henrik; Alenius, Harri; Toskala, Elina

    2014-06-01

    The aim of this study was to evaluate the associations between nasal nitric oxide and nasal symptoms, sinus opacification, and markers of allergic inflammation in allergic and in nonallergic rhinitis while taking into account the effect of sinus obstruction. We studied 175 young adult subjects divided into three groups: 1) allergic rhinitis, 2) nonallergic rhinitis, and 3) controls. We measured nasal nitric oxide using the breath-holding method and exhaled nitric oxide and scored semiquantitatively nasal computed tomography scans for opacification and obstruction. We also assessed the visual analogue scores of nasal symptoms, eosinophil count, and interleukin-13 mRNA levels in nasal biopsies. The level of nasal nitric oxide correlated with exhaled nitric oxide (r = 0.377, P < .001). In allergic rhinitis, nasal nitric oxide was elevated when compared to the controls, and an inverse correlation existed between the nasal nitric oxide level and sinus ostial obstruction (r = -0.272, P = .013). In nonallergic rhinitis, the level of nasal nitric oxide was similar to that of the controls. In allergic rhinitis, nasal nitric oxide correlated positively with the opacification score (r = 0.250, P = .033) and the nasal eosinophil count (r = 0.293, P = .030) of patients without a marked sinus ostial obstruction. Sinus ostial obstruction lowers the level of nasal nitric oxide and reduces its value as an indicator of allergic mucosal inflammation. A high nasal nitric oxide level may be a useful marker of eosinophilic inflammation in the nasal cavity and indicate the absence of marked sinus ostial obstruction. 3b. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  2. Mice lacking brain/kidney phosphate-activated glutaminase (GLS1) have impaired glutamatergic synaptic transmission, altered breathing, disorganized goal-directed behavior and die shortly after birth

    PubMed Central

    Masson, Justine; Darmon, Michèle; Conjard, Agnès; Chuhma, Nao; Ropert, Nicole; Thoby-Brisson, Muriel; Foutz, Arthur S.; Parrot, Sandrine; Miller, Gretchen M.; Jorisch, Renée; Polan, Jonathan; Hamon, Michel; Hen, René; Rayport, Stephen

    2009-01-01

    Neurotransmitter glutamate has been thought to derive mainly from glutamine via the action of glutaminase type 1 (GLS1). To address the importance of this pathway in glutamatergic transmission, we knocked out GLS1 in mice. The insertion of a STOP cassette by homologous recombination produced a null allele that blocked transcription, encoded no immunoreactive protein and abolished GLS1 enzymatic activity. Null mutants were slightly smaller, were deficient in goal-directed behavior, hypoventilated and died in the first post-natal day. No gross or microscopic defects were detected in peripheral organs or in the central nervous system. In cultured neurons from the null mutants, miniature EPSC amplitude and duration were normal; however, the amplitude of evoked EPSCs decayed more rapidly with sustained 10 Hz stimulation, consistent with an observed reduction in depolarization-evoked glutamate release. Because of this activity-dependent impairment in glutamatergic transmission, we surmised that respiratory networks, which require temporal summation of synaptic input, would be particularly affected. We found that the amplitude of inspirations was decreased in vivo, chemosensitivity to CO2 was severely altered, and the frequency of pacemaker activity recorded in the respiratory generator in the Pre-Bötzinger complex, a glutamatergic brainstem network that can be isolated in vitro, was increased. Our results show that while alternate pathways to GLS1 glutamate synthesis support baseline glutamatergic transmission, the GLS1 pathway is essential for maintaining the function of active synapses, and so the mutation is associated with impaired respiratory function, abnormal goal-directed behavior and neonatal demise. PMID:16641247

  3. Aesthetic and functional outcome following nasal reconstruction.

    PubMed

    Mureau, Marc A M; Moolenburgh, Sanne E; Levendag, Peter C; Hofer, Stefan O P

    2007-10-01

    Few reports on outcome of aesthetic nasal reconstruction exist. Therefore, subjective and objective aesthetic and functional outcome following nasal reconstruction was assessed. Outcome was assessed in 38 consecutive patients treated for subtotal nasal defects using standardized semistructured interviews. Standardized physical examination forms and photographs were used. In six patients, one aesthetic subunit was involved; in 14, two; and in 18, three or more. Defects were classified as skin only (13 percent), skin/cartilage (21 percent), and full thickness (66 percent). Some defects (32 percent) involved adjacent aesthetic units. Inner lining was reconstructed with local mucosa or turnover skin flaps. Support was provided with regional cartilage grafts and/or composite septal flaps. Skin defects were reconstructed with forehead, nasolabial, cheek advancement, Abbé, facial artery perforator, or free radial forearm flaps. Nasal reconstructions required 116 procedures. Thirty-three patients participated in the follow-up study. Mucosal crusting was noted in 36 percent, passage difficulties in 31 percent, and worse olfaction in 16 percent. Phonation was unchanged. Eighty-one percent were very satisfied with nasal function. Flap color match was moderate to good in 97 percent; hair growth occurred in 61 percent. At critical inspection, a thicker flap (58 percent), smaller ostium nasi (77 percent), thicker alar rim (86 percent), and minor alar rim retraction (46 percent) were noted. Seventy-nine percent were very satisfied with total nasal appearance. Although objective functional and aesthetic outcome following nasal reconstruction sometimes shows impairment compared with the normal situation, it gives high subjective patient satisfaction with function and aesthetics.

  4. Similarity and Enhancement: Nasality from Moroccan Arabic Pharyngeals and Nasals

    ERIC Educational Resources Information Center

    Zellou, Georgia Eve

    2012-01-01

    Experimental studies of the articulation, acoustics, and perception of nasal and pharyngeal consonants and adjacent vowels were conducted to investigate nasality in Moroccan Arabic (MA). The status of nasality in MA is described as coarticulatorily complex, where two phoneme types (pharyngeal segments and nasal segments) yield similar…

  5. Comparison of Nasal Acceleration and Nasalance across Vowels

    ERIC Educational Resources Information Center

    Thorp, Elias B.; Virnik, Boris T.; Stepp, Cara E.

    2013-01-01

    Purpose: The purpose of this study was to determine the performance of normalized nasal acceleration (NNA) relative to nasalance as estimates of nasalized versus nonnasalized vowel and sentence productions. Method: Participants were 18 healthy speakers of American English. NNA was measured using a custom sensor, and nasalance was measured using…

  6. Similarity and Enhancement: Nasality from Moroccan Arabic Pharyngeals and Nasals

    ERIC Educational Resources Information Center

    Zellou, Georgia Eve

    2012-01-01

    Experimental studies of the articulation, acoustics, and perception of nasal and pharyngeal consonants and adjacent vowels were conducted to investigate nasality in Moroccan Arabic (MA). The status of nasality in MA is described as coarticulatorily complex, where two phoneme types (pharyngeal segments and nasal segments) yield similar…

  7. Comparison of Nasal Acceleration and Nasalance across Vowels

    ERIC Educational Resources Information Center

    Thorp, Elias B.; Virnik, Boris T.; Stepp, Cara E.

    2013-01-01

    Purpose: The purpose of this study was to determine the performance of normalized nasal acceleration (NNA) relative to nasalance as estimates of nasalized versus nonnasalized vowel and sentence productions. Method: Participants were 18 healthy speakers of American English. NNA was measured using a custom sensor, and nasalance was measured using…

  8. Revision of the overresected nasal tip complex.

    PubMed

    Davis, Richard E

    2012-08-01

    Tip deformities resulting from previous nasal surgery range from mild to profound. For the mild deformity, morbidity is low and successful correction is usually achieved with a modest and targeted surgical adjustment. However, for the profound deformity, overt cosmetic deformities and corresponding functional impairment are the byproducts of severe derangements in skeletal architecture. Hence, for the severely damaged nasal tip, a complex surgical revision in which the decimated nasal tip framework is reconstructed with autologous cartilage grafts is essential. However, rebuilding the decimated nasal tip is a challenging and risky procedure that is best left to the seasoned rhinoplasty specialist. Careful assessment of the previously operated tissues, combined with an accurate cosmetic analysis, must be juxtaposed with the patient's cosmetic desires to derive an individualized and effective treatment plan. Atraumatic soft tissue technique, combined with a strategic yet balanced and judicious application of graft material, often culminate in satisfactory surgical outcomes. Proper assessment, technical skill, and sound clinical judgment are all critical ingredients in successful restoration of the surgically compromise nasal tip. Copyright © 2012 by Thieme Medical Publishers, Inc.

  9. Handedness, eyedness and nasal cycle in children with autism.

    PubMed

    Dane, Senol; Balci, Nese

    2007-06-01

    Autism is referred to as cerebral lateralization abnormality. In this study, the possible relationships among handedness, eyedness and nasal cycle in autism have been investigated. Thirty-seven children with autism and 20 controls were included in the study. The patient group included 27 boys and 10 girls who ranged in age from 5 to 20 years. For hand preference, hand used to write and throw a ball was accepted as dominant hand. For eye preference or dominance, eye used to look through keyhole of a door was accepted as dominant eye. Nasal dominance was assessed by a method of measuring the nasal airflow. The rates of left-handedness and left-eyedness were higher in children with autism compared to normal populations. A majority of children with autism had left nasal dominance. Autism and early language impairment may be associated with left handedness, eyedness and nasal dominance.

  10. Breathing difficulty - lying down

    MedlinePlus

    Waking at night short of breath; Paroxysmal nocturnal dyspnea; PND; Difficulty breathing while lying down; Orthopnea ... obstructive pulmonary disease (COPD) Cor pulmonale Heart failure ... conditions that lead to it) Panic disorder Sleep apnea Snoring

  11. Shortness of Breath

    MedlinePlus

    ... Wheezing Worsening of pre-existing shortness of breath Self-care To help keep chronic shortness of breath ... JA, et al. Dyspnea. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa.: Saunders ...

  12. Minimizing Shortness of Breath

    MedlinePlus

    ... postures and exposure to environmental irritants. Pursed-Lip Breathing One focus of occupational therapy is to teach ... the accessory muscles and manage respiratory symptoms. Monitor Breathing During an activity, it is important to pause ...

  13. Pursed lip breathing (image)

    MedlinePlus

    ... were going to whistle or blow out a candle. Breathe out (exhale) slowly through your lips for 4 or ... were going to whistle or blow out a candle. Breathe out (exhale) slowly through your lips for 4 or ...

  14. Effects of short term forced oral breathing in rat pups on weight gain, hydration and stress.

    PubMed

    Padzys, Guy S; Thornton, Simon N; Martrette, Jean-Marc; Trabalon, Marie

    2011-02-01

    Nasal obstruction is a risk factor in sleep-disordered breathing with a negative impact on the quality of life in humans. We investigated hydration changes produced by short term reversible, bilateral, nasal obstruction in young developing rat pups. Physiological parameters of growth (weight gain and gastric content weight) and dehydration were analyzed during two periods; during nasal obstruction at post-natal day 8 (days 9, 11 and 13), plus 7 and 90 days after recovery of nasal breathing (day 15 and adulthood). Body weight gain in oral breathing rat pups was slower compared to controls. Gastric weight was decreased significantly only in oral breathing rat pups on days 9 and 11 while plasma osmolality and vasopressin levels increased (indicators of dehydration). There were no differences between controls and treated rat pups by day 15, or at adulthood. Short term nasal obstruction-induced forced oral breathing, decreased gastric content which had a negative impact on growth and blood glucose concentration in the short term for female rat pups. Plasma corticosterone levels increased during the dehydration but were normal in males by 90 days. This could be a model for blocked nose syndrome in the newborn. Possible long term consequences on development are discussed. Copyright © 2010 Elsevier Inc. All rights reserved.

  15. Sleep disordered breathing in pregnancy

    PubMed Central

    2015-01-01

    Key points Sleep disordered breathing (SDB) is common and the severity increases as pregnancy progresses. Frequent snoring, older age and high pre-pregnancy body mass index (>25 kg⋅m−2) could be reliable indicators for SDB in early pregnancy. SDB screening tools, including questionnaires, used in the nonpregnant population have poor predictive ability in pregnancy. Accumulating evidence suggests that SDB during pregnancy may be associated with increased risk of adverse pregnancy outcomes, including gestational diabetes and pre-eclampsia. However, the results should be interpreted cautiously because several studies failed to adjust for potential maternal confounders and have other study limitations. There are no pregnancy-specific practice guidelines for SDB treatment. Many clinicians and practices follow recommendations for the treatment in the general population. Women with pre-existing SDB might need to be reassessed, particularly after the sixth month of pregnancy, because symptoms can worsen with nasal congestion and weight gain. Educational aims To highlight the prevalence and severity of sleep disordered breathing (SDB) in the pregnant population. To inform readers about risk factors for SDB in pregnancy. To explore the impact of SDB on adverse maternal and fetal outcomes, and biological pathways for associated adverse maternal and fetal outcomes. To introduce current management options for SDB in pregnancy, including medical and behavioural approaches. Sleep disordered breathing (SDB) is very common during pregnancy, and is most likely explained by hormonal, physiological and physical changes. Maternal obesity, one of the major risk factors for SDB, together with physiological changes in pregnancy may predispose women to develop SDB. SDB has been associated with poor maternal and fetal outcomes. Thus, early identification, diagnosis and treatment of SDB are important in pregnancy. This article reviews the pregnancy-related changes affecting the

  16. What Causes Bad Breath?

    MedlinePlus

    ... A Week of Healthy Breakfasts Shyness What Causes Bad Breath? KidsHealth > For Teens > What Causes Bad Breath? A A A en español ¿Qué es lo que provoca el mal aliento? Bad breath, or halitosis , can be a major problem, ...

  17. Skeletal and occlusal characteristics in mouth-breathing pre-school children.

    PubMed

    Mattar, Sara Elisa M; Anselmo-Lima, Wilma T; Valera, Fabiana C P; Matsumoto, Mirian A N

    2004-01-01

    This study verified the influence of chronic mouth breathing on dentofacial growth and developmental in pre-school children. The study evaluated 73 children, both sexes, ranging from 3 to 6 years of age. After the otorhinolaryngological breathing diagnosis, 44 mouth-breathing children and 29 nasal-breathing children were compared according to facial and occlusal characteristics. The skeletal pattern measurements SN.GoGn, BaN.PtGn, PP.PM, Ar-Go, S-Go indicated a tendency to mouth-breathing children presenting a dolicofacial pattern. According to occlusal characteristics, only the intermolar distance showed a significant correlation with a narrow maxillary arch in mouth-breathing subjects. Based on the results of this study, mouth-breathing can influence craniofacial and occlusal development early in childhood.

  18. Association between breastfeeding and the development of breathing patterns in children.

    PubMed

    Limeira, Adriana Bezerra; Aguiar, Carlos Menezes; de Lima Bezerra, Niedje Siqueira; Câmara, Andréa Cruz

    2013-04-01

    The aims of the present study were to evaluate the association between breastfeeding and breathing development and to investigate associations between breastfeeding duration and the breathing patterns in children. A cross-sectional study was carried out at the Institute of Integrative Medicine Professor Fernando Figueira, Recife, Brazil, with a random sample of 732 children aged between 6 and 9 years. Breastfeeding and breathing patterns were identified using a questionnaire that was filled out by mothers or guardians, and a clinical examination of the children. Data were analyzed statistically by Pearson's chi-square test at 5 % significance level. The prevalence of mouth breathing was 48 %, whereas 52 % of the children were nasal breathers. Six hundred-forty children were breastfed; 46.2 % of them were mouth breathers and 53.8 % were nasal breathers. Ninety-two children were not breastfed; 59.8 % of them were mouth breathers and 40.2 % were nasal breathers. Breastfeeding for 24 months or more, as well as exclusive breastfeeding in the first 6 months, was associated with the development of nasal breathing. Extended breastfeeding was associated with correct development of the breathing pattern.

  19. Etiology, clinical manifestations and concurrent findings in mouth-breathing children.

    PubMed

    Abreu, Rubens Rafael; Rocha, Regina Lunardi; Lamounier, Joel Alves; Guerra, Angela Francisca Marques

    2008-01-01

    To investigate the etiology, main clinical manifestations and other concurrent findings in mouth-breathing children aged 3 to 9 years and resident in the urban area of Abaeté (MG), Brazil. This study was based on a representative random sample of the town population, of 23,596 inhabitants. Clinical diagnosis of mouth-breathing was defined as a combination of snoring, sleeping with mouth open, drooling on the pillow and frequent or intermittent nasal obstruction. Children with a clinical diagnosis of mouth-breathing underwent nasal endoscopy, allergy skin tests and X ray of the rhinopharynx, full blood tests, eosinophil counts, total IgE assay and fecal parasitology. Data were analyzed using SPSS version 10.5. The main causes of mouth-breathing were: allergic rhinitis (81.4%), enlarged adenoids (79.2%), enlarged tonsils (12.6%), and obstructive deviation of the nasal septum (1.0%). The main clinical manifestations of mouth breathers were: sleeping with mouth open (86%), snoring (79%), itchy nose (77%), drooling on the pillow (62%), nocturnal sleep problems or agitated sleep (62%), nasal obstruction (49%), and irritability during the day (43%). Certain clinical manifestations are very common among mouth-breathing children. These manifestations must be recognized and considered in the clinical diagnosis of mouth-breathing.

  20. Nasal symptoms and clinical findings in adult patients treated for unilateral cleft lip and palate.

    PubMed

    Morén, Staffan; Mani, Maria; Lundberg, Kristina; Holmström, Mats

    2013-10-01

    The aim of the study was to investigate self-experienced nasal symptoms among adults treated for UCLP and the association to clinical findings, and to evaluate whether palate closure in one-stage or two-stages affected the symptoms or clinical findings. All people with UCLP born between 1960-1987, treated at Uppsala University Hospital, were considered for participation in this cross-sectional population study with long-term follow-up. Eighty-three patients (76% participation rate) participated, a mean of 37 years after the first operation. Fifty-two patients were treated with one-stage palate closure and 31 with two-stage palate closure. An age-matched group of 67 non-cleft controls completed the same study protocol, which included a questionnaire regarding nasal symptoms, nasal inspection, anterior rhinoscopy, and nasal endoscopy. Patients reported a higher frequency of nasal symptoms compared with the control group, e.g., nasal obstruction (81% compared with 60%) and mouth breathing (20% compared with 5%). Patients also rated their nasal symptoms as having a more negative impact on their daily life and physical activities than controls. Nasal examination revealed higher frequencies of nasal deformities among patients. No positive correlation was found between nasal symptoms and severity of findings at nasal examination. No differences were identified between patients treated with one-stage and two-stage palate closure regarding symptoms or nasal findings. Adult patients treated for UCLP suffer from more nasal symptoms than controls. However, symptoms are not associated with findings at clinical nasal examination or method of palate closure.

  1. Nasal septal trauma in children.

    PubMed

    Olsen, K D; Carpenter, R J; Kern, E B

    1979-07-01

    If the septal component of a nasal injury is adequately managed, usually the entire nasal injury will be well managed. Major or minor nasal trauma can cause cartilage fracture, deviation, dislocation, hematoma, or abscess formation, and the various associated sequelae, some of them life-threatening. A negative x-ray report should never be used as a substitute for a complete intranasal examination in any child with nasal trauma. Any nasal abnormality should be referred for immediate evaluation and treatment.

  2. Nasal corticosteroid sprays

    MedlinePlus

    ... best for decreasing symptoms during that season. Several brands of nasal corticosteroid sprays are available. They all ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

  3. Budesonide Nasal Spray

    MedlinePlus

    ... by an allergy to pollen, mold, dust, or pets). Budesonide nasal spray should not be used to ... disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, ...

  4. Cyanocobalamin Nasal Gel

    MedlinePlus

    ... B12 can cause anemia (condition in which the red blood cells do not bring enough oxygen to the organs) ... be treated with vitamin B12 injections. After the red blood cells have returned to normal, cyanocobalamin nasal gel can ...

  5. Nasal fracture (image)

    MedlinePlus

    A nasal fracture is a break in the bone over the ridge of the nose. It usually results from a blunt ... and is one of the most common facial fracture. Symptoms of a broken nose include pain, blood ...

  6. Chapter 6: Nasal polyps.

    PubMed

    Settipane, Russell A; Peters, Anju T; Chiu, Alexander G

    2013-01-01

    Nasal polyps occur in 1-4% of the population, usually occurring in the setting of an underlying local or systemic disease. The most common associated condition is chronic rhinosinusitis (CRS). A high prevalence of nasal polyps is also seen in allergic fungal rhinosinusitis, aspirin-exacerbated respiratory disease, Churg-Strauss syndrome, and cystic fibrosis. In the setting of CRS, nasal polyps are not likely to be cured by either medical or surgical therapy; however, control is generally attainable. The best medical evidence supports the use of intranasal corticosteroids for maintenance therapy and short courses of oral corticosteroids for exacerbations. The evidence for short- and long-term antibiotics is much less robust. For patients with symptomatic nasal polyposis nonresponsive to medical therapies, functional endoscopic sinus surgery provides an adjunctive therapeutic option.

  7. Nasal packing and stenting

    PubMed Central

    Weber, Rainer K.

    2011-01-01

    Nasal packs are indispensable in ENT practice. This study reviews current indications, effectiveness and risks of nasal packs and stents. In endoscopic surgery, nasal packs should always have smooth surfaces to minimize mucosal damage, improve wound healing and increase patient comfort. Functional endoscopic endonasal sinus surgery allows the use of modern nasal packs, since pressure is no longer required. So called hemostatic/resorbable materials are a first step in this direction. However, they may lead to adhesions and foreign body reactions in mucosal membranes. Simple occlusion is an effective method for creating a moist milieu for improved wound healing and avoiding dryness. Stenting of the frontal sinus is recommended if surgery fails to produce a wide, physiologically shaped drainage path that is sufficiently covered by intact tissue. PMID:22073095

  8. Saline nasal washes

    MedlinePlus

    ... Be sure you only use distilled, boiled, or filtered water. While rare, some tap water may contain small ... pot or nasal bulb with distilled, boiled, or filtered water after every use and let it dry. Use ...

  9. Nasal nitric oxide and regulation of human pulmonary blood flow in the upright position.

    PubMed

    Sánchez Crespo, Alejandro; Hallberg, Jenny; Lundberg, Jon O; Lindahl, Sten G E; Jacobsson, Hans; Weitzberg, Eddie; Nyrén, Sven

    2010-01-01

    There are a number of evidences suggesting that lung perfusion distribution is under active regulation and determined by several factors in addition to gravity. In this work, we hypothesised that autoinhalation of nitric oxide (NO), produced in the human nasal airways, may be one important factor regulating human lung perfusion distribution in the upright position. In 15 healthy volunteers, we used single-photon emission computed tomography technique and two tracers (99mTc and 113mIn) labeled with human macroaggregated albumin to assess pulmonary blood flow distribution. In the sitting upright position, subjects first breathed NO free air through the mouth followed by the administration of the first tracer. Subjects then switched to either nasal breathing or oral breathing with the addition of exogenous NO-enriched air followed by the administration of the second tracer. Compared with oral breathing, nasal breathing induced a blood flow redistribution of approximately 4% of the total perfusion in the caudal to cranial and dorsal to ventral directions. For low perfused lung regions like the apical region, this represents a net increase of 24% in blood flow. Similar effects were obtained with the addition of exogenous NO during oral breathing, indicating that NO and not the breathing condition was responsible for the blood flow redistribution. In conclusion, these results provide evidence that autoinhalation of endogenous NO from the nasal airways may ameliorate the influence of gravity on pulmonary blood flow distribution in the upright position. The presence of nasal NO only in humans and higher primates suggest that it may be an important part of the adaptation to bipedalism.

  10. Measurement of nasal nitric oxide: evaluation of six different sampling methods.

    PubMed

    de Winter-de Groot, K M; van der Ent, C K

    2009-01-01

    Specific guidelines are developed for the measurement of bronchial FE(NO), however, nasal nitric oxide (nNO) measurement is not standardised yet, resulting in divergent nNO values. This study compares six different sampling methods for nNO as described in the literature, to analyse their outcome and short term and long term reproducibility. nNO concentrations were measured in 38 healthy subjects. Each subject performed nNO measurements during tidal breathing (nNO-TB), single breath quiet exhalations (nNO-QE), QE with oral exhalation against a resistance (nNO-QE + R), breath holding (nNO-BH) and during single-breath humming exhalations at 128 and 440 Hz (nNO-HE(128) and nNO-HE(440), respectively). To assess short term and long term reproducibility all manoeuvres were repeated after one and 24 h. Lowest values were found during quiet exhalation (mean nNO-QE was 364 p.p.b., SEM 27). Methods in which there is turbulence of nasal flow (as in TB, HE(128) and HE(440)) result in higher nNO levels. Highest values were found in methods with decreased nasal flow [when there is no nasal flow as in BH or when the velum is closed as in QE + R: mean nNO 763 p.p.b. (SEM 61)]. NNO during humming at 440 Hz was significantly higher than at 128 Hz (P < 0.01). The within-subject coefficient of variation of repeated measurements was lowest during humming and breath holding, 3.4 and 3.8%, respectively. Concerning short term and long term reproducibility, best agreement is reached with humming and second best with breath holding. Different methods result in different levels and reproducibility of nNO. In regard to this, methods of humming and breath holding are recommended for standardised measurement of nasal NO.

  11. Nasal bots...a fascinating world!

    PubMed

    Angulo-Valadez, Carlos E; Scholl, Philip J; Cepeda-Palacios, Ramón; Jacquiet, Philippe; Dorchies, Philippe

    2010-11-24

    Larvae causing obligatory myiasis are numerous and they may affect cutaneous and subcutaneous tissues, wounds, nasopharyngeal cavities (nasal bots), internal organs and the digestive tract (bots) of domestic and wild animals and humans as well. Nasal bots belong to the Family Oestridae, Subfamily Oestrinae, which includes several important genera: Oestrus, Kirkioestrus, and Gedoelstia infecting Artiodactyla (except Cervidae) in Africa and Eurasia, Cephenemyia and Pharyngomyia infecting Cervidae, Rhinoestrus infecting horses, Cephalopina infecting camels, Pharyngobolus infecting African elephants, and Tracheomyia infecting Australian kangaroos. Nasal bots are widespread in Mediterranean and tropical areas and in affected animals they induce sneezing and nasal discharge which may become caked with dust making breathing very difficult. The aforementioned species of larvae are host-specific but sometimes the may be deposited in human eyes inducing a painful opthalmomyiasis of short duration. The first fascinating trait of these parasites is the very efficient morphological and biological adaptations to parasitism they show either as larvae or as adults, in order to facilitate their survival and search for a suitable host. Nasal bots have reached different degrees of complexity in their life cycles. Indeed, while for some species (e.g., Oestrus ovis, Rhinoestrus usbekistanicus) larvae are injected by flies directly into nostrils and develop in the sinuses before being ejected for external pupation, some other species migrate from eyes to blood before returning to nasal cavities either through the ethmoid bone (Gedoelstia hässleri) or via lungs and bronchi (Gedoelstia cristata). Moreover, larvae are very well-adapted to their environment being able to undergo through hypobiosis either inside or outside the host, according to the climatic environmental conditions and seasonality. The second fascinating trait of nasal bots is related to host behavioural and immune

  12. Autologous Diced Cartilage in Nasal Septoplasty

    PubMed Central

    Sersar, Sameh Ibrahim; Yassin, Ibrahim; Eldin Aly, Mohammed Saad

    2016-01-01

    Diced rib cartilage is an acceptable option in severe nasal deformities. We present our preliminary experience in KAMC in nasal septoplasties using the autologous diced costal cartilage. This is a retrospective study of the 22 cases who needed the autologous diced costal cartilage in our centre in 4 years. All our patients needed autologous diced rib cartilages. Twelve were wrapped with temporalis fascia, eight needed rectus fascia and perichondrium was used in only 2 cases. The naso-frontal angle for the whole series decreased by a mean of 4.41° (p=0.008) for the group using the rectus fascia diced cartilage graft. From the aesthetic point of view, all cases were satisfied except 3 (13.6%); two in the group of diced cartilage temporalis fascia; group 1. From the functional breathing view, only 1 case was not satisfied. He was in group 1. Autologous rib cartilage was shown to be a good graft in nasal septoplasty especially if wrapped with rectus fascia. PMID:27853694

  13. Nasal high flow reduces dead space

    PubMed Central

    Feng, Sheng; Domanski, Ulrike; Franke, Karl-Josef; Celik, Gülnaz; Bartenstein, Peter; Becker, Sven; Meyer, Gabriele; Schmid, Otmar; Eickelberg, Oliver; Tatkov, Stanislav; Nilius, Georg

    2017-01-01

    Recent studies show that nasal high flow (NHF) therapy can support ventilation in patients with acute or chronic respiratory disorders. Clearance of dead space has been suggested as being the key mechanism of respiratory support with NHF therapy. The hypothesis of this study was that NHF in a dose-dependent manner can clear dead space of the upper airways from expired air and decrease rebreathing. The randomized crossover study involved 10 volunteers using scintigraphy with 81mKrypton (81mKr) gas during a breath-holding maneuver with closed mouth and in 3 nasally breathing tracheotomized patients by volumetric capnography and oximetry through sampling CO2 and O2 in the trachea and measuring the inspired volume with inductance plethysmography following NHF rates of 15, 30, and 45 l/min. The scintigraphy revealed a decrease in 81mKr gas clearance half-time with an increase of NHF in the nasal cavities [Pearson’s correlation coefficient cc = −0.55, P < 0.01], the pharynx (cc = −0.41, P < 0.01), and the trachea (cc = −0.51, P < 0.01). Clearance rates in nasal cavities derived from time constants and MRI-measured volumes were 40.6 ± 12.3 (SD), 52.5 ± 17.7, and 72.9 ± 21.3 ml/s during NHF (15, 30, and 45 l/min, respectively). Measurement of inspired gases in the trachea showed an NHF-dependent decrease of inspired CO2 that correlated with an increase of inspired O2 (cc = −0.77, P < 0.05). NHF clears the upper airways of expired air, which reduces dead space by a decrease of rebreathing making ventilation more efficient. The dead space clearance is flow and time dependent, and it may extend below the soft palate. NEW & NOTEWORTHY Clearance of expired air in upper airways by nasal high flow (NHF) can be extended below the soft palate and de facto causes a reduction of dead space. Using scintigraphy, the authors found a relationship between NHF, time, and clearance. Direct measurement of CO2 and O2 in the trachea confirmed a reduction of rebreathing, providing

  14. Click production during breathing in a sperm whale (Physeter macrocephalus)

    NASA Astrophysics Data System (ADS)

    Wahlberg, Magnus; Frantzis, Alexandros; Alexiadou, Paraskevi; Madsen, Peter T.; Møhl, Bertel

    2005-12-01

    A sperm whale (Physeter macrocephalus) was observed at the surface with above- and underwater video and synchronized underwater sound recordings. During seven instances the whale ventilated its lungs while clicking. From this observation it is inferred that click production is achieved by pressurizing air in the right nasal passage, pneumatically disconnected from the lungs and the left nasal passage, and that air flows anterior through the phonic lips into the distal air sac. The capability of breathing and clicking at the same time is unique among studied odontocetes and relates to the extreme asymmetry of the sperm whale sound-producing forehead.

  15. Alterations in Maxillary Sinus Volume among Oral and Nasal Breathers

    PubMed Central

    Agacayak, Kamil Serkan; Gulsun, Belgin; Koparal, Mahmut; Atalay, Yusuf; Aksoy, Orhan; Adiguzel, Ozkan

    2015-01-01

    Background Oral breathing causes many changes in the facial anatomical structures in adult patients. In this study we aimed to determine the effects of long-term oral breathing (>5 years) on the maxillary sinus volumes among adult male patients. Material/Methods We accessed medical records of 586 patients who had undergone cone beam computed tomography (CBCT) for any reason between September 2013 and April 2014. Patients who had undergone cone-beam dental volumetric tomography scans for any reason and who had answered a questionnaire about breathing were screened retrospectively. Cone beam dental volumetric tomography (I-Cat, Imaging Sciences International, Hatfield, PA, USA) was used to take the images of the maxillo-facial area at a setting of 120 kVp and 3.7 mA. This study involved male patients older than 21 years of age. Results The study included a total of 239 male patients, of which 68 were oral breathers and 171 were nasal breathers. The mean age of the oral breathers was 48.4 years and that of the nasal breathers was 46.7 years and the difference was not statistically significant (p>0.05). The mean maxillary sinus volumes of the oral and nasal breathers were 9043.49±1987.90 and 10851.77±2769.37, respectively, and the difference in maxillary sinus volume between the 2 groups was statistically significant (p<0.001). Conclusions The volume of maxillary sinus in oral breathers (>5 years) was significantly lower than in nasal breathers, but it remains unclear whether this is due to malfunctioning of the nasal cavity or due to the underlying pathological condition. PMID:25553770

  16. Nasal highflow improves ventilation in patients with COPD

    PubMed Central

    Bräunlich, Jens; Köhler, Marcus; Wirtz, Hubert

    2016-01-01

    Background Nasal highflow (NHF) provides a warmed and humidified air stream up to 60 L/min. Recent data demonstrated a positive effect in patients with acute hypoxemic respiratory failure, especially when caused by pneumonia. Preliminary data show a decrease in hypercapnia in patients with COPD. Therefore, NHF should be evaluated as a new ventilatory support device. This study was conducted to assess the impact of different flow rates on ventilatory parameters in patients with COPD. Materials and methods This interventional clinical study was performed with patients suffering from severe COPD. The aim was to characterize flow-dependent changes in mean airway pressure, breathing volumes, breathing frequency, and decrease in partial pressure of CO2 (pCO2). Mean airway pressure was measured in the nasopharyngeal space (19 patients). To evaluate breathing volumes, we used a polysomnographic device (18 patients). All patients received 20 L/min, 30 L/min, 40 L/min, and 50 L/min and – to illustrate the effects – nasal continuous positive airway pressure and nasal bilevel positive airway pressure. Capillary blood gas analyses were performed in 54 patients with hypercapnic COPD before and two hours after the use of NHF. We compared the extent of decrease in pCO2 when using 20 L/min and 30 L/min. Additionally, comfort and dyspnea during the use of NHF were surveyed. Results NHF resulted in a minor flow dependent increase in mean airway pressure. Tidal volume increased, and breathing rate decreased. The calculated minute volume decreased under NHF breathing. In spite of this fact, hypercapnia decreased with increasing flow (20 L/min vs 30 L/min). Additionally, an improvement in dyspnea was observed. The rapid shallow breathing index shows a decrease when using NHF. Conclusion NHF leads to a flow-dependent reduction in pCO2. This is most likely achieved by a washout of the respiratory tract and a functional reduction in dead space. In summary, NHF enhances effectiveness of

  17. Prosthetic Management of a Nasal Septal Defect using a Custom Made Unilateral Intranasal Stent: A Case Report

    PubMed Central

    Karunakaran, Harshakumar; Rodrigues, Sheela Virginia

    2016-01-01

    Various etiologies including congenital malformations, infections, trauma, iatrogenic causes or complications of systemic diseases can result in perforation of the nasal septum. The common symptoms associated with such defects include difficulty in breathing, nasal twang in voice, rhinorrhea, etc. Obturation can be achieved by insertion of a unilateral nasal stent. An attempt has been made in the present report to address the prosthetic management of pateint having nasal septum perforation utilizing a unilateral, custom made heat cured acrylic stent and the details of the technique are presented. PMID:27656584

  18. Titanium Mesh Nasal Repair without Nasal Lining.

    PubMed

    Zenga, Joseph; Kao, Katherine; Chen, Collin; Gross, Jennifer; Hahn, Samuel; Chi, John J; Branham, Gregory H

    2017-02-01

    The objective of this study was to describe outcomes for patients who underwent titanium mesh reconstruction of full-thickness nasal defects without internal lining repair. This is a retrospective cohort study. Patients with through-and-through nasal defects were identified at a single academic institution between 2008 and 2016. Nasal reconstruction was performed with either titanium mesh and external skin reconstruction without repair of the intranasal lining or traditional three-layer closure. Five patients underwent titanium mesh reconstruction and 11 underwent traditional three-layer repair. Median follow-up was 11 months (range, 2-66 months). The only significant difference between groups was older age in patients undergoing titanium reconstruction (mean, 81 vs. 63 years; difference of 18; 95% confidence interval [CI], 4-32 years). Defect extent including overall size and structures removed was similar between groups (p > 0.05). Paramedian forehead flap was the most common external reconstruction in both groups (100% for titanium mesh and 73% for three-layer closure). Time under anesthesia was significantly shorter for titanium mesh reconstruction (median, 119 vs. 314 minutes; difference of 195; 95% CI, 45-237). Estimated blood loss and length of hospital stay were similar between groups (p > 0.05). Complication rates were substantial although not significantly different, 40 and 36% in titanium and three-layer reconstruction, respectively (p > 0.05). All patients with complications after titanium reconstruction had prior or postoperative radiotherapy. Titanium mesh reconstruction of through-and-through nasal defects can successfully be performed without reconstruction of the intranasal lining, significantly decreasing operative times. This reconstructive technique may not be suitable for patients who undergo radiotherapy.

  19. Relationship between Oral Flow Patterns, Nasal Obstruction, and Respiratory Events during Sleep

    PubMed Central

    Suzuki, Masaaki; Furukawa, Taiji; Sugimoto, Akira; Katada, Koji; Kotani, Ryosuke; Yoshizawa, Takayuki

    2015-01-01

    Study Objectives: Sleep breathing patterns are altered by nasal obstruction and respiratory events. This study aimed to describe the relationships between specific sleep oral flow (OF) patterns, nasal airway obstruction, and respiratory events. Methods: Nasal flow and OF were measured simultaneously by polysomnography in 85 adults during sleep. OF was measured 2 cm in front of the lips using a pressure sensor. Results: OF could be classified into three patterns: postrespiratory event OF (postevent OF), during-respiratory event OF (during-event OF), and spontaneous arousal-related OF (SpAr-related OF). Postevent OFs begin at the end of airflow reduction, are preceded by respiratory arousal, and are accompanied by postapneic hyperventilation; during-event OFs occur during nasal flow reduction; and SpAr-related OFs to OF begin during stable breathing, and are preceded by spontaneous arousal but are rarely accompanied by apnea/hypopnea. Multivariate regression showed that nasal obstruction was predictive of SpAr-related OF. The relative frequency of SpAr-related OF events was negatively correlated with the apnea-hypopnea index. The fraction of SpAr-related OF duration relative to total OF duration was significantly greater in patients with nasal obstruction than in those without. Conclusions: SpAr-related OF was associated with nasal obstruction, but not respiratory events. This pattern thus functions as a “nasal obstruction bypass”, mainly in normal subjects and patients with mild sleep disordered breathing (SDB). By contrast, the other two types were related to respiratory events and were typical patterns seen in patients with moderate and severe SDB. Citation: Suzuki M, Furukawa T, Sugimoto A, Katada K, Kotani R, Yoshizawa T. Relationship between oral flow patterns, nasal obstruction, and respiratory events during sleep. J Clin Sleep Med 2015;11(8):855–860. PMID:25766699

  20. Deposition of radon progeny in nonhuman primate nasal airways

    SciTech Connect

    Yeh, H.C.; Cheng, Y.S.; Su, Y.F. . Inhalation Toxicology Research Inst.); Morgan, K.T. )

    1991-01-01

    Information on aerosol deposition patterns in the human respiratory tract is needed to improve health risk estimates for exposure to airborne radon progeny. To investigate this, deposition of {sup 220}Rn progeny in Rhesus monkey nasal casts was examined. A substantial fraction of the inhaled ultrafine particles are deposited in the nasal cast. Deposition efficiency increases with decreasing particle size, reaching a maximum value of 80% for particles 1.7 nm in diameter. Breathing flow rate has a minimal effect on deposition efficiency. Deposition efficiencies for particles smaller than 100 nm in diameter are similar for monkey and human nasal casts. Equations based on turbulent diffusion can be fitted to these data for either inspirational or expirational flow. These mathematical expressions will be useful for modifying the inhaled particle deposition and dosimetry models. 20 refs., 9 figs., 1 tab (MHB)

  1. Comparison of single-breath and tidal breathing exhaled nitric oxide levels in infants.

    PubMed

    Franklin, P J; Turner, S W; Mutch, R C; Stick, S M

    2004-03-01

    The aim of this study was to compare two different methods, tidal breathing (TB) and single-breath (SB), for measuring fractional exhaled nitric oxide (FENO) in infants. FENO was measured in 71 infants with either recurrent wheeze (n=32), recurrent cough (n=16) or no symptoms (healthy, n=23) using both methods. For TB measurements five breaths were collected into a gas sampling bag (off-line reservoir sampling). The SB method was modified from the raised volume rapid thoraco-abdominal technique. Agreement between the two methods was investigated and both methods were used to compare FENO in infants with and without symptoms. Flow dependence of SB FENO was demonstrated using two expiratory flows (11 and 40 mL x s(-1)). There was a moderate correlation (r=0.60) but poor agreement between levels using the TB and SB methods. A significant difference in FENO between healthy children and children with wheeze was found using the SB but not the TB method. Due to lower expiratory flow and reduced nasal nitric oxide contamination the single-breath technique may be more sensitive than the tidal breathing method for detecting differences in exhaled nitric oxide between infants with and without respiratory symptoms.

  2. Influence of breathing route on upper airway lining liquid surface tension in humans

    PubMed Central

    Verma, Manisha; Seto-Poon, Margaret; Wheatley, John R; Amis, Terence C; Kirkness, Jason P

    2006-01-01

    We have recently demonstrated that the severity of sleep-disordered breathing in obstructive sleep apnoea hypopnoea syndrome (OSAHS) can be reduced by lowering the surface tension (γ) of the upper airway lining liquid (UAL). Morning xerostomia (related to oral breathing during sleep) is reported by most OSAHS patients. In the present study we examine relationships between breathing route, oral mucosal ‘wetness’ and the γ of UAL. We studied eight healthy subjects (age, 25 ± 5 years [mean ± s.d.]; body-mass index, 23 ± 2 kg m−2) during a 120 min challenge of both nasal-only breathing (mouth taped) and oral-only breathing (nose clip), each on a separate day (randomized). Both oral mucosal ‘wetness’ (5 s contact gravimetric absorbent paper strip method) and the γ (‘pull-off’ force technique) of 0.2 μl samples of UAL obtained from the posterior pharyngeal wall were measured at 15 min intervals (mouth tape removed and replaced as required). Upper airway mucosal ‘wetness’ increased during 120 min of nasal breathing from 4.0 ± 0.4 (mean ± s.e.m.) to 5.3 ± 0.3 μl (5 s)−1 but decreased from 4.5 ± 0.4 to 0.1 ± 0.2 μl (5 s)−1 with oral breathing (both P < 0.001, repeated-measures ANOVA, Tukey's multiple comparison test, post hoc test). Concurrently, the γ of UAL decreased from 59.3 ± 2.2 to 51.8 ± 0.98 mN m−1 with nasal breathing but increased from 64.4 ± 2.7 to 77.4 ± 1.1 mN m−1 with oral breathing (P < 0.001). For the group and all conditions studied, γ of UAL values strongly correlated with upper airway mucosal ‘wetness’ (correlation coefficient, r2=−0.34, P < 0.001; linear regression). We conclude that oral breathing increases and nasal breathing decreases the γ of UAL in healthy subjects during wakefulness. We speculate that nasal breathing in OSAHS patients during sleep may promote a low γ of UAL that may contribute to reducing the severity of sleep-disordered breathing. PMID:16690717

  3. Chondrosarcoma of the nasal septum

    PubMed Central

    Bahgat, Mohammed; Bahgat, Yassin; Bahgat, Ahmed; Elwany, Yasmine

    2012-01-01

    Chondrosarcoma of the nasal septum is a rare malignancy. When it occurs, early diagnosis is difficult because patients generally present with common, non-specific sinonasal complaints. This is the report of a 62-year-old woman who presented with a 1-month history of nasal obstruction, headache and anosmia. Nasal endoscopy showed a nasal mass obstructing both nasal cavities not separable from the septum. A wedge biopsy of the nasal mass was taken. Histopathology was suggestive of chondrosarcoma. The tumour was removed by an endoscopic approach. The clinical presentation, diagnosis and treatment of this case as well as a review of the literature are discussed. PMID:22669930

  4. [Congenital nasal obstruction due to pyriform aperture stenosis. A case series].

    PubMed

    Cuestas, G; José, G; Demarchi, V; Razetti, J; Boccio, C

    2015-01-01

    Nasal obstruction in neonates is a potentially fatal condition due to their exclusive nasal breathing. The main cause is inflammatory or infectious rhinitis. Congenital, neoplastic, traumatic or iatrogenic causes are less frequent. Choanal atresia is the most common congenital nasal anomaly. A less common etiology of congenital nasal obstruction is pyriform aperture stenosis. Suspicion might arise in any newborn with varying degrees of stridor and respiratory distress, associated with the difficulty of passing a probe through anterior nares. Diagnosis should be confirmed by a computed tomography of the craniofacial massif. The therapeutic approach will depend on the severity of symptoms. We describe our experience with 5 patients with this condition, treated surgically using a sub-labial approach, and followed by nasal stenting.

  5. Breathing metabolic simulator

    NASA Technical Reports Server (NTRS)

    Bartlett, R. G.; Hendricks, C. M.; Morison, W. B.

    1972-01-01

    The development of a breathing metabolic simulator (BMS) is reported. This BMS simulates all of the breathing and metabolic parameters required for complete evaluation and test of life support and resuscitation equipment. It is also useful for calibrating and validating mechanical and gaseous pulmonary function test procedures. Breathing rate, breathing depth, breath velocity contour, oxygen uptake, and carbon dioxide release are all variable over wide ranges simulating conditions from sleep to hard work with respiratory exchange ratios covering the range from hypoventilation. In addition, all of these parameters are remotely controllable to facilitate use of the device in hostile or remote environments. The exhaled breath is also maintained at body temperature and a high humidity. The simulation is accurate to the extent of having a variable functional residual capacity independent of other parameters.

  6. Comparing Thoracic and Intra-Nasal Pressure Transients to Monitor Active Odor Sampling during Odor-Guided Decision Making in the Mouse

    PubMed Central

    Reisert, Johannes; Golden, Glen J.; Matsumura, Koichi; Smear, Matt; Rinberg, Dmitry; Gelperin, Alan

    2013-01-01

    Background Recording of physiological parameters in behaving mice has seen an immense increase over recent years driven by, for example, increased miniaturization of recording devices. One parameter particularly important for odorant-driven behaviors is the breathing frequency, since the latter dictates the rate of odorant delivery to the nasal cavity and the olfactory receptor neurons located therein. New Method Typically, breathing patterns are monitored by either measuring the breathing-induced temperature or pressure changes in the nasal cavity. Both require the implantation of a nasal cannula and tethering of the mouse to either a cable or tubing. To avoid these limitations we used an implanted pressure sensor which reads the thoracic pressure and transmits the data telemetrically, thus making it suitable for experiments which require a freely moving animal. Results Mice performed a Go/NoGo odorant-driven behavioral task with the implanted pressure sensor, which proved to work reliably to allow recording of breathing signals over several weeks from a given animal. Comparison to existing Method(s) We simultaneously recorded the thoracic and nasal pressure changes and found that measuring the thoracic pressure change yielded similar results compared to measurements of nasal pressure changes. Conclusion Telemetrically recorded breathing signals are a feasible method to monitor odorant-guided behavioral changes in breathing rates. Its advantages are most significant when recording from a freely moving animal over several weeks. The advantages and disadvantages of different methods to record breathing patterns are discussed. PMID:24056232

  7. [Numerical simulation study on effects of ambient temperature on airflow in the nasal cavity].

    PubMed

    Xiong, Guan-xia; Li, Jian-feng; Lei, Wen-bin; Zhou, Xu-hui; Zhan, Jie-min; Xu, Geng

    2011-11-01

    To study the aerodynamics of the normal human nasal cavity under different ambient temperatures. Based on CT scanning, a model of a healthy adult's nasal cavity was established using computational fluid dynamics software from Fluent. Airflow in this model was simulated and calculated at ambient temperatures of 0 °C, 24 °C, and 37 °C during periodic breathing. Ambient temperature only had an impact on the temperature in the nasal cavity during the inspiratory phase, and the temperature distribution was not symmetrical in the inspiratory acceleration and deceleration phases. The ambient temperature significantly affected airflow speed in main nasal passages during the inspiratory process, but had little impact on flow status (proportion and streamline of airflow in different nasal passages). Temperature differences increased the irregular air movement within sinuses. The anterior nasal segment, including the area between the valve and the head of the middle turbinate, was the most effective part of the nasal airway in heating the ambient air. Our findings describe the effects of ambient temperature on airflow parameters in the nasal cavity within a single respiratory cycle. This data is more comprehensively and accurately to determine the relationship between nasal cavity aerodynamics and physiological functions.

  8. Effects of cold dry air nasal stimulation on airway mucosal blood flow in humans.

    PubMed

    Le Merre, C; Isber, J; Chediak, A D; Wanner, A

    2003-10-01

    Several studies have demonstrated that nasal challenges can induce reflex responses in the respiratory system. Some authors have described bronchoconstriction and modification of the pattern of breathing following nasal challenges by irritants and cold air. We propose to determine the effect of nasal stimulation with cold dry air on airway mucosal blood flow (Qaw) in the proximal tracheal bronchial tree of healthy humans. Nine healthy subjects participated in the study. Baseline measurement Qaw, nasal airway resistance (NAR) and airway caliber by specific airways conductance (SGaw) were followed by nasal challenge with cold dry air. Qaw, NAR and Sgaw were determined after the challenge. In those subjects in which a significant decline in Qaw was recorded the protocol was repeated after pretreatment with nasal anesthesia using topical lidocaine. Cold dry air challenge produced a significant decrease in mean Qaw for the nine subjects and this response was abolished by pretreatment with nasal anesthesia using topical lidocaine. There was no significant change in Sgaw and NAR after the challenge and topical lidocaine anesthesia. Our data indicates that nasal stimulation with cold dry air leads to a reduction in Qaw and that this effect may be mediated by a nasal reflex.

  9. Snoring and Nasal Congestion

    MedlinePlus

    ... and soft palate. This negative pressure increases the vibration of these "noise-makers" (the uvula and soft ... is generally considered the noisy breathing caused by vibrations of the upper airway during sleep. In contrast ...

  10. Impact of nasal obstruction on sleep quality: a community-based study of women.

    PubMed

    Bengtsson, Caroline; Jonsson, Lars; Holmström, Mats; Svensson, Malin; Theorell-Haglöw, Jenny; Lindberg, Eva

    2015-01-01

    The aim of the study was to analyse the impact of self-reported nasal obstruction on sleep quality in women. A community-based sample of 400 women underwent a full night of polysomnography. Airway diseases, allergies and sleep-related symptoms were assessed by questionnaires. Women with subjective nasal obstruction were subdivided into three groups: persistent nasal obstruction (PNO, n = 46), hay fever (n = 88) and nasal obstruction at night (NON, n = 30). Sleep problems and related daytime symptoms were most prevalent among women with NON. After adjusting for age, BMI, smoking and asthma, NON was an independent predictor of 'Difficulties inducing sleep due to nasal obstruction' [adjusted odds ratio (95 % CI): 89.5 (27.0-296.7)], 'Snoring' [4.2 (1.7-10.2)], 'Sweating at night' [2.6 (1.1-6.1)], 'Difficulties maintaining sleep' [2.7 (1.2-6.2)], and 'Waking up hastily gasping for breath' [32.2 (8.7-119.1)]. 'Dry mouth on awakening' [7.7 (3.2-18.4)], 'Waking up unrefreshed' [2.7 (1.2-6.0)], 'Excessive daytime sleepiness' [2.6 (1.1-6.0)], and 'Daytime nasal obstruction' [12.2 (4.8-31.2)] were also associated with NON. Persistent nasal obstruction and hay fever were both associated with some reported sleep problems due to an overlap with NON. When women with NON were excluded, only 'Daytime nasal obstruction' was still significantly associated with PNO, while hay fever was associated with 'Daytime nasal obstruction' and 'Waking up hastily gasping for breath'. There were no significant differences in objectively measured sleep variables between any of the three subgroups and the study cohort. Self-reported nasal obstruction at night in women has a significant effect on several subjective day- and nighttime symptoms, but it does not appear to affect objectively measured sleep quality.

  11. Nasal Respiration Entrains Human Limbic Oscillations and Modulates Cognitive Function

    PubMed Central

    Jiang, Heidi; Zhou, Guangyu; Arora, Nikita; Schuele, Stephan; Rosenow, Joshua; Gottfried, Jay A.

    2016-01-01

    The need to breathe links the mammalian olfactory system inextricably to the respiratory rhythms that draw air through the nose. In rodents and other small animals, slow oscillations of local field potential activity are driven at the rate of breathing (∼2–12 Hz) in olfactory bulb and cortex, and faster oscillatory bursts are coupled to specific phases of the respiratory cycle. These dynamic rhythms are thought to regulate cortical excitability and coordinate network interactions, helping to shape olfactory coding, memory, and behavior. However, while respiratory oscillations are a ubiquitous hallmark of olfactory system function in animals, direct evidence for such patterns is lacking in humans. In this study, we acquired intracranial EEG data from rare patients (Ps) with medically refractory epilepsy, enabling us to test the hypothesis that cortical oscillatory activity would be entrained to the human respiratory cycle, albeit at the much slower rhythm of ∼0.16–0.33 Hz. Our results reveal that natural breathing synchronizes electrical activity in human piriform (olfactory) cortex, as well as in limbic-related brain areas, including amygdala and hippocampus. Notably, oscillatory power peaked during inspiration and dissipated when breathing was diverted from nose to mouth. Parallel behavioral experiments showed that breathing phase enhances fear discrimination and memory retrieval. Our findings provide a unique framework for understanding the pivotal role of nasal breathing in coordinating neuronal oscillations to support stimulus processing and behavior. SIGNIFICANCE STATEMENT Animal studies have long shown that olfactory oscillatory activity emerges in line with the natural rhythm of breathing, even in the absence of an odor stimulus. Whether the breathing cycle induces cortical oscillations in the human brain is poorly understood. In this study, we collected intracranial EEG data from rare patients with medically intractable epilepsy, and found evidence

  12. Nasal Respiration Entrains Human Limbic Oscillations and Modulates Cognitive Function.

    PubMed

    Zelano, Christina; Jiang, Heidi; Zhou, Guangyu; Arora, Nikita; Schuele, Stephan; Rosenow, Joshua; Gottfried, Jay A

    2016-12-07

    The need to breathe links the mammalian olfactory system inextricably to the respiratory rhythms that draw air through the nose. In rodents and other small animals, slow oscillations of local field potential activity are driven at the rate of breathing (∼2-12 Hz) in olfactory bulb and cortex, and faster oscillatory bursts are coupled to specific phases of the respiratory cycle. These dynamic rhythms are thought to regulate cortical excitability and coordinate network interactions, helping to shape olfactory coding, memory, and behavior. However, while respiratory oscillations are a ubiquitous hallmark of olfactory system function in animals, direct evidence for such patterns is lacking in humans. In this study, we acquired intracranial EEG data from rare patients (Ps) with medically refractory epilepsy, enabling us to test the hypothesis that cortical oscillatory activity would be entrained to the human respiratory cycle, albeit at the much slower rhythm of ∼0.16-0.33 Hz. Our results reveal that natural breathing synchronizes electrical activity in human piriform (olfactory) cortex, as well as in limbic-related brain areas, including amygdala and hippocampus. Notably, oscillatory power peaked during inspiration and dissipated when breathing was diverted from nose to mouth. Parallel behavioral experiments showed that breathing phase enhances fear discrimination and memory retrieval. Our findings provide a unique framework for understanding the pivotal role of nasal breathing in coordinating neuronal oscillations to support stimulus processing and behavior. Animal studies have long shown that olfactory oscillatory activity emerges in line with the natural rhythm of breathing, even in the absence of an odor stimulus. Whether the breathing cycle induces cortical oscillations in the human brain is poorly understood. In this study, we collected intracranial EEG data from rare patients with medically intractable epilepsy, and found evidence for respiratory entrainment

  13. Nasal Airway Evaluation After Le Fort I Osteotomy Combined With Septoplasty in Patients With Cleft Lip and Palate.

    PubMed

    Wang, Zhongying; Wang, Peihua; Zhang, Yixin; Shen, Guofang

    2017-01-01

    Septal deviation constitutes an important component of both esthetic deformity and airway compromise in patients with cleft lip and palate (CLP). The posterior parts of the nasal septum presented greater deviation than the anterior parts in patients with complete unilateral CLP. Le Fort I down-fracture provides better access to the nasal septum than intranasal incision during rhinoplasty, especially to the posterior part. This study objectively and subjectively evaluated the nasal function after Le Fort I osteotomy combined with septoplasty in patients with complete unilateral CLP. Twenty-three patients with complete unilateral CLP presenting with nasal obstruction and septum deviation were included (12-combined surgery group; 11-control group). Types of septum deviation in the patients were analyzed. Presurgical and 6-month-postsurgical acoustic rhinometry (AR) was performed for objective assessment; and the nasal obstruction symptom evaluation (NOSE) scale was used for subjective assessment. The authors used SPSS to compare the baseline and follow-up results. Acoustic rhinometry assessment showed improvements in the nasal minimal cross-sectional area (MCA), nasal resistance, and nasal volumes in 12 patients who received combined surgery. For the 2 groups, significant improvements in nasal breathing were documented (by NOSE scores) at 6 months after surgery. Simultaneous management of the maxillary dysplasia (Le Fort I osteotomy) and intranasal pathology (septoplasty) were effective for relief of nasal airway obstruction in patients with complete unilateral CLP. The combination of objective (AR) and subjective (NOSE scale) assessments allowed better evaluation of the nasal function.

  14. Infarcted angiomatous nasal polyps.

    PubMed

    Sheahan, Patrick; Crotty, Paul L; Hamilton, Sam; Colreavy, Michael; McShane, Donald

    2005-03-01

    Angiomatous nasal polyps are a rarely reported subtype of inflammatory sinonasal polyps that are characterized by extensive vascular proliferation and ectasia. Compromise of their vascular supply may occasionally lead to infarction, resulting in clinical, radiological and pathological features that simulate a neoplastic process. In the present paper, the salient characteristics of this unusual entity are described. The clinical, radiological and pathological features of two patients with infarcted angiomatous nasal polyps are presented. Grossly, the polyps had an unusual inhomogenous appearance and texture and were associated with a foul odor. CT findings included bony expansion and destruction. MRI findings included markedly inhomogenous contrast enhancement on T1-weighted images. Histopathologically, both cases showed abundant vascular ectasia, with widespread intraluminal thrombosis and necrosis. Recanalization and reparative changes were also present. Angiomatous nasal polyps are poorly documented in the literature. Although entirely benign, they may simulate neoplastic processes, thus awareness of their existence is of considerable importance.

  15. Nasal spray flu vaccine (image)

    MedlinePlus

    The flu vaccine can also be administered as a nasal spray instead of the usual injection method. It can be ... the recombinant influenza vaccine (RIV). The nasal spray flu vaccine (live attenuated influenza vaccine or LAIV) should not ...

  16. Enforced mouth breathing decreases lung function in mild asthmatics.

    PubMed

    Hallani, Mervat; Wheatley, John R; Amis, Terence C

    2008-06-01

    Nasal breathing provides a protective influence against exercise-induced asthma. We hypothesized that enforced oral breathing in resting mild asthmatic subjects may lead to a reduction in lung function. Asymptomatic resting mild asthmatic volunteers (n = 8) were instructed to breathe either nasally only (N; tape over lips) or orally only (O; nose clip) for 1 h each, on separate days. Lung function (% predicted FEV(1)) was measured using standard spirometry at baseline and every 10 min for 1 h. 'Difficulty in breathing' was rated using a Borg scale at the conclusion of the N and O periods. Baseline FEV(1) on the N (101.2 +/- 3.8% predicted) and O (102.7 +/- 3.9% predicted) days was not significantly different (P > 0.3). At 60 min, FEV(1) on the O day (96.5 +/- 4.1% predicted) was significantly less than on the N day (101.0 +/- 3.5% predicted; P < 0.009). On the N day, FEV(1) did not change with time (P > 0.3), whereas on the O day, FEV(1) fell progressively (slope = -0.06 +/- 0.01% FEV(1)/min, P < 0.0001; linear mixed effects modelling). Three subjects experienced coughing/wheezing at the end of the O day but none experienced symptoms at the end of the N day. Subjects perceived more 'difficulty breathing in' at the end of the O day (1.5 +/- 0.4 arbitrary units) than on the N day (0.4 +/- 0.3 arbitrary unit; P < 0.05). Enforced oral breathing causes a decrease in lung function in mild asthmatic subjects at rest, initiating asthma symptoms in some. Oral breathing may play a role in the pathogenesis of acute asthma exacerbations.

  17. Nasal reconstruction after epithelioma.

    PubMed

    Rodríguez-Camps, S

    2001-01-01

    In this paper we present our procedure for the treatment, histopathological diagnosis, and resection of skin cancer in the nasal pyramid and its subsequent reconstruction. Because we are dealing with the most important anatomical feature of the face our goal is an aesthetic reconstruction [2,4] according to the anatomical subunits criterion of Burget [3]. First, a histopathological diagnosis is made to determine the nature of the tumor. Then, we proceed with the resection according to the Mohs Micrographic Surgery [1,5,7]. Then we begin with the first step of the nasal reconstruction.

  18. Large rhinolith causing nasal obstruction

    PubMed Central

    Dincer Kose, Onur; Kose, Taha Emre; Erdem, Mehmet Ali; Cankaya, Abdulkadir Burak

    2015-01-01

    Rhinoliths are calcified masses located in the nasal cavity and may cause symptoms such as nasal obstruction, fetid odour and facial pain. They are usually diagnosed incidentally on radiographic examinations or depending on the symptoms. In this paper we report a 27-year-old Caucasian woman with a calcified mass in the right nasal cavity causing nasal obstruction, anosmia and facial pain. The calcified mass was removed by endonasal approach. PMID:25759270

  19. Nasalance Norms in Greek Adults

    ERIC Educational Resources Information Center

    Okalidou, Areti; Karathanasi, Asimina; Grigoraki, Eleni

    2011-01-01

    The purposes of this study were to derive nasalance norms for monolingual Greek speakers, to examine nasalance scores as a function of gender and to draw cross-linguistic comparisons based on normative data. Participants read aloud a corpus of linguistic material, consisting of (1) a nasal text, an oral text and a balanced text; (2) a set of nasal…

  20. Nasalance Norms in Greek Adults

    ERIC Educational Resources Information Center

    Okalidou, Areti; Karathanasi, Asimina; Grigoraki, Eleni

    2011-01-01

    The purposes of this study were to derive nasalance norms for monolingual Greek speakers, to examine nasalance scores as a function of gender and to draw cross-linguistic comparisons based on normative data. Participants read aloud a corpus of linguistic material, consisting of (1) a nasal text, an oral text and a balanced text; (2) a set of nasal…

  1. Lysosomal exoglycosidases in nasal polyps.

    PubMed

    Chojnowska, Sylwia; Minarowska, Alina; Knaś, Małgorzata; Niemcunowicz-Janica, Anna; Kołodziejczyk, Paweł; Zalewska-Szajda, Beata; Kępka, Alina; Minarowski, Łukasz; Waszkiewicz, Napoleon; Zwierz, Krzysztof; Szajda, Sławomir Dariusz

    2013-01-01

    Nasal polyps are smooth outgrowths assuming a shape of grapes, formed from the nasal mucosa, limiting air flow by projecting into a lumen of a nasal cavity. Up to now the surgical resection is the best method of their treatment, but etiology and pathogenesis of the nasal polyps is not yet fully established. The aim of the study was the assessment of the selected lysosomal exoglycosidases activity in the nasal polyps. In this study the activity of β-galactosidase, α-mannosidase and α-fucosidase was determined in the tissue of the nasal polyps obtained from 40 patients (10F, 30M) and control tissues derived from mucosa of lower nasal conchas obtained during mucotomy from 20 patients (10F, 10M). We observed significant lower values of GAL, FUC and tendency to decrease of MAN and GLU concentration in nasal polyps (P) in comparison to control healthy nasal mucosa (C). In nasal polyp tissue (P) no differences of GAL, MAN and FUC specific activity in comparison to control mucosa (C) were found. Our research supports bioelectrical theory of the nasal polyps pathogenesis and directs attention at research on glycoconjugates and glycosidases of the nasal mucosa extracellular matrix. Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

  2. Cosmetic and Functional Nasal Deformities

    MedlinePlus

    ... nasal complaints. Nasal deformity can be categorized as “cosmetic” or “functional.” Cosmetic deformity of the nose results in a less ... taste , nose bleeds and/or recurrent sinusitis . A cosmetic or functional nasal deformity may occur secondary to ...

  3. Nasal obstruction and human communication.

    PubMed

    Malinoff, R; Moreno, C

    1989-04-01

    Nasal obstruction may cause a variety of communication disorders, particularly in children. The effects of nasal obstruction on hearing, speech, language, and voice are examined. Methods for assessing the effects of nasal obstruction are delineated, and recommendations for therapeutic interventions are described.

  4. Increased oxygen load in the prefrontal cortex from mouth breathing: a vector-based near-infrared spectroscopy study

    PubMed Central

    Sano, Sayaka; Oka, Noriyuki; Yoshino, Kayoko; Kato, Toshinori

    2013-01-01

    Individuals who habitually breathe through the mouth are more likely than nasal breathers to have sleep disorders and attention deficit hyperactive disorder. We hypothesized that brain hemodynamic responses in the prefrontal cortex might be different for mouth and nasal breathing. To test this hypothesis, we measured changes in oxyhemoglobin and deoxyhemoglobin in the prefrontal cortex during mouth breathing and nasal breathing in healthy adults (n=9) using vector-based near-infrared spectroscopy. The angle k, calculated from changes in oxyhemoglobin and deoxyhemoglobin and indicating the degree of oxygen exchange, was significantly higher during mouth breathing (P<0.05), indicating an increased oxygen load. Mouth breathing also caused a significant increase in deoxyhemoglobin, but oxyhemoglobin did not increase. This difference in oxygen load in the brain arising from different breathing routes can be evaluated quantitatively using vector-based near-infrared spectroscopy. Phase responses could help to provide an earlier and more reliable diagnosis of a patient’s habitual breathing route than a patient interview. PMID:24169579

  5. Increased oxygen load in the prefrontal cortex from mouth breathing: a vector-based near-infrared spectroscopy study.

    PubMed

    Sano, Masahiro; Sano, Sayaka; Oka, Noriyuki; Yoshino, Kayoko; Kato, Toshinori

    2013-12-04

    Individuals who habitually breathe through the mouth are more likely than nasal breathers to have sleep disorders and attention deficit hyperactive disorder. We hypothesized that brain hemodynamic responses in the prefrontal cortex might be different for mouth and nasal breathing. To test this hypothesis, we measured changes in oxyhemoglobin and deoxyhemoglobin in the prefrontal cortex during mouth breathing and nasal breathing in healthy adults (n=9) using vector-based near-infrared spectroscopy. The angle k, calculated from changes in oxyhemoglobin and deoxyhemoglobin and indicating the degree of oxygen exchange, was significantly higher during mouth breathing (P<0.05), indicating an increased oxygen load. Mouth breathing also caused a significant increase in deoxyhemoglobin, but oxyhemoglobin did not increase. This difference in oxygen load in the brain arising from different breathing routes can be evaluated quantitatively using vector-based near-infrared spectroscopy. Phase responses could help to provide an earlier and more reliable diagnosis of a patient's habitual breathing route than a patient interview.

  6. Breathing-metabolic simulator

    NASA Technical Reports Server (NTRS)

    Bartlett, R. G.; Hendricks, C. M.; Morison, W. B.

    1972-01-01

    Breathing-metabolic simulator was developed to be used for evaluation of life support equipment. Apparatus simulates human breathing rate and controls temperature and humidity of exhaled air as well as its chemical composition. All functions are designed to correspond to various degrees of human response.

  7. From breathing to respiration.

    PubMed

    Fitting, Jean-William

    2015-01-01

    The purpose of breathing remained an enigma for a long time. The Hippocratic school described breathing patterns but did not associate breathing with the lungs. Empedocles and Plato postulated that breathing was linked to the passage of air through pores of the skin. This was refuted by Aristotle who believed that the role of breathing was to cool the heart. In Alexandria, breakthroughs were accomplished in the anatomy and physiology of the respiratory system. Later, Galen proposed an accurate description of the respiratory muscles and the mechanics of breathing. However, his heart-lung model was hampered by the traditional view of two non-communicating vascular systems - veins and arteries. After a period of stagnation in the Middle Ages, knowledge progressed with the discovery of pulmonary circulation. The comprehension of the purpose of breathing progressed by steps thanks to Boyle and Mayow among others, and culminated with the contribution of Priestley and the discovery of oxygen by Lavoisier. Only then was breathing recognized as fulfilling the purpose of respiration, or gas exchange. A century later, a controversy emerged concerning the active or passive transfer of oxygen from alveoli to the blood. August and Marie Krogh settled the dispute, showing that passive diffusion was sufficient to meet the oxygen needs.

  8. What Controls Your Breathing?

    MedlinePlus

    ... Explore How the Lungs Work What Are... The Respiratory System What Happens When You Breathe What Controls Your Breathing Lung Diseases & Conditions Clinical Trials Links Related Topics Asthma Bronchitis COPD How the Heart Works Respiratory Failure Send a link to NHLBI to someone ...

  9. Comparison of nasal acceleration and nasalance across vowels.

    PubMed

    Thorp, Elias B; Virnik, Boris T; Stepp, Cara E

    2013-10-01

    The purpose of this study was to determine the performance of normalized nasal acceleration (NNA) relative to nasalance as estimates of nasalized versus nonnasalized vowel and sentence productions. Participants were 18 healthy speakers of American English. NNA was measured using a custom sensor, and nasalance was measured using the KayPentax Nasometer II. Speech stimuli consisted of CVC syllables with the vowels (//, /æ/, /i/, /u/) and sentences loaded with high front, high back, low front, and low back vowels in both nasal and nonnasal contexts. NNA showed a small but significant effect of the vowel produced during syllable stimuli but no significant effect of vowel loading during sentence stimuli. Nasalance was significantly affected by the vowel being produced during both syllables and sentences with large effect sizes. Both NNA and nasalance were highly sensitive and specific to nasalization. NNA was less affected by vowel than nasalance. Discrimination of nasal versus nonnasal stimuli using NNA and nasalance was comparable, suggesting potential for use of NNA for biofeedback applications. Future work to improve calibration of NNA is needed to lower intersubject variability.

  10. As the Nasal Spine Goes, So Goes the Septum.

    PubMed

    Rengaraja, Devkumar; Jagade, Mohan; Kale, Vitthal; Attakil, Anoop; Kar, Rajesh; Singhal, Arpita; Rao, Karthik; Gupta, Pallavi

    2016-11-01

    "As the septum goes, so goes the nose". A well-known phrase by Maurice Cottle forms the pillar of septoplasty. Since the inception of septal surgeries, numerous methods of septoplasty have been described. But, if not performed meticulously, may lead to deformity. For a successful surgery, understanding the anatomy and addressing the anterior nasal spine and maintaining the tip integrity is vital. To study the outcomes of "ROUND ABOUT technique" to correct deviated nasal septum which focuses on the importance of anterior spine and hence maintain the tip integrity. This was a prospective, single-centre outcome study of 35 patients with symptomatic nasal obstruction. Here, we describe a method of elevating the mucoperichondrial and mucoperiosteal flaps bilaterally, without transecting the quadrilateral cartilage of the septum. The Sino Nasal Outcome Test-22 (SNOT-22) Questionnaire was administered pre-operatively and after 3 months following surgery. The post-operative follow-up period ranged from 3 to 6 months (mean= 4.5 months) to evaluate the functional and aesthetic outcomes of the performed procedure. A total of 35 patients underwent surgery by this technique who presented with deviated nasal septum and variable degrees of nasal obstruction. To assess the statistical outcome, Paired t-test was applied. Mean SNOT-22 scores decreased significantly from 40.02 pre-operatively to 18.65 three months after surgery. The results sustained after 6 months (p-value <0.0001), 85% of these patients had improved breathing post-operatively and none of the patients complained any aesthetic criticisms. The patients were content and the requirement of medications post-operatively were minimal. The ROUND ABOUT technique is a very effective and safe method in correcting the septal deviations especially the ones with caudal or dorsal deflections. It also helps in maintaining the tip integrity and addressing the anterior nasal spine. It avoids the complications of conventional

  11. As the Nasal Spine Goes, So Goes the Septum

    PubMed Central

    Jagade, Mohan; Kale, Vitthal; Attakil, Anoop; Kar, Rajesh; Singhal, Arpita; Rao, Karthik; Gupta, Pallavi

    2016-01-01

    Introduction "As the septum goes, so goes the nose". A well-known phrase by Maurice Cottle forms the pillar of septoplasty. Since the inception of septal surgeries, numerous methods of septoplasty have been described. But, if not performed meticulously, may lead to deformity. For a successful surgery, understanding the anatomy and addressing the anterior nasal spine and maintaining the tip integrity is vital. Aim To study the outcomes of “ROUND ABOUT technique” to correct deviated nasal septum which focuses on the importance of anterior spine and hence maintain the tip integrity. Materials and Methods This was a prospective, single-centre outcome study of 35 patients with symptomatic nasal obstruction. Here, we describe a method of elevating the mucoperichondrial and mucoperiosteal flaps bilaterally, without transecting the quadrilateral cartilage of the septum. The Sino Nasal Outcome Test-22 (SNOT-22) Questionnaire was administered pre-operatively and after 3 months following surgery. The post-operative follow-up period ranged from 3 to 6 months (mean= 4.5 months) to evaluate the functional and aesthetic outcomes of the performed procedure. Results A total of 35 patients underwent surgery by this technique who presented with deviated nasal septum and variable degrees of nasal obstruction. To assess the statistical outcome, Paired t-test was applied. Mean SNOT-22 scores decreased significantly from 40.02 pre-operatively to 18.65 three months after surgery. The results sustained after 6 months (p-value <0.0001), 85% of these patients had improved breathing post-operatively and none of the patients complained any aesthetic criticisms. The patients were content and the requirement of medications post-operatively were minimal. Conclusion The ROUND ABOUT technique is a very effective and safe method in correcting the septal deviations especially the ones with caudal or dorsal deflections. It also helps in maintaining the tip integrity and addressing the anterior

  12. Impact of Middle vs. Inferior Total Turbinectomy on Nasal Aerodynamics

    PubMed Central

    Dayal, Anupriya; Rhee, John S.; Garcia, Guilherme J. M.

    2016-01-01

    Objectives This computational study aims to: (1) Use virtual surgery to theoretically investigate the maximum possible change in nasal aerodynamics after turbinate surgery; (2) Quantify the relative contributions of the middle and inferior turbinates to nasal resistance and air conditioning; (3) Quantify to what extent total turbinectomy impairs the nasal air conditioning capacity. Study Design Virtual surgery and computational fluid dynamics (CFD). Setting Academic tertiary medical center. Subjects and Methods Ten patients with inferior turbinate hypertrophy were studied. Three-dimensional models of their nasal anatomies were built based on pre-surgery computed tomography scans. Virtual surgery was applied to create models representing either total inferior turbinectomy (TIT) or total middle turbinectomy (TMT). Airflow, heat transfer, and humidity transport were simulated at a 15 L/min steady-state inhalation rate. The surface area stimulated by mucosal cooling was defined as the area where heat fluxes exceed 50 W/cm2. Results In both virtual total turbinectomy models, nasal resistance decreased and airflow increased. However, the surface area where heat fluxes exceed 50 W/cm2 either decreased (TIT) or did not change significantly (TMT), suggesting that total turbinectomy may reduce the stimulation of cold receptors by inspired air. Nasal heating and humidification efficiencies decreased significantly after both TIT and TMT. All changes were greater in the TIT models than in the TMT models. Conclusion TIT yields greater increases in nasal airflow, but also impairs the nasal air conditioning capacity to a greater extent than TMT. Radical resection of the turbinates may decrease the surface area stimulated by mucosal cooling. PMID:27165673

  13. Impact of Middle versus Inferior Total Turbinectomy on Nasal Aerodynamics.

    PubMed

    Dayal, Anupriya; Rhee, John S; Garcia, Guilherme J M

    2016-09-01

    This computational study aims to (1) use virtual surgery to theoretically investigate the maximum possible change in nasal aerodynamics after turbinate surgery, (2) quantify the relative contributions of the middle and inferior turbinates to nasal resistance and air conditioning, and (3) quantify to what extent total turbinectomy impairs the nasal air-conditioning capacity. Virtual surgery and computational fluid dynamics. Academic tertiary medical center. Ten patients with inferior turbinate hypertrophy were studied. Three-dimensional models of their nasal anatomies were built according to presurgery computed tomography scans. Virtual surgery was applied to create models representing either total inferior turbinectomy (TIT) or total middle turbinectomy (TMT). Airflow, heat transfer, and humidity transport were simulated at a steady-state inhalation rate of 15 L/min. The surface area stimulated by mucosal cooling was defined as the area where heat fluxes exceed 50 W/m(2). In both virtual total turbinectomy models, nasal resistance decreased and airflow increased. However, the surface area where heat fluxes exceed 50 W/m(2) either decreased (TIT) or did not change significantly (TMT), suggesting that total turbinectomy may reduce the stimulation of cold receptors by inspired air. Nasal heating and humidification efficiencies decreased significantly after both TIT and TMT. All changes were greater in the TIT models than in the TMT models. TIT yields greater increases in nasal airflow but also impairs the nasal air-conditioning capacity to a greater extent than TMT. Radical resection of the turbinates may decrease the surface area stimulated by mucosal cooling. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  14. Routine nasal packing follwoing nasal surgery-Is it necessary?

    PubMed

    Basha, S I; Gupta, D; Kaluskar, S K

    2005-01-01

    The practice of routine nasal packing after nasal surgery is usually customary and not evidence based. Post operative complications, while uncoumon, are sometimes pack related. A retrospective analysis of 110 patients who underwent a variety of nasal operations was performed to determine the incidence of complications when nasal packs were not routinely inserted 9 cases (8.2%) [6 out of these were revision surgeries] needed nasal packing for haemostasis at the end of surgery. 4 cases (3.6%) required to be packed in the immediate post operative period. One patient who required nasal packing developed a unilateral adhesion. No patient developed septal hematoma. The need for routine nasal packing is not supported. Packing should be indicated where there continuous bleeding at.

  15. Effects of sulfur oxides on nasal and lung function in adolescents with extrinsic asthma

    SciTech Connect

    Koenig, J.Q.; Morgan, M.S.; Horike, M.; Pierson, W.E.

    1985-12-01

    Ten adolescent subjects with extrinsic asthma were exposed during intermittent exercise to filtered air, 0.5 ppm of sulfur dioxide (SO2), or 100 micrograms/m3 of sulfuric acid (H2SO4) on 5 separate days. The purpose of the study was to compare changes in nasal power (the work of nose breathing) with pulmonary functional changes depending on the route of inhalation of the sulfur oxide pollutants, oral inhalation through a rubber mouthpiece or oronasal inhalation via a face mask. Nasal power was measured with a modified skin diving mask equipped with two differential pressure transducers. Statistically significant changes in total respiratory resistance, FEV1, and maximum flow calculated at 50% and 75% vital capacity were observed after all exposures to SO2 and H2SO4. The magnitude of change in FEV1 and maximum flow calculated at 50% vital capacity was higher after oral compared to oronasal inhalation of SO2. The nasal work of breathing increased 32% after SO2 exposure by mouthpiece and 30% after SO2 exposure via face mask (p less than 0.05). The nasal power changes after the H2SO4 exposures were not different from the sham exposures. We conclude that oronasal inhalation of 0.5 ppm of SO2 produces a significant increase in the nasal work of breathing and that the route of exposure reduces but does not eliminate the lower airway reactions observed on oral exposure.

  16. Azelastine Nasal Spray

    MedlinePlus

    ... and replace with the pump unit. Prime the delivery system (pump unit) with four sprays or until a fine mist appears. If 3 days or more have elapsed since your last use of the nasal spray, reprime the pump with two sprays or until a fine mist appears.

  17. Management of nasal hemangiomas.

    PubMed

    Hochman, Marcelo; Mascareno, Alfredo

    2005-01-01

    Infantile hemangiomas commonly involve the nose. Because of the nose's prominence as an aesthetically and functionally sensitive area, management of these lesions has important implications. The available options including medical therapy, lasers, and surgery are reviewed with recommendations specific to nasal tip and lobule lesions based on the senior author's (M.H.) experience.

  18. Oxymetazoline Nasal Spray

    MedlinePlus

    ... Rinse the tip of the dispenser with hot water or wipe it clean after you use it.Follow the directions for using the nasal spray that appear on the package label. If you are using a product that comes in a pump dispenser, press down on the rim several times ...

  19. Cromolyn Sodium Nasal Solution

    MedlinePlus

    Cromolyn comes as a solution to use with a special nasal applicator. It usually is inhaled three to six times a day to prevent allergy ... first time, read the instructions provided with the solution. Ask your doctor, pharmacist, or respiratory therapist to ...

  20. Effect of route of breathing on response to exposure in a swine confinement building.

    PubMed

    Cormier, Y; Laviolette, M; Bedard, G; Dosman, J; Israel-Assayag, E

    1998-05-01

    Exposure of naive subjects to swine buildings results in acute nasal, lung, and peripheral blood inflammatory responses with an increase in nonallergic airway responsiveness. Because nasal passages filter large particles and soluble gases and because swine building exposure results in an acute inflammatory response at this level, we questioned what effect breathing through or avoiding this route would have on local and systemic inflammation. Nine normal young men 23 to 37 yr of age were exposed for 5 h to a swine building, once breathing normally and once with the mouth occluded (n = 8) (Protocol 1) or the nose occluded (n = 4) (Protocol 2); three subjects participated in both protocols. For each protocol each subject underwent a methacholine challenge for PC20 measurement, a nasal lavage, venous blood puncture, and a bronchoalveolor lavage (BAL) once before and once after each swine building exposure. Bronchial responsiveness as measured by PC20 decreased in most subjects after swine building exposure and was not influenced by the route of breathing. Nasal lavage neutrophils increased tenfold after each swine exposure, except when the nose was occluded where no alteration was observed. Total BAL cells significantly increased after each exposure to the swine building, this increase was not modified by the route of breathing. In Protocol 1, white blood cells increased from a baseline level of 7.0 to 10.5 x 10(9) cells/L after exposure with normal breathing and to 10.7 x 10(9) cells/L during nasal breathing exclusively. For Protocol 2, these respective values were: 5.6, 11.7 and 10.4 x 10(9)/L. Interleukins 6 and 8 levels in BAL, nasal washes, and serum were increased by swine building exposure, except in the nasal wash when the nose was occluded. In conclusion, the lung and blood responses to exposure in a swine confinement building are not modified by the route of breathing, suggesting that nasal inflammation and filtration are not important in the process and that

  1. Airflow and nanoparticle deposition in rat nose under various breathing and sniffing conditions

    PubMed Central

    Jiang, Jianbo; Zhao, Kai

    2010-01-01

    Accurate prediction of nanoparticle (1~100 nm) deposition in the rat nasal cavity is important for assessing the toxicological impact of inhaled nanoparticles as well as for potential therapeutic applications. A quasi-steady assumption has been widely adopted in the past investigations on this topic, yet the validity of such simplification under various breathing and sniffing conditions has not been carefully examined. In this study, both steady and unsteady computational fluid dynamics (CFD) simulations were conducted in a published rat nasal model under various physiologically realistic breathing and sniffing flow rates. The transient airflow structures, nanoparticle transport and deposition patterns in the whole nasal cavity and the olfactory region were investigated and compared with steady state simulation of equivalent flow rate. The results showed that (1) the quasi-steady flow assumption for cyclic flow was valid for over 70% of the cycle period during all simulated breathing and sniffing conditions in the rat nasal cavity, or the unsteady effect was only significant during the transition between the respiratory phases; (2) yet the quasi-steady assumption for nanoparticle transport was not valid, except in the vicinity of peak respiration. In general, the total deposition efficiency of nanoparticle during cyclic breathing would be lower than that of steady state due to the unsteady effect on particle transport and deposition, and further decreased with the increase of particle size, sniffing frequency, and flow rate. In the contrary, previous study indicated that for micro-scale particles (0.5~4μm), the unsteady effect would increase deposition efficiencies in rat nasal cavity. Combined, these results suggest that the quasi-steady assumption of nasal particle transport during cycling breathing should be used with caution for an accurate assessment of the toxicological and therapeutic impact of particle inhalation. Empirical equations and effective steady

  2. Breathing retraining - a five-year follow-up of patients with dysfunctional breathing.

    PubMed

    Hagman, Carina; Janson, Christer; Emtner, Margareta

    2011-08-01

    The term dysfunctional breathing (DB) has been introduced to describe patients who display divergent breathing patterns and have breathing problems that cannot be attributed to a specific medical diagnosis. Patients with DB are often misdiagnosed as having asthma. To describe patients with DB, five years after a breathing retraining intervention. Out of initially 25 patients with DB and 25 age and sex-matched patients with asthma, 22 patients with DB and 23 patients with asthma (ages 25-78 years) were followed up after five years. Data were collected from posted self-report questionnaires. Only patients with DB had received breathing retraining, consisting of information, advice and diaphragmatic breathing. Patients were evaluated regarding quality of life (SF-36), anxiety, depression, sense of coherence, hyperventilation, influence on daily life, emergency room (ER) visits, and symptoms associated with DB. Quality of life (SF-36), physical component summary scale (PCS), had improved in patients with DB from 43 to 47 (p = 0.03). The number of ER visits had decreased from 18 to 2 in patients with DB (p = 0.02). Symptoms associated with DB had decreased extensively, from a mean score of 6.9 to 2.7, on a DB criterion list (p < 0.001). Patients with DB were less impaired by their breathing problems both in daily life and when exercising (p < 0.001). The only difference found over time in the asthma group concerned quality of health, bodily pain, which had deteriorated, from 77 to 68 (p = 0.049). This five-year follow-up study indicates that patients with dysfunctional breathing benefit from breathing retraining. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Characterizing adult human nasal airway dimensions

    SciTech Connect

    Guilmette, R.A.; Griffith, W.C.

    1994-11-01

    Respiratory tract models used in calculating radiation dose from exposure to inhaled radioactive aerosols have only recently focused attention on the importance of the nasal airways (NAs). Because the NAs are the first tissues of the respiratory tract available for aerosol deposition in normally nose-breathing people, any deposition of aerosol in this anatomical structure will reduce the amounts available to be deposited in the remainder of the respiratory tract. Thus, uncertainties in estimating the deposition fractions in the NAs will propagate throughout the remainder of the respiratory tract, creating errors in the calculated dose estimates. Additionally, there is evidence that the NAs are also at risk for induction of cancer from exposure to certain occupational aerosols such as wood dust, leather dust, chromium, and nickel. The purpose of this investigation was to conduct an anatomical study to assess the variabilities in NA dimensions.

  4. Nasalance norms in Greek adults.

    PubMed

    Okalidou, Areti; Karathanasi, Asimina; Grigoraki, Eleni

    2011-08-01

    The purposes of this study were to derive nasalance norms for monolingual Greek speakers, to examine nasalance scores as a function of gender and to draw cross-linguistic comparisons based on normative data. Participants read aloud a corpus of linguistic material, consisting of (1) a nasal text, an oral text and a balanced text; (2) a set of nasal sentences and four sets of oral sentences and (3) repetitions of each of 12 syllable types (8 oral and 4 nasal). The last two sets of material corpus were based on an adaptation of the Simplified Nasometric Assessment Procedures Test (SNAP test) test ( MacKay and Kummer, 1994 ) in Greek, called the G-SNAP test. Eighty monolingual healthy young adult speakers of Greek, 40 males (mean age = 21 years) and 40 females (mean age = 20.5 years), with normal hearing and speech characteristics and unremarkable history were included in the study. The Nasometer (model 6200-3) was used to derive nasalance scores. Mean normative nasalance for spoken Greek was 25.50%, based on the G-oronasal text (with 8.6% nasals). Nasalance scores did not differ significantly with respect to gender. Finally, spoken Greek consistently yielded lower nasalance scores than other languages examined in past work. The aforementioned normative data on nasalance of young adult speakers of Greek are valid across gender and have direct clinical utility as they provide valuable reference information for the diagnosis and management of Greek adults with resonance disorders caused by velar dysfunction.

  5. Microphonic versus end-tidal carbon dioxide nasal airflow detection in neonates with apnea.

    PubMed

    Toubas, P L; Duke, J C; Sekar, K C; McCaffree, M A

    1990-12-01

    Impedance pneumography in combination with expired CO2 monitoring are commonly used techniques for detecting central and obstructive apnea in infants. In this investigation an American Telephone and Telegraph StarSet-1 3000-ohm self-actuating microphone connected to the end of an infant cannula was used to monitor neonatal nasal airflow to detect breaths and apnea. The microphone was placed in a soundproof container to eliminate environmental sound artifacts. Analyses of 100 breaths from five patient samples during active and quiet sleep showed that there was no significant difference between microphone and expired CO2 recording of respiration. The techniques were 98% and 96% sensitive, respectively. Microphonic detection of nasal airflow identified 27 of the 32 episodes of upper airway obstruction (84.2%) registered by end-tidal CO2 recording. Inspiratory and expiratory events could also be well documented. Microphonic recording of nasal airflow is a reliable and inexpensive technique to detect apnea.

  6. Diagnostic and treatment implications of nasal obstruction in snoring and obstructive sleep apnea.

    PubMed

    Scharf, M B; Cohen, A P

    1998-10-01

    The purpose of this review is to highlight fundamental aspects of obstructive sleep apnea (OSA), and to present an overview of the medical literature that pertains to the clinical interplay between various allergy-related disorders, nasal patency, and OSA. This should enable the reader to play a more proactive role in the diagnosis, management, and prevention of OSA. Relevant reviews, texts, and articles. The MEDLINE database was used to find related literature. In predisposed individuals, OSA, sleep fragmentation, and the sequelae of disturbed sleep often result from nasal obstruction. Since breathing through the nose appears to be the preferred route during sleep, nasal obstruction frequently leads to nocturnal mouth breathing, snoring, and ultimately to OSA. Allergists can thus play a vital role in assessing sleep problems in their patients with allergic rhinitis and other upper respiratory disorders, in treating these problems more aggressively, and in some instances, in preventing them.

  7. What is normal nasal airflow? A computational study of 22 healthy adults.

    PubMed

    Zhao, Kai; Jiang, Jianbo

    2014-06-01

    Nasal airflow is essential for the functioning of the human nose. Given individual variation in nasal anatomy, there is yet no consensus what constitutes normal nasal airflow patterns. We attempt to obtain such information that is essential to differentiate disease-related conditions. Computational fluid dynamics (CFD) simulated nasal airflow in 22 healthy subjects during resting breathing. Streamline patterns, airflow distributions, velocity profiles, pressure, wall stress, turbulence, and vortical flow characteristics under quasi-steady state were analyzed. Patency ratings, acoustically measured minimum cross-sectional area (MCA), and rhinomanometric nasal resistance (NR) were examined for potential correlations with morphological and airflow-related variables. Common features across subjects included: >50% total pressure drop reached near the inferior turbinate head; wall shear stress, NR, turbulence energy, and vorticity were lower in the turbinate than in the nasal valve region. However, location of the major flow path and coronal velocity distributions varied greatly across individuals. Surprisingly, on average, more flow passed through the middle than the inferior meatus and correlated with better patency ratings (r = -0.65, p < 0.01). This middle flow percentage combined with peak postvestibule nasal heat loss and MCA accounted for >70% of the variance in subjective patency ratings and predicted patency categories with 86% success. Nasal index correlated with forming of the anterior dorsal vortex. Expected for resting breathing, the functional impact for local and total turbulence, vorticity, and helicity was limited. As validation, rhinomanometric NR significantly correlated with CFD simulations (r = 0.53, p < 0.01). Significant variations of nasal airflow found among healthy subjects; Key features may have clinically relevant applications. © 2014 ARS-AAOA, LLC.

  8. What is normal nasal airflow? A computational study of 22 healthy adults

    PubMed Central

    Zhao, Kai; Jiang, Jianbo

    2014-01-01

    Objective Nasal airflow is essential for functioning of the human nose. Given individual variation in nasal anatomy, there is yet no consensus what constitutes normal nasal airflow patterns. We attempt to obtain such information that is essential to differentiate disease-related variations. Methods Computational fluid dynamics (CFD) simulated nasal airflow in 22 healthy subjects during resting breathing. Streamline patterns, airflow distributions, velocity profiles, pressure, wall stress, turbulence, and vortical flow characteristics under quasi-steady state were analyzed. Patency ratings, acoustically measured minimum cross-sectional area (MCA), and rhinomanometric nasal resistance (NR) were examined for potential correlations with morphological and airflow-related variables. Results Common features across subjects included: >50% total pressure-drop reached near the inferior turbinate head; wall shear stress, NR, turbulence energy, and vorticity were lower in the turbinate than in the nasal valve region. However, location of the major flow path and coronal velocity distributions varied greatly across individuals. Surprisingly, on average, more flow passed through the middle than the inferior meatus and correlated with better patency ratings (r=-0.65, p<0.01). This middle flow percentage combined with peak post-vestibule nasal heat loss and MCA accounted for >70% of the variance in subjective patency ratings and predicted patency categories with 86% success. Nasal index correlated with forming of the anterior dorsal vortex. Expected for resting breathing, the functional impact for local and total turbulence, vorticity, and helicity was limited. As validation, rhinomanometric NR significantly correlated with CFD simulations (r=0.53, p<0.01). Conclusion Significant variations of nasal airflow found among healthy subjects; Key features may have clinically relevant applications. PMID:24664528

  9. Nanostructured optical fibre sensors for breathing airflow monitoring

    NASA Astrophysics Data System (ADS)

    Kang, Y.; Ruan, H.; Wang, Y.; Arregui, F. J.; Matias, I. R.; Claus, R. O.

    2006-05-01

    A nanostructured optical fibre-based thin film sensor was designed for non-invasive, fast and reliable monitoring of respiratory airflow. Molecular-level self-assembly processing method was used to form multi-layered inorganic nanocluster and polymer thin films on the distal ends of optical fibres to form such sensors. In order to optimize the sensing performance, an analytical model based on the condensation of exhaled water vapour on the coating surface was established for the breathing analysis. By varying thin film chemistry the physically small sensors offer high sensitivity to breathing air in terms of variations in the reflected optical power. Moreover, the sensor performances in comparison with a medical nasal thermistor suggest such a thin film sensor is an excellent device for advanced breathing airflow monitoring.

  10. Robust nondimensional estimators to assess the nasal airflow in health and disease.

    PubMed

    Sanmiguel-Rojas, E; Burgos, M A; Del Pino, C; Sevilla-García, M A; Esteban-Ortega, F

    2017-06-02

    There are significant variations of both human nose shapes and airflow patterns inside nasal cavities, so it is difficult to provide a comprehensive medical identification using a universal template for what otolaryngologists consider normal breathing at rest. In addition, airflow patterns present even more random characteristics in diseased nasal cavities. To give a medical assessment to differentiate the nasal cavities in health and disease, we propose 2 nondimensional estimators obtained from both medical images and computational fluid dynamics. The first mathematical estimator ϕ is a function of geometric features and potential asymmetries between nasal passages, while the second estimator R represents in fluid mechanics terms the total nasal resistance that corresponds to the atmosphere-choana pressure drop. These estimators only require global information such as nasal geometry and magnitudes of flow determined by simulations under laminar conditions. We find that these estimators take low and high values for healthy and diseased nasal cavities, respectively. Our study, based on 24 healthy and 25 diseased Caucasian subjects, reveals that there is an interval of values associated with healthy cavities that clusters in a small region of the plane ϕ-R. Therefore, these estimators can be seen as a first approximation to provide nasal airflow data to the clinician in a noninvasive method, as the computed tomography scan that provides the required images is routinely obtained as a result of the preexisting naso-sinusal condition. Copyright © 2017 John Wiley & Sons, Ltd.

  11. Optimal technique for deep breathing exercises after cardiac surgery.

    PubMed

    Westerdahl, E

    2015-06-01

    Cardiac surgery patients often develop a restrictive pulmonary impairment and gas exchange abnormalities in the early postoperative period. Chest physiotherapy is routinely prescribed in order to reduce or prevent these complications. Besides early mobilization, positioning and shoulder girdle exercises, various breathing exercises have been implemented as a major component of postoperative care. A variety of deep breathing maneuvres are recommended to the spontaneously breathing patient to reduce atelectasis and to improve lung function in the early postoperative period. Different breathing exercises are recommended in different parts of the world, and there is no consensus about the most effective breathing technique after cardiac surgery. Arbitrary instructions are given, and recommendations on performance and duration vary between hospitals. Deep breathing exercises are a major part of this therapy, but scientific evidence for the efficacy has been lacking until recently, and there is a lack of trials describing how postoperative breathing exercises actually should be performed. The purpose of this review is to provide a brief overview of postoperative breathing exercises for patients undergoing cardiac surgery via sternotomy, and to discuss and suggest an optimal technique for the performance of deep breathing exercises.

  12. Neither internal nor external nasal dilation improves cycling 20-km time trial performance.

    PubMed

    Adams, Catriona M; Peiffer, Jeremiah J

    2017-04-01

    Research is equivocal regarding endurance performance benefits of external nasal dilators, and currently research focusing on internal nasal dilators is non-existent. Both devices are used within competitive cycling. This study examined the influence of external and internal nasal dilation on cycling economy of motion and 20-km time trial performance. The study utilized a randomized, counterbalanced cross-over design. Fifteen trained cyclists completed three exercise sessions consisting of a 15min standardized warm up and 20-km cycling time trial while wearing either a Breathe Right(®) external nasal dilator, Turbine(®) internal nasal dilator or no device (control). During the warm up, heart rate, ratings of perceived exertion and dyspnea and expired gases were collected. During the time trial, heart rate, perceived exertion, and dyspnea were collected at 4-km intervals and mean 20-km power output was recorded. No differences were observed for mean 20-km power output between the internal (270±45W) or external dilator (271±44W) and control (272±44W). No differences in the economy of motion were observed throughout the 15-min warm up between conditions. The Turbine(®) and Breathe Right(®) nasal dilators are ineffective at enhancing 20-km cycling time trial performance. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  13. Breathing metabolic simulator.

    NASA Technical Reports Server (NTRS)

    Bartlett, R. G., Jr.; Hendricks, C. M.; Morison, W. B.

    1971-01-01

    Description of a device for simulation of the human breathing and metabolic parameters required for the evaluation of respiratory diagnostic, monitoring, support and resuscitation equipment. The remotely controlled device allows wide variations in breathing rate and depth, breath velocity contour, oxygen uptake and carbon dioxide release to simulate conditions from sleep to hard work, with respiration exchange ratios ranging from hypoventilation to hyperventilation. It also reduces the cost of prolonged testing when simulation chambers with human subjects require three shifts of crews and standby physicians. Several block diagrams of the device and subsystems are given.

  14. Breathing metabolic simulator.

    NASA Technical Reports Server (NTRS)

    Bartlett, R. G., Jr.; Hendricks, C. M.; Morison, W. B.

    1971-01-01

    Description of a device for simulation of the human breathing and metabolic parameters required for the evaluation of respiratory diagnostic, monitoring, support and resuscitation equipment. The remotely controlled device allows wide variations in breathing rate and depth, breath velocity contour, oxygen uptake and carbon dioxide release to simulate conditions from sleep to hard work, with respiration exchange ratios ranging from hypoventilation to hyperventilation. It also reduces the cost of prolonged testing when simulation chambers with human subjects require three shifts of crews and standby physicians. Several block diagrams of the device and subsystems are given.

  15. [Differential proteins analysis among human nasal inverted papilloma and nasal polyposis and normal nasal mucosa].

    PubMed

    Meng, Qing-shu; Jin, Sheng; Zhang, Qiu-hang; Zhang, Man

    2010-04-01

    Proteomics-based approach was applied to analyze and compare the difference of proteins among human nasal inverted papilloma (NIP), nasal polyposis and normal nasal mucosa, in order to screen different proteins as marker. The total proteins of NIP, nasal polyposis and normal nasal mucosa were separated by two-dimensional gel electrophoresis (2-DE). Protein image obtained by using the gel of Calibrated GS-800 Densitometer system, and determined different protein spots. Six differential proteins between NIP and nasal polyp tissue were identified, which were galectin-1, Manganese-superoxide dismutase, galectin-7, trichostatin A, prohibitin and transferring. All of them were increased in NIP. Six differential proteins were possibly involved in NIP, which provided a new way for discriminating NIP from nasal polyposis. The data would be good for the establishment of NIP protein 2-DE map.

  16. The incompressibility assumption in computational simulations of nasal airflow.

    PubMed

    Cal, Ismael R; Cercos-Pita, Jose Luis; Duque, Daniel

    2017-06-01

    Most of the computational works on nasal airflow up to date have assumed incompressibility, given the low Mach number of these flows. However, for high temperature gradients, the incompressibility assumption could lead to a loss of accuracy, due to the temperature dependence of air density and viscosity. In this article we aim to shed some light on the influence of this assumption in a model of calm breathing in an Asian nasal cavity, by solving the fluid flow equations in compressible and incompressible formulation for different ambient air temperatures using the OpenFOAM package. At low flow rates and warm climatological conditions, similar results were obtained from both approaches, showing that density variations need not be taken into account to obtain a good prediction of all flow features, at least for usual breathing conditions. This agrees with most of the simulations previously reported, at least as far as the incompressibility assumption is concerned. However, parameters like nasal resistance and wall shear stress distribution differ for air temperatures below [Formula: see text]C approximately. Therefore, density variations should be considered for simulations at such low temperatures.

  17. Characterization of exhaled nitric oxide: introducing a new reproducible method for nasal nitric oxide measurements.

    PubMed

    Palm, J P; Graf, P; Lundberg, J O; Alving, K

    2000-08-01

    Nitric oxide (NO) is present in the human nasal airways and has been suggested to originate primarily from the paranasal sinuses. The aim of this study was to establish a new and reproducible method for measurement of nasal NO. Through repeated single-breath measurements the intra- and inter-individual variations of NO levels in nasally (into a tightly fitting mask covering the nose) and orally exhaled air were determined in healthy humans. Variations due to the methods used were investigated. The contribution of oral NO to the nasal exhalations by introducing a mouthwash procedure was also studied. This study shows distinct individual values of NO in nasally and orally exhaled air of healthy humans. Some diurnal variability was also found with a rise in NO in nasally and orally exhaled air over the day, but no, or little, day-to-day variability when comparing the results from separate mornings. There was no correlation between NO levels in nasally and orally exhaled air, whereas there was a strong correlation between NO levels in air exhaled through the left and right nostril. The levels of NO in air exhaled at 0.17 L x s(-1) through either nostril separately were higher than in air exhaled at the same flow rate through both nostrils simultaneously. After the introduction of a mouthwash procedure the level of NO in orally, but not nasally exhaled air was reduced. To conclude the method using nasal exhalation into a nose mask is highly reproducible. It is also suggested that subtracting the level of NO in orally exhaled air, after mouthwash, from that in nasally exhaled air, would adequately reflect nasal NO levels.

  18. The role of septoplasty in the management of nasal septum fracture: a randomized quality of life study.

    PubMed

    Younes, A; Elzayat, S

    2016-11-01

    Fracture of the nasal septum is a common injury. Fracture reduction using Ash forceps is the standard treatment for non-severely comminuted cases. In this study, septoplasty was compared to Ash forceps reduction of nasal septum fractures with regard to the quality of life outcome of patient breathing. Thirty consecutive patients with non-comminuted septal fractures were divided randomly into two groups. In group I, fractures were managed by closed reduction (using Ash forceps), while in group II, fractures were managed by septoplasty surgery. Each patient completed a validated quality of life scale for breathing (Nasal Obstruction Symptom Evaluation, NOSE) preoperatively and at 3 months postoperative. In group I, the mean difference between postoperative and preoperative NOSE scores was -28.33 (range -40 to -15), while in group II the mean difference was -44.33 (range -70 to -30). There was a significant improvement in nasal breathing quality of life in group II compared with group I (t-test, P=0.001). The results of this study showed a significant improvement in quality of life outcome with the use of septoplasty compared to closed reduction for acute septal fractures. Septoplasty could be recommended for patients with acute nasoseptal fractures to ensure better nasal breathing outcomes.

  19. Breath holding spell

    MedlinePlus

    ... such as Riley-Day syndrome or Rett syndrome Iron deficiency anemia A family history of breath holding spells ( ... tests may be done to check for an iron deficiency. Other tests that may be done include: EKG ...

  20. Shortness of Breath

    MedlinePlus

    ... with blood clots in the legs or pelvis (deep venous thrombosis), debilitating medical conditions, immobility, or inherited ... it hard for a person to take a deep breath, which usually results in retention of carbon ...

  1. Stop, Breathe & Think app.

    PubMed

    Shaw, Natalie

    2014-07-15

    The Stop, Breathe & Think app is free, thanks to underwriting from Tools for Peace, the non-profit organisation that teaches people of all ages how to develop and apply kindness and compassion in their daily lives.

  2. Shortness-of-Breath

    MedlinePlus

    ... can lead to shortness of breath include anxiety, panic attacks, anemia and even constipation. The experience of shortness ... are used to treat patients with anxiety or panic attacks. Other commonly used drugs include bronchodilators to widen ...

  3. Breathing difficulties - first aid

    MedlinePlus

    ... Aid If someone is having breathing difficulty, call 911 or your local emergency number right away, then: ... immediately. When to Contact a Medical Professional Call 911 or your local emergency number if you or ...

  4. Breath alcohol test

    MedlinePlus

    ... of alcohol in the air you breathe out (exhale). How the Test is Performed There are many ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: ...

  5. Breathing - slowed or stopped

    MedlinePlus

    ... who is not responsive is called cardiac (or cardiopulmonary) arrest. In infants and children, the most common ... brain inflammation and infection that affects vital brain functions) Gastroesophageal reflux (heartburn) Holding one's breath Meningitis (inflammation ...

  6. Minimizing Shortness of Breath

    MedlinePlus

    ... and begin to limit our daily activities. Increase Awareness Occupational therapists find that shortness of breath is ... first steps for patients is to increase their awareness and help them recognize symptoms of shortness of ...

  7. Breath-Holding Spells

    MedlinePlus

    ... cause kids to stop breathing and sometimes lose consciousness for up to a minute. In the most ... pose a choking hazard once your child regains consciousness roll your child over onto his or her ...

  8. Breathing Problems - Multiple Languages

    MedlinePlus

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Breathing Problems URL of this page: https://medlineplus.gov/languages/breathingproblems.html Other topics A-Z Expand Section ...

  9. Bad Breath - Multiple Languages

    MedlinePlus

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Bad Breath URL of this page: https://medlineplus.gov/languages/badbreath.html Other topics A-Z Expand Section ...

  10. Continuous Positive Airway Pressure Strategies with Bubble Nasal Continuous Positive Airway Pressure: Not All Bubbling Is the Same: The Seattle Positive Airway Pressure System.

    PubMed

    Welty, Stephen E

    2016-12-01

    Premature neonates are predisposed to complications, including bronchopulmonary dysplasia (BPD). BPD is associated with long-term pulmonary and neurodevelopmental consequences. Noninvasive respiratory support with nasal continuous positive airway pressure (CPAP) has been recommended strongly by the American Academy of Pediatrics. However, CPAP implementation has shown at least a 50% failure rate. Enhancing nasal CPAP effectiveness may decrease the need for mechanical ventilation and reduce the incidence of BPD. Bubble nasal CPAP is better than nasal CPAP using mechanical devices and the bubbling provides air exchange in distal respiratory units. The Seattle PAP system reduces parameters that assess work of breathing. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Breath-Holding Spells

    MedlinePlus

    ... Lessons? Visit KidsHealth in the Classroom What Other Parents Are Reading Your Child's Development (Birth to 3 Years) Feeding Your 1- to 3-Month-Old Feeding Your 4- to 7-Month-Old Feeding Your 8- to 12-Month-Old Feeding Your 1- to 2-Year-Old Breath-Holding ... > For Parents > Breath-Holding Spells Print A A A What's ...

  12. A Real-time Method to Evaluate the Nasal Deposition and Clearance of Acetone in the Human Volunteer

    SciTech Connect

    Thrall, Karla D. ); Schwartz, Ronald E.; Weitz, Karl K. ); Soelberg, Jolen J. ); Foureman, Gary L.; Prah, James D.; Timchalk, Charles

    2003-05-01

    Nasal dosimetry models have become increasingly quantitative as insights into tissue deposition/clearance and computational fluid dynamics have become available. Validation of these models requires sufficient experimental data. However, investigations into respiratory deposition, particularly in human volunteers, have been historically limited due to methodological limitations. To overcome this, a method for evaluating the nasal wash-in, wash-out phenomena of a highly water-soluble compound in human volunteers was developed and characterized. This methodology was assessed using controlled human inhalation exposures to uniformly labeled 13C-acetone at approximately 1 ppm concentration for 30 minutes under different breathing maneuvers (inhale nose/exhale nose; inhale nose/exhale mouth; inhale mouth/exhale nose). A small-diameter air-sampling probe inserted in the nasopharyngeal cavity of the volunteer was connected directly to an ion-trap mass spectrometer capable of sampling every 0.8 sec. A second ion-trap mass spectrometer simultaneously sampled from the volunteer?s exhaled breath stream via a breath-inlet device interface. Together, the two mass spectrometers provided real-time appraisal of the 13C-acetone concentrations in the nasopharyngeal region and in the exhaled breath stream before, during, and after the different breathing maneuvers. The breathing cycle (depth and frequency) and heart rate were concurrently monitored throughout the exposure using a heart rate monitor and a human plethysmograph to differentiate inhalation and exhalation. Graphical overlay of the plethysmography results with the mass spectrometer measurements show clear quantifiable differences in 13C-acetone levels at the nasal probe as a function of breathing maneuvers. Breath-by-breath analysis of 13C-acetone concentrations indicate that between 40-75% of the compound is absorbed upon inhalation and nearly all of that absorbed released back into the breath stream during exhalation.

  13. Assessment of nasal patency after rhinoplasty through the Glatzel mirror

    PubMed Central

    de Pochat, Victor Diniz; Alonso, Nivaldo; Mendes, Rogério Rafael da Silva; Gravina, Paula Rocha; Cronenberg, Eduardo Valente; Meneses, José Valber Lima

    2012-01-01

    Summary Introduction: Objective evaluation of nasal function is a constant challenge for plastic surgeons, otolaryngologists, and allergists. The modified Glatzel mirror can evaluate nasal expiratory flow; however, there is little information on this method and its use in the measurement of nasal patency after surgical procedures. Objective: To compare, in a prospective study, the functional results before and after cosmetic rhinoplasty and evaluate the use of the Glatzel mirror as an objective method to assess nasal patency. Methods: To achieve this objective, we analyzed the functional results of surgery through a subjective questionnaire and objective evaluation through a modified Glatzel mirror, and evaluated the correlation between the 2 methods. Twenty patients (14 women and 6 men) underwent aesthetic rhinoplasty using spreader grafts. Pre- and postoperative evaluation (90–120 days) included a respiratory quality score (subjective) and modified Glatzel mirror test (objective). Subsequently, the Spearman test was used to compare the pre- and postoperative subjective and objective data. Results: The subjective evaluation demonstrated a statistical difference between pre- and postoperative scores (8 ± 2 and 9.4 ± 0.7, P ≤ 0.001). There was no statistical difference in mean nasal patency by modified Glatzel mirror. No statistically significant correlation was observed when comparing the modified Glatzel mirror values with the subjective scores reported by patients pre- or postoperatively. Conclusion: The Glatzel method lacks sensitivity in detecting patient-reported improvements in breathing following rhinoplasty. This suggests that the method is a poor assessment tool to detect small, post-surgical changes in the nasal airways. PMID:25991955

  14. Electronic rhinological thermometer for three-point air temperature measurement in nasal cavity

    NASA Astrophysics Data System (ADS)

    Śnieg, Marcin; Paczesny, Daniel; Weremczuk, Jerzy

    2008-01-01

    This article describes the design and construction of diagnostic medical system for air temperature measurement in nasal cavity. Concept of three-point thermometer is connected with single point electronic thermometer for air temperature measurement in nasal cavity that was previously constructed [1]. Researches were done in Microsystems and Sensors Research Group (WUT) with cooperation of physicians and laryngologists from Otolaryngology Department, Military Medical Institute, Warsaw. Measurement system consist of microprocessor module which periodically collects samples of air temperature from different part of nasal cavity, measurement head with three temperature sensors, and computer software presenting on-line results, calculating breathing parameters and storing data in database. Air temperature is measured in nasal cavity, middle part cavity and nasopharynx during regular respiration process.

  15. Some acoustic features of nasal and nasalized vowels: a target for vowel nasalization.

    PubMed

    Feng, G; Castelli, E

    1996-06-01

    In order to characterize acoustic properties of nasal and nasalized vowels, these sounds will be considered as a dynamic trend from an oral configuration toward an [n]-like configuration. The latter can be viewed as a target for vowel nasalization. This target corresponds to the pharyngonasal tract and it can be modeled, with some simplifications, by a single tract without any parallel paths. Thus the first two resonance frequencies (at about 300 and 1000 Hz) characterize this target well. A series of measurements has been carried out in order to describe the acoustic characteristics of the target. Measured transfer functions confirm the resonator nature of the low-frequency peak. The introduction of such a target allows the conception of the nasal vowels as a trend beginning with a simple configuration, which is terminated in the same manner, so allowing the complex nasal phenomena to be bounded. A complete study of pole-zero evolutions for the nasalization of the 11 French vowels is presented. It allows the proposition of a common strategy for the nasalization of all vowels, so a true nasal vowel can be placed in this nasalization frame. The measured transfer functions for several French nasal vowels are also given.

  16. Effects of nasal mask leak and heated humidification on nasal mucosa in the therapy with nasal continuous positive airway pressure (nCPAP).

    PubMed

    Fischer, Yvonne; Keck, Tilman; Leiacker, Richard; Rozsasi, Ajnacska; Rettinger, Gerhard; Gruen, Philipp M

    2008-11-01

    The purpose of this study was to determine the objective short-term influence of nasal continuous positive airway pressure (nCPAP) therapy, nasal mask leak (NML) and heated humidifiers (HH) to nasal conditioning of spontaneously breathing subjects. This was a prospective, non-randomized, non-blinded day-time study. Eighteen healthy subjects were enrolled in the study. All subjects received nCPAP therapy for 60 min in three different conditions successively: (1) nCPAP without humidification, (2) nCPAP with a defined leakage of nasal mask (slashed circle 28.3 mm2) and (3) nCPAP with HH. Nasal humidity and temperature were measured in the anterior turbinate area using a miniaturized thermocouple and a relative humidity sensor. The measurements were accomplished at the beginning of therapy, after 60, 120 and 180 min. Absolute humidity (aH) in the anterior turbinate area decreased significantly (p = 0.0075) from 17.41 +/- 3.81 mg/l (baseline) to 15.27 +/- 2.21 mg/l (nCPAP alone). With attachment of a NML, aH decreased from 15.27 mg/l not significantly (p = 0.058) to 13.77 +/- 2.28 mg/l (nCPAP and NML) compared to nCPAP alone. After addition of heated humidification to nCPAP, aH increased again from 13.77 mg/l significantly (p = 0.042) to 15.29 +/- 3.51 mg/l (nCPAP and HH) compared to aH (nCPAP+NML). No difference was found between aH (nCPAP and HH) and aH (nCPAP alone). Airway temperature did not change significantly after application of nCPAP alone, nCPAP and NML, and nCPAP and HH. These data indicate that nCPAP therapy with NML tends to have more remarkable reduction of the nasal humidity than nCPAP therapy without NML. nCPAP with heated humidifier is able to compensate the dehydration effects induced by nCPAP therapy with NML by increasing the aH at the anterior turbinate area to the levels observed during breathing with nCPAP alone.

  17. Effect of nasal deviation on quality of life.

    PubMed

    de Lima Ramos, Sueli; Hochman, Bernardo; Gomes, Heitor Carvalho; Abla, Luiz Eduardo Felipe; Veiga, Daniela Francescato; Juliano, Yara; Dini, Gal Moreira; Ferreira, Lydia Masako

    2011-07-01

    Nasal deviation is a common complaint in otorhinolaryngology and plastic surgery. This condition not only causes impairment of nasal function but also affects quality of life, leading to psychological distress. The subjective assessment of quality of life, as an important aspect of outcomes research, has received increasing attention in recent decades. Quality of life is measured using standardized questionnaires that have been tested for reliability, validity, and sensitivity. The aim of this study was to evaluate health-related quality of life, self-esteem, and depression in patients with nasal deviation. Sixty patients were selected for the study. Patients with nasal deviation (n = 32) were assigned to the study group, and patients without nasal deviation (n = 28) were assigned to the control group. The diagnosis of nasal deviation was made by digital photogrammetry. Quality of life was assessed using the Medical Outcomes Study 36-Item Short Form Health Survey questionnaire; the Rosenberg Self-Esteem/Federal University of São Paulo, Escola Paulista de Medicina Scale; and the 20-item Self-Report Questionnaire. There were significant differences between groups in the physical functioning and general health subscales of the Medical Outcomes Study 36-Item Short Form Health Survey (p < 0.05). Depression was detected in 11 patients (34.4 percent) in the study group and in two patients in the control group, with a significant difference between groups (p < 0.05). Nasal deviation is an aspect of rhinoplasty of which the surgeon should be aware so that proper psychological diagnosis can be made and suitable treatment can be planned because psychologically the patients with nasal deviation have significantly worse quality of life and are more prone to depression. Risk, II.(Figure is included in full-text article.).

  18. The detection of breathing behavior using Eulerian-enhanced thermal video.

    PubMed

    Bennett, Stephanie L; Goubran, Rafik; Knoefel, Frank

    2015-01-01

    The current gold standard for detecting and distinguishing between types of sleep apnea is expensive and invasive. This paper aims to examine the potential of inexpensive and unobtrusive thermal cameras in the identification and distinction between types of sleep apnea. A thermal camera was used to gather video of a subject performing regular nasal breathing, nasal hyperventilation and an additional trial simulating one type of sleep apnea. Simultaneously, a respiratory inductance plethysmography (RIP) band gathered respiratory data. Thermal video of all three trials were subjected to Eulerian Video Magnification; a procedure developed at MIT for enhancing subtle color variations in video data. Post magnification, nasal regions of interest were defined and mean region intensities were found for each frame of each trial. These signals were compared to determine the best performing region and compared to RIP data to validate breathing behavior. While some regions performed better, all region intensity signals depicted correct breathing behavior. The mean intensity signals for normal breathing and hyperventilation were correct and correlated well with RIP data. Furthermore, the RIP data resulting from the sleep apnea simulation clearly depicted chest movement while the corresponding mean intensity signal depicted lack of cyclical air flow. These results indicate that a subject's breathing behavior can be captured using thermal video and suggest that, with further development and additional equipment, thermal video can be used to detect and distinguish between types of sleep apnea.

  19. Exhaled nitric oxide measurement in patients affected by nasal polyposis.

    PubMed

    Galli, Jacopo; Montuschi, Paolo; Passàli, Giulio Cesare; Laruffa, Marianna; Parrilla, Claudio; Paludetti, Gaetano

    2012-08-01

    Nitric oxide (NO) is produced in the respiratory tract with a major contribution coming from paranasal sinuses and the nose. The pathophysiological role of NO in the airways has been debated. The aims of this study were to measure fraction of exhaled NO (FENO), a validated marker of airway inflammation, in patients affected by nasal polyposis with and without asthma; to assess the importance of FENO measurement in detecting subclinical involvement of lower airways in patients with clinical rhinosinusal symptoms; and to clarify the impact of endoscopic surgical removal of polyps on airway inflammation. The study was conducted at the O.R.L. Clinic and Clinical Pharmacology Unit, University Hospital Agostino Gemelli, Rome, Italy. Prospective study. Concentrations of FENO were measured with the NIOX system (Aerocrine, Stockholm, Sweden) by using a single-breath online method, according to the American Thoracic Society guidelines. Compared with those in healthy subjects (15 [11-19] ppb, n = 15; P < .0001), FENO values were elevated in patients with nasal polyposis (41 [21-77] ppb, n = 43). There was no significant difference in FENO concentrations between asthmatic and nonasthmatic patients with nasal polyposis (P = .73). Concentrations of FENO in patients with nasal polyposis were decreased after surgery (64.2 [30.0-132.7] ppb vs 56.0 [26.4-73.8] ppb, respectively; P = .03). The fraction of exhaled NO is elevated in the inflammatory process involving both the rhinosinusal district and lower airways, supporting the one-airway disease hypothesis.

  20. A system to reproduce human breathing patterns: its development and validation.

    PubMed

    Häussermann, S; Bailey, A G; Maul, C

    2000-01-01

    Studies of aerosol deposition in models of the human respiratory tract play a significant role in developing our understanding of drug delivery by inhalation and particle retention in the lungs during exposure to polluted environments. To use replica casts of human airways and compare the results with in vivo data, a device is required to simulate human breathing. The objective of this study was to simulate human breathing for nasal casts. Breathing through the nose is normally limited to about 50 L/min. Therefore, a system was built to simulate human breathing patterns as well as artificial ones up to this flow rate. The system consists of a reciprocating piston in a cylinder, which is displaced by a synchronous motor via a linear actuator. The desired signal to drive the motor is given in real time by purpose-written software. The rotation and position of the motor are controlled by an electronic position control unit. The validation of the system shows that it simulates breathing up to 50 L/min closely even for complex waveforms. At breathing rates above 50 L/min, a slight difference is apparent between the desired breathing pattern and the simulated one. The breathing simulator has been shown to be a reliable tool for reproducing a wide variety of breathing patterns.

  1. Effect of mouth breathing on masticatory muscle activity during chewing food.

    PubMed

    Ikenaga, N; Yamaguchi, K; Daimon, S

    2013-06-01

    The aim of this study was to examine the effect of mouth breathing on masticatory muscle activity during chewing food. Masseter muscle activity during chewing of a rice ball was recorded in 45 adult volunteers (three women), identified as nose breathers. Surface electrodes were placed on the skin according to the orientation of the masseter muscle to record the activity of this muscle while the subjects chewed the food until swallowing. Each activity was recorded twice, once with nose breathing and once with mouth breathing induced by nasal obstruction. The integrated and mean electromyography values for mouth breathing were significantly lower than the values for nose breathing (P < 0·05). The resting and total duration of chewing were significantly prolonged (P < 0·05) and the active duration significantly shorter (P < 0·05) when breathing through the mouth compared with the nose. Significantly more chewing strokes were counted for mouth breathing compared with nose breathing (P < 0·05). Taken together, the results indicate that mouth breathing decreases chewing activity and reduces the vertical effect upon the posterior teeth.

  2. Comparison between Perceptual Assessments of Nasality and Nasalance Scores

    ERIC Educational Resources Information Center

    Brunnegard, Karin; Lohmander, Anette; van Doorn, Jan

    2012-01-01

    Background: There are different reports of the usefulness of the Nasometer[TM] as a complement to listening, often as correlation calculations between listening and nasalance measurements. Differences between findings have been attributed to listener experience and types of speech stimuli. Aims: To compare nasalance scores from the Nasometer with…

  3. Nasal septum injury in preterm infants using nasal prongs 1

    PubMed Central

    Bonfim, Suely de Fátima Santos Freire; de Vasconcelos, Maria Gorete Lucena; de Sousa, Nayara Francisca Cabral; da Silva, Daiana Vieira Câmara; Leal, Luciana Pedrosa

    2014-01-01

    OBJECTIVE: to assess the incidence and risk factors associated with nasal septum injury in premature infants using reused and new nasal prongs. METHOD: the study was a cohort from an open therapeutic intervention. The sample included 70 infants with a gestational age inferior to 37 weeks, who used nasal prongs and were hospitalized at the neonatal service of a hospital in Recife-PE, in the Northeast of Brazil. The data were collected in patient files through the assessment of the application of the device and of the nasal septum. Multinomial Logistic Regression and Survival analyses were applied. RESULTS: the incidence of nasal injury corresponded to 62.9%. In the multiple analysis, only the length of the infant's treatment was a determinant factor for the occurrence and severity of the injuries. CONCLUSION: the type of nasal prong does not serve as a risk factor for the nasal injury. The high incidence of nasal injury indicates the need to adapt the nursing care with emphasis on prevention. PMID:25493679

  4. Comparison between Perceptual Assessments of Nasality and Nasalance Scores

    ERIC Educational Resources Information Center

    Brunnegard, Karin; Lohmander, Anette; van Doorn, Jan

    2012-01-01

    Background: There are different reports of the usefulness of the Nasometer[TM] as a complement to listening, often as correlation calculations between listening and nasalance measurements. Differences between findings have been attributed to listener experience and types of speech stimuli. Aims: To compare nasalance scores from the Nasometer with…

  5. Temporary forced oral breathing affects neonates oxygen consumption, carbon dioxide elimination, diaphragm muscles structure and physiological parameters.

    PubMed

    Padzys, Guy Stéphane; Omouendze, Linda Priscillia

    2014-11-01

    We studied adaptation of diaphragm, oxygen consumption and carbon dioxide elimination to forced oral breathing (lasting for only 4 days) following reversible bilateral nasal obstruction performed on day 8 post-natal male rats. Diaphragm myosin heavy chain (MHC) composition, oxygen consumption, carbon dioxide elimination and hormones level were analysed during nasal obstruction period. Diaphragm muscle showed significant increases in adult isoforms (MHC 1, 2a) in oral breathing group versus control. Reversible nasal obstruction was associated with a decrease of oxygen consumption and carbon dioxide elimination. Nasal obstruction period was associated with reduced growth of the olfactory bulbs and an initial decrease in lung growth. One day after implementing nasal obstruction, basal corticosterone levels had increased (by over 1000). Oral breathing was also associated with a lower level of thyroid hormone. We conclude that a 4 day nasal obstruction period in young rats leads to hormonal changes and to Diaphragm myosin heavy chain structural adaptation. Copyright © 2014. Published by Elsevier Ireland Ltd.

  6. Visualization of nasal airflow patterns in a patient affected with atrophic rhinitis using particle image velocimetry

    NASA Astrophysics Data System (ADS)

    Garcia, G. J. M.; Mitchell, G.; Bailie, N.; Thornhill, D.; Watterson, J.; Kimbell, J. S.

    2007-10-01

    The relationship between airflow patterns in the nasal cavity and nasal function is poorly understood. This paper reports an experimental study of the interplay between symptoms and airflow patterns in a patient affected with atrophic rhinitis. This pathology is characterized by mucosal dryness, fetor, progressive atrophy of anatomical structures, a spacious nasal cavity, and a paradoxical sensation of nasal congestion. A physical replica of the patient's nasal geometry was made and particle image velocimetry (PIV) was used to visualize and measure the flow field. The nasal replica was based on computed tomography (CT) scans of the patient and was built in three steps: three-dimensional reconstruction of the CT scans; rapid prototyping of a cast; and sacrificial use of the cast to form a model of the nasal passage in clear silicone. Flow patterns were measured by running a water-glycerol mixture through the replica and evaluating the displacement of particles dispersed in the liquid using PIV. The water-glycerol flow rate used corresponded to an air flow rate representative of a human breathing at rest. The trajectory of the flow observed in the left passage of the nose (more affected by atrophic rhinitis) differed markedly from what is considered normal, and was consistent with patterns of epithelial damage observed in cases of the condition. The data are also useful for validation of computational fluid dynamics predictions.

  7. Response characteristics for thermal and pressure devices commonly used for monitoring nasal and oral airflow during sleep studies.

    PubMed

    Gehring, J M; Cho, J-G; Wheatley, J R; Amis, T C

    2014-03-01

    We examined thermocouple and pressure cannulae responses to oral and nasal airflow using a polyester model of a human face, with patent nasal and oral orifices instrumented with a dual thermocouple (F-ONT2A, Grass) or a dual cannula (0588, Braebon) pressure transducer (± 10 cm H2O, Celesco) system. Tidal airflow was generated using a dual compartment facemask with pneumotachographs (Fleisch 2) connected to the model orifices. During nasal breathing: thermocouple amplitude = 0.38 Ln [pneumotachograph amplitude] + 1.31 and pressure cannula amplitude = 0.93 [pneumotachograph amplitude](2.15); during oral breathing: thermocouple amplitude = 0.44 Ln [pneumotachograph amplitude] + 1.07 and pressure cannula amplitude = 0.33 [pneumotachograph amplitude](1.72); (all range ∼ 0.1-∼ 4.0 L s(-1); r(2) > 0.7). For pneumotachograph amplitudes <1 L s(-1) (linear model) change in thermocouple amplitude/unit change in pneumotachograph amplitude was similar for nasal and oral airflow, whereas nasal pressure cannula amplitude/unit change in pneumotachograph amplitude was almost four times that for oral. Increasing oral orifice area from 0.33 cm(2) to 2.15 cm(2) increased oral thermocouple amplitude/unit change in pneumotachograph amplitude by ∼ 58% but decreased pressure cannula amplitude/unit change in pneumotachograph amplitude by 49%. For pneumotachograph amplitudes up to 1 L s(-1), alterations in inspiratory/expiratory ratios or total respiratory time did not affect the sensitivity of either nasal or oral pressure cannulae or the nasal thermocouple, but the oral thermocouple sensitivity was influenced by respiratory cycle time. Different nasal and oral responses influence the ability of these systems to quantitatively assess nasal and oral airflow and oro-nasal airflow partitioning.

  8. Accuracy of CO₂ monitoring via nasal cannulas and oral bite blocks during sedation for esophagogastroduodenoscopy.

    PubMed

    Chang, Kuo-Chen; Orr, Joe; Hsu, Wei-Chih; Yu, Lu; Tsou, Mei-Yung; Westenskow, Dwayne R; Ting, Chien-Kun

    2016-04-01

    Esophagogastroduodenoscopy procedures are typically performed under conscious sedation. Drug-induced respiratory depression is a major cause of serious adverse effects during sedation. Capnographic monitoring of respiratory activity improves patient safety during procedural sedation. This bench study compares the performance of the nasal cannulas and oral bite blocks used to monitor exhaled CO2 during sedation. We used a spontaneously breathing mechanical lung to evaluated four CO2 sampling nasal cannulas and three CO2 sampling bite blocks. We placed pneumatic resistors in the mouth of the manikin to simulate different levels of mouth opening. We compared CO2 measurements taken from the sampling device to CO2 measurements taken directly from the trachea. The end tidal CO2 concentration (PETCO2) measured through the bite blocks and nasal cannulas was always lower than the corresponding PETCO2 measured at the trachea. The difference became larger as the amount of oxygen delivered through the devices increased. The difference was larger during normal ventilation than during hypoventilation. The difference became larger as the amount of oral breathing increased. The two nasal cannulas without oral cups failed to provide sufficient CO2 for breath detection when the mouth was fully open and oxygen was delivered at 10 L/min. Our simulation found that respiratory rate can be accurately monitored during the procedure using a CO2 sampling bite block or a nasal cannula with oral cup. The accuracy of PETCO2 measurements depends on the device used, the amount of supplement oxygen, the amount of oral breathing and the patient's minute ventilation.

  9. Effect of anatomy on human nasal air flow and odorant transport patterns: implications for olfaction.

    PubMed

    Zhao, Kai; Scherer, Peter W; Hajiloo, Shoreh A; Dalton, Pamela

    2004-06-01

    Recent studies that have compared CT or MRI images of an individual's nasal anatomy and measures of their olfactory sensitivity have found a correlation between specific anatomical areas and performance on olfactory assessments. Using computational fluid dynamics (CFD) techniques, we have developed a method to quickly (nasal CT scans from an individual patient into an anatomically accurate 3-D numerical nasal model that can be used to predict airflow and odorant transport, which may ultimately determine olfactory sensitivity. The 3-D model can be also be rapidly modified to depict various anatomical deviations, such as polyps and their removal, that may alter nasal airflow and impair olfactory ability. To evaluate the degree to which variations in critical nasal areas such as the olfactory slit and nasal valve can alter airflow and odorant transport, inspiratory and expiratory airflow with odorants were simulated using numerical finite volume methods. Results suggest that anatomical changes in the olfactory region (upper meatus below the cribriform plate) and the nasal valve region will strongly affect airflow patterns and odorant transport through the olfactory region, with subsequent effects on olfactory function. The ability to model odorant transport through individualized models of the nasal passages holds promise for relating anatomical deviations to generalized or selective disturbances in olfactory perception and may provide important guidance for treatments for nasal-sinus disease, occupational rhinitis and surgical interventions that seek to optimize airflow and improve deficient olfactory function.

  10. Streptococcus pneumoniae Colonization Is Required To Alter the Nasal Microbiota in Cigarette Smoke-Exposed Mice.

    PubMed

    Shen, Pamela; Whelan, Fiona J; Schenck, L Patrick; McGrath, Joshua J C; Vanderstocken, Gilles; Bowdish, Dawn M E; Surette, Michael G; Stämpfli, Martin R

    2017-10-01

    Smokers have nasal microbiota dysbiosis, with an increased frequency of colonizing bacterial pathogens. It is possible that cigarette smoke increases pathogen acquisition by perturbing the microbiota and decreasing colonization resistance. However, it is difficult to disentangle microbiota dysbiosis due to cigarette smoke exposure from microbiota changes caused by increased pathogen acquisition in human smokers. Using an experimental mouse model, we investigated the impact of cigarette smoke on the nasal microbiota in the absence and presence of nasal pneumococcal colonization. We observed that cigarette smoke exposure alone did not alter the nasal microbiota composition. The microbiota composition was also unchanged at 12 h following low-dose nasal pneumococcal inoculation, suggesting that the ability of the microbiota to resist initial nasal pneumococcal acquisition was not impaired in smoke-exposed mice. However, nasal microbiota dysbiosis occurred as a consequence of established high-dose nasal pneumococcal colonization at day 3 in smoke-exposed mice. Similar to clinical reports on human smokers, an enrichment of potentially pathogenic bacterial genera such as Fusobacterium, Gemella, and Neisseria was observed. Our findings suggest that cigarette smoke exposure predisposes to pneumococcal colonization independent of changes to the nasal microbiota and that microbiota dysbiosis observed in smokers may occur as a consequence of established pathogen colonization. Copyright © 2017 American Society for Microbiology.

  11. High-Flow Nasal Cannula Versus Conventional Oxygen Therapy in Emergency Department Patients With Cardiogenic Pulmonary Edema: A Randomized Controlled Trial.

    PubMed

    Makdee, Onlak; Monsomboon, Apichaya; Surabenjawong, Usapan; Praphruetkit, Nattakarn; Chaisirin, Wansiri; Chakorn, Tipa; Permpikul, Chairat; Thiravit, Phakphoom; Nakornchai, Tanyaporn

    2017-10-01

    High-flow nasal cannula is a new method for delivering high-flow supplemental oxygen for victims of respiratory failure. This randomized controlled trial compares high-flow nasal cannula with conventional oxygen therapy in emergency department (ED) patients with cardiogenic pulmonary edema. We conducted an open-label randomized controlled trial in the ED of Siriraj Hospital, Bangkok, Thailand. Patients aged 18 years or older with cardiogenic pulmonary edema were randomly assigned to receive either conventional oxygen therapy or high-flow nasal cannula. The primary outcome was the respiratory rate 60 minutes postintervention. We enrolled 128 participants (65 in the conventional oxygen therapy and 63 in the high-flow nasal cannula groups). Baseline high-flow nasal cannula and conventional oxygen therapy mean respiratory rates were 28.7 breaths/min (SD 3.2) and 28.6 breaths/min (SD 3.5). Mean respiratory rates at 60 minutes postintervention were lower in the high-flow nasal cannula group (21.8 versus 25.1 breaths/min; difference 3.3; 95% confidence interval 1.9 to 4.6). No significant differences were found in the admission rate, ED and hospital lengths of stay, noninvasive ventilation, intubation, or mortality. In patients with cardiogenic pulmonary edema in the ED, high-flow nasal cannula therapy may decrease the severity of dyspnea during the first hour of treatment. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  12. Same Noses, Different Nasalance Scores: Data from Normal Subjects and Cleft Palate Speakers for Three Systems for Nasalance Analysis

    ERIC Educational Resources Information Center

    Bressmann, Tim; Klaiman, Paula; Fischbach, Simone

    2006-01-01

    Nasalance scores from the Nasometer, the NasalView and the OroNasal System were compared. The data was collected from 50 normal participants and 19 hypernasal patients with cleft palate. The Nasometer had the lowest nasalance scores for the non-nasal Zoo Passage and that the OroNasal System had the lowest nasalance scores for the Nasal Sentences.…

  13. Nasal and Olfactory Deposition with Normal and Bidirectional Intranasal Delivery Techniques: In Vitro Tests and Numerical Simulations.

    PubMed

    Xi, Jinxiang; Wang, Zhaoxuan; Nevorski, Danielle; White, Thomas; Zhou, Yue

    2017-04-01

    Intranasal delivery protocols that can effectively deposit drugs to the olfactory region are severely lacking. Furthermore, it is still challenging to quantify nasal deposition on a regional or local basis, which is crucial in assessing the performance of targeted olfactory drug delivery. To visually and quantitatively compare drug depositions in the nose and olfactory region with normal and bidirectional breathing patterns with vibrating mesh and jet nebulizers. A sectional nose cast was developed based on an anatomically accurate nasal airway model to visualize deposition patterns and quantify regional doses. Sar-Gel was used to visualize the deposition pattern inside the nose and the delivered doses were measured using a high precision scale. Numerical modeling was performed to understand the underlying mechanisms in both the normal and bidirectional deliveries. Results show that the bidirectional technique yielded higher deposition in both the nasal cavity and the olfactory region for both nebulizers. However, the vibrating mesh nebulizer was found to be more responsive to the bidirectional breathing and elicited more increase in the olfactory delivery than the PARI Sinus. The deposition patterns under the bidirectional breathing are highly different between the two nasal passages, with more dispersed distributions in the nasal passage with exiting flows. For both nebulizers, reducing the inhalation flow rates increased the nasal dose, but decreased the olfactory dose, which was consistent between in vitro measurements and numerical simulations. The bi directional technique with a vibrating mesh nebulizer is recommended for both nasal systematic and olfactory drug deliveries. The Sar-Gel based method in combination with sectional nasal casts appears to be a practical approach to visualize local depositions.

  14. Epiglottic movements during breathing in humans

    PubMed Central

    Amis, T C; O'Neill, N; Di Somma, E; Wheatley, J R

    1998-01-01

    Using X-ray fluoroscopy we measured antero-posterior (A–P) and cranio-caudal (C–C) displacements of the epiglottic tip (ET), corniculate cartilage and hyoid bone in seven seated, normal human subjects (age 34 ± 3 years; mean ±s.e.m.; 4 males, 3 females) breathing via a nasal mask or mouthpiece with (RL) and without (UB) a fixed resistive load.During UB, via either mouth or nose, there were no significant A-P ET movements. During RL via the nose the ET at peak expiratory flow was 2.6 ± 1.3 mm cranial to its position at peak inspiratory flow (P <0.05, ANOVA). C–C movements of the ET correlated strongly with C-C movements of the corniculate cartilage and hyoid bone.The ET, corniculate cartilage and hyoid bone (at zero airflow) were situated more caudally during oral UB than for any other condition.When present, epiglottic movements during breathing do not appear to be independent of those of the larynx and hyoid. Furthermore, epiglottic position may be related to the level of upper airway resistance. PMID:9729637

  15. [Historical study on traditional Chinese formulations and crude drugs used for bad breath].

    PubMed

    Masuda, Megumi; Murata, Kazuya; Matsuda, Hideaki; Honda, Mami; Honda, Shun-Ichi; Tani, Tadato

    2011-01-01

    Bad breath is a topic of general interest. In this study, the treatment for bad breath in traditional Chinese medicine was reviewed with a special focus on pathologic diagnosis and crude drug prescriptions. It was shown that bad breath developed based on both systemic and local diseases. Some systemic conditions, including nasal, paranasal, pulmonary and digestive diseases, are considered to cause bad breath. The morbid state of a patient with bad breath has been recognized as being based on "heat syndrome" and "Qi-stagnation syndrome." Bad breath based on "heat syndrome" is manifested as thirst and ulceration of the oral cavity, and has been treated with crude drugs such as Coptis rhizome, Scutellaria root and gypsum. One case study reported that bad breath resulting from a dry mouth was treated with byakkokaninjinto, a Kampo formulation containing gypsum. "Qi" is considered to be the vital energy of all life forms including for the functioning of organs and mental and emotional activity. "Qi-stagnation syndrom," referring to the dysfunction of organs, is manifested as psychosomatic symptoms such as irritability, a flushed face and restlessness. Bad breath based on "Qi-stagnation syndrome" has been treated with crude drugs such as Cnidium rhizome, clove and cinnamon bark. Modern dental and medical treatment both accept the participation of psychogenic agents in the development of bad breath. Bad breath also develops based on periodontal and oral diseases. This type of bad breath has been treated with mouth-wash (collutorium) containing Asiasarum root, Angelica dahurica root and Cnidium rhizome. This historical evidence regarding crude drug prescriptions contributes to the development of mouth care products for preventing and treating bad breath.

  16. Imposed Work of Breathing for Flow Meters with In-Line versus Flow-Through Technique during Simulated Neonatal Breathing

    PubMed Central

    2015-01-01

    Background The ability to determine airflow during nasal CPAP (NCPAP) treatment without adding dead space or resistance would be useful when investigating the physiologic effects of different NCPAP systems on breathing. The aim of this study was to investigate the effect on pressure stability of different flow measuring devices at the in-line and flow-through position, using simulated neonatal breathing. Methods Six different flow measure devices were evaluated by recording pressure changes and imposed work of breathing for breaths with 16 and 32 ml tidal volumes. The tests were performed initially with the devices in an in line position and with 5 and 10 L/min using flow through technique, without CPAP. The flow meters were then subsequently tested with an Infant Flow CPAP system at 3, 5 and 8 cm H2O pressure using flow through technique. The quality of the recorded signals was compared graphically. Results The resistance of the measuring devices generated pressure swings and imposed work of breathing. With bias flow, the resistance also generated CPAP pressure. Three of the devices had low resistance and generated no changes in pressure stability or CPAP pressure. The two devices intended for neonatal use had the highest measured resistance. Conclusion The importance of pressure stability and increased work of breathing during non-invasive respiratory support are insufficiently studied. Clinical trials using flow-through technique have not focused on pressure stability. Our results indicate that a flow-through technique might be a way forward in obtaining a sufficiently high signal quality without the added effects of rebreathing and increased work of breathing. The results should stimulate further research and the development of equipment for dynamic flow measurements in neonates. PMID:26192188

  17. Correlation between nasal airflow characteristics and clinical relevance of nasal septal deviation to nasal airway obstruction.

    PubMed

    Kim, Sung Kyun; Heo, Go Eun; Seo, Anna; Na, Yang; Chung, Seung-Kyu

    2014-02-01

    Since the imbalance of the nasal cavities due to nasal septal deviation (NSD) is a commonly observed anatomic variation in healthy adults, clinicians must often decide whether or not it is clinically relevant to the symptoms of nasal airway obstruction (NAO). Main reason for this is a lack of data correlating the symptoms of NAO with objective findings. The aim of our study is to find the correlation between fluid dynamic parameters and the anatomy of nasal cavity with NSD by numerical simulation. We generated 6 computational models of nasal cavities with NSD were created from computed tomographic images: 3 symptomatic patients with NAO and 3 asymptomatic patients. Computational fluid dynamics (CFD) was used to simulate steady inspiratory airflows in each nasal cavity model and compare the fluid dynamic properties of each. In the symptomatic cases, the pressure drop from the naris to the end of the septum was larger, and more uneven flow partitioning was observed. Local maximum velocity and wall shear stress were higher in the symptomatic group than in the asymptomatic group. The symptoms of NAO seem to be related more to the nasal resistance from the naris to the end of the septum than to the total nasal resistance from naris to nasopharynx. Factors correlated with NAO by CFD can be used as elements in patient-specific objective diagnostic tools for NAO in the presence of NSD. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. Airflow and nanoparticle deposition in rat nose under various breathing and sniffing conditions: a computational evaluation of the unsteady effect.

    PubMed

    Jiang, Jianbo; Zhao, Kai

    2010-11-01

    Accurate prediction of nanoparticle (1~100 nm) deposition in the rat nasal cavity is important for assessing the toxicological impact of inhaled nanoparticles as well as for potential therapeutic applications. A quasi-steady assumption has been widely adopted in the past investigations on this topic, yet the validity of such simplification under various breathing and sniffing conditions has not been carefully examined. In this study, both steady and unsteady computational fluid dynamics (CFD) simulations were conducted in a published rat nasal model under various physiologically realistic breathing and sniffing flow rates. The transient airflow structures, nanoparticle transport and deposition patterns in the whole nasal cavity and the olfactory region were investigated and compared with steady state simulation of equivalent flow rate. The results showed that (1) the quasi-steady flow assumption for cyclic flow was valid for over 70% of the cycle period during all simulated breathing and sniffing conditions in the rat nasal cavity, or the unsteady effect was only significant during the transition between the respiratory phases; (2) yet the quasi-steady assumption for nanoparticle transport was not valid, except in the vicinity of peak respiration. In general, the total deposition efficiency of nanoparticle during cyclic breathing would be lower than that of steady state due to the unsteady effect on particle transport and deposition, and further decreased with the increase of particle size, sniffing frequency, and flow rate. In the contrary, previous study indicated that for micro-scale particles (0.5~4μm), the unsteady effect would increase deposition efficiencies in rat nasal cavity. Combined, these results suggest that the quasi-steady assumption of nasal particle transport during cycling breathing should be used with caution for an accurate assessment of the toxicological and therapeutic impact of particle inhalation. Empirical equations and effective steady

  19. Numerical simulation of airflow and micro-particle deposition in human nasal airway pre- and post-virtual sphenoidotomy surgery.

    PubMed

    Bahmanzadeh, Hojat; Abouali, Omid; Faramarzi, Mohammad; Ahmadi, Goodarz

    2015-06-01

    In the present study, the effects of endoscopic sphenoidotomy surgery on the flow patterns and deposition of micro-particles in the human nasal airway and sphenoid sinus were investigated. A realistic model of a human nasal passage including nasal cavity and paranasal sinuses was constructed using a series of CT scan images of a healthy subject. Then, a virtual sphenoidotomy by endoscopic sinus surgery was performed in the left nasal passage and sphenoid sinus. Transient airflow patterns pre- and post-surgery during a full breathing cycle (inhalation and exhalation) were simulated numerically under cyclic flow condition. The Lagrangian approach was used for evaluating the transport and deposition of inhaled micro-particles. An unsteady particle tracking was performed for the inhalation phase of the breathing cycle for the case that particles were continuously entering into the nasal airway. The total deposition pattern and sphenoid deposition fraction of micro-particles were evaluated and compared for pre- and post-surgery cases. The presented results show that sphenoidotomy increased the airflow into the sphenoid sinus, which led to increased deposition of micro-particles in this region. Particles up to 25 μm were able to penetrate into the sphenoid in the post-operation case, and the highest deposition in the sphenoid for the resting breathing rate occurred for 10 μm particles at about 1.5%. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Breathing Like a Fish

    ERIC Educational Resources Information Center

    Katsioloudis, Petros J.

    2010-01-01

    Being able to dive and breathe underwater has been a challenge for thousands of years. In 1980, Fuji Systems of Tokyo developed a series of prototype gills for divers as a way of demonstrating just how good its membranes are. Even though gill technology has not yet reached the point where recipients can efficiently use implants to dive underwater,…

  1. Life and Breath

    ERIC Educational Resources Information Center

    Ellis, Helen D.

    1974-01-01

    This article describes a public education program combining the screening process and a follow-up program for teaching victims of emphysema and other respiratory diseases how to better their living condition through proper breathing, avoidance of air pollutants and cigarette smoking, and taking better care of themselves physically. (PD)

  2. Metabolic breath analyzer

    NASA Technical Reports Server (NTRS)

    Perry, C. L.

    1971-01-01

    Instrument measures metabolic breathing rate and dynamics of human beings in atmospheres ranging from normal air to 100 percent oxygen at ambient pressures from 14.7 to 3.0 psia. Measurements are made at rest or performing tasks up to maximum physical capacity under either zero or normal gravity.

  3. Life and Breath

    ERIC Educational Resources Information Center

    Ellis, Helen D.

    1974-01-01

    This article describes a public education program combining the screening process and a follow-up program for teaching victims of emphysema and other respiratory diseases how to better their living condition through proper breathing, avoidance of air pollutants and cigarette smoking, and taking better care of themselves physically. (PD)

  4. Breathing metabolic simulator

    NASA Technical Reports Server (NTRS)

    Bartlett, R. G., Jr.; Hendricks, C. M.; Morison, W. B.

    1972-01-01

    A description is given of an automatic computer controlled second generation breathing metabolic simulator (BMS). The simulator is used for evaluating and testing respiratory diagnostic, monitoring, support, and resuscitation equipment. Any desired sequence of metabolic activities can be simulated on the device for up to 15 hours. The computer monitors test procedures and provides printouts of test results.

  5. The Air We Breathe

    NASA Technical Reports Server (NTRS)

    Davila, Dina

    2010-01-01

    Topics discussed include NASA mission to pioneer the future in space exploration, scientific discovery and aeronautics research; the role of Earth's atmosphere, atmospheric gases, layers of the Earth's atmosphere, ozone layer, air pollution, effects of air pollution on people, the Greenhouse Effect, and breathing on the International Space Station.

  6. Portable Breathing Assembly

    NASA Image and Video Library

    2017-06-12

    In the Space Station Processing Facility at NASA's Kennedy Space Center in Florida, Jacobs Test and Operations Support Contract, or TOSC, technicians fill portable breathing apparatuses, or PBAS. The PBAs are to be use on board the International Space Staton to provide astronauts with breathable air in the event of a fire or other emergency situation.

  7. Breathing Like a Fish

    ERIC Educational Resources Information Center

    Katsioloudis, Petros J.

    2010-01-01

    Being able to dive and breathe underwater has been a challenge for thousands of years. In 1980, Fuji Systems of Tokyo developed a series of prototype gills for divers as a way of demonstrating just how good its membranes are. Even though gill technology has not yet reached the point where recipients can efficiently use implants to dive underwater,…

  8. Medical Issues: Breathing

    MedlinePlus

    ... About Us News Facebook Twitter YouTube Learn About SMA About SMA Types of SMA Causes & Diagnosis Genetics Testing Carriers What Diagnosis Means ... Care Packages Information Packets Equipment Pool Living With SMA Medical Issues Palliative Breathing Orthopedics Nutrition Equipment Daily ...

  9. Portable Breathing Assembly

    NASA Image and Video Library

    2017-06-12

    In the Space Station Processing Facility at NASA's Kennedy Space Center in Florida, Jacobs Test and Operations Support Contract, or TOSC, technician Rod Ostgrard helps fill portable breathing apparatuses, or PBAS. The PBAs are to be use on board the International Space Staton to provide astronauts with breathable air in the event of a fire or other emergency situation.

  10. Portable Breathing Assembly

    NASA Image and Video Library

    2017-06-12

    In the Space Station Processing Facility at NASA's Kennedy Space Center in Florida, Jacobs Test and Operations Support Contract, or TOSC, technician John Thompson helps fill portable breathing apparatuses, or PBAS. The PBAs are to be use on board the International Space Staton to provide astronauts with breathable air in the event of a fire or other emergency situation.

  11. The Air We Breathe

    NASA Technical Reports Server (NTRS)

    Davila, Dina

    2010-01-01

    Topics discussed include NASA mission to pioneer the future in space exploration, scientific discovery and aeronautics research; the role of Earth's atmosphere, atmospheric gases, layers of the Earth's atmosphere, ozone layer, air pollution, effects of air pollution on people, the Greenhouse Effect, and breathing on the International Space Station.

  12. Factors influencing breath ammonia determination.

    PubMed

    Solga, Steven F; Mudalel, Matthew; Spacek, Lisa A; Lewicki, Rafal; Tittel, Frank; Loccioni, Claudio; Russo, Adolfo; Risby, Terence H

    2013-09-01

    Amongst volatile compounds (VCs) present in exhaled breath, ammonia has held great promise and yet it has confounded researchers due to its inherent reactivity. Herein we have evaluated various factors in both breath instrumentation and the breath collection process in an effort to reduce variability. We found that the temperature of breath sampler and breath sensor, mouth rinse pH, and mode of breathing to be important factors. The influence of the rinses is heavily dependent upon the pH of the rinse. The basic rinse (pH 8.0) caused a mean increase of the ammonia concentration by 410 ± 221 ppb. The neutral rinse (pH 7.0), slightly acidic rinse (pH 5.8), and acidic rinse (pH 2.5) caused a mean decrease of the ammonia concentration by 498 ± 355 ppb, 527 ± 198 ppb, and 596 ± 385 ppb, respectively. Mode of breathing (mouth-open versus mouth-closed) demonstrated itself to have a large impact on the rate of recovery of breath ammonia after a water rinse. Within 30 min, breath ammonia returned to 98 ± 16% that of the baseline with mouth open breathing, while mouth closed breathing allowed breath ammonia to return to 53 ± 14% of baseline. These results contribute to a growing body of literature that will improve reproducibly in ammonia and other VCs.

  13. Pathogenesis of nasal polyposis

    PubMed Central

    Hulse, K. E.; Stevens, W. W.; Tan, B. K.; Schleimer, R. P.

    2015-01-01

    Summary Chronic rhinosinusitis with nasal polyps (CRSwNP) is a complex inflammatory condition that affects a large proportion of the population world-wide and is associated with high cost of management and significant morbidity. Yet, there is a lack of population-based epidemiologic studies using current definitions of CRSwNP, and the mechanisms that drive pathogenesis in this disease remain unclear. In this review, we summarize the current evidence for the plethora of factors that likely contribute to CRSwNP pathogenesis. Defects in the innate function of the airway epithelial barrier, including diminished expression of antimicrobial products and loss of barrier integrity, combined with colonization by fungi and bacteria likely play a critical role in the development of chronic inflammation in CRSwNP. This chronic inflammation is characterized by elevated expression of many key inflammatory cytokines and chemokines, including IL-5, thymic stromal lymphopoietin and CCL11, that help to initiate and perpetuate this chronic inflammatory response. Together, these factors likely combine to drive the influx of a variety of immune cells, including eosinophils, mast cells, group 2 innate lymphoid cells and lymphocytes, which participate in the chronic inflammatory response within the nasal polyps. Importantly, however, future studies are needed to demonstrate the necessity and sufficiency of these potential drivers of disease in CRSwNP. In addition to the development of new tools and models to aid mechanistic studies, the field of CRSwNP research also needs the type of robust epidemiologic data that has served the asthma community so well. Given the high prevalence, costs and morbidity, there is a great need for continued research into CRS that could facilitate the development of novel therapeutic strategies to improve treatment for patients who suffer from this disease. PMID:25482020

  14. Dysfunction of central control of breathing in amyotrophic lateral sclerosis.

    PubMed

    Howell, Bradley N; Newman, Daniel S

    2017-08-01

    Dysfunction in central control of breathing in some amyotrophic lateral sclerosis (ALS) patients is not adequately detected with standard evaluation for respiratory dysfunction. Nocturnal oximetry reveals periodic desaturations despite normal respiratory muscle movements. Continuous diaphragmatic electromyography has provided in vivo data consistent with impaired central control of diaphragm motor units. Current understanding of central control of breathing identifies the pre-Botzinger complex as the inspiratory rhythm generator. Animal models of pre-Botzinger complex neurodegeneration demonstrate rapid eye movement-related central sleep apneas progressing to loss of rapid eye movement sleep, also apparent in some ALS patients. Evidence supports the hypothesis that dysfunction in central control of breathing in some ALS patients may be related to pre-Botzinger complex degeneration. As the impact dysfunction of central control of breathing has on ALS becomes better defined the current standard of evaluating respiratory dysfunction in ALS patients may need updating. Muscle Nerve 56: 197-201, 2017. © 2017 Wiley Periodicals, Inc.

  15. 21 CFR 874.3900 - Nasal dilator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3900 Nasal dilator. (a) Identification. A nasal... nasal airflow. The device decreases airway resistance and increases nasal airflow. The external...

  16. 21 CFR 874.3900 - Nasal dilator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3900 Nasal dilator. (a) Identification. A nasal... nasal airflow. The device decreases airway resistance and increases nasal airflow. The external...

  17. The Relationship between Nasalance and Nasality in Children with Cleft Palate.

    ERIC Educational Resources Information Center

    Watterson, Thomas; And Others

    1993-01-01

    This study correlated measures of nasalance computed by the Nasometer with listener judgments of nasality of speech passages spoken by 25 children with craniofacial disorders. Results showed a significant correlation between nasalance and nasality only when nasal consonants were not included in the passage spoken. (Author/DB)

  18. Easy removal of nasal magnets.

    PubMed

    Starke, Lori

    2005-09-01

    This article uses a case report and discussion to demonstrate the removal of magnets which have become lodged in the nasal cavity as a result of using magnet-backed earrings to decorate the alae. If bi-alar decoration is used, removal of nasal magnets can present more of a challenge than other nasal foreign bodies. This is because of their attraction to each other through the septum and because of the edema that can form around the magnets. This case discusses that removal of magnets lodged in the nares can be easily achieved with minimal trauma, by the use of a household pocket magnet.

  19. Craniofacial development and physiological state after early oral breathing in rats.

    PubMed

    Padzys, Guy S; Tankosic, Christiane; Trabalon, Marie; Martrette, Jean-Marc

    2012-02-01

    In this study we determined whether craniofacial development in rats could be influenced by an early temporary (3 d) nasal obstruction associated with forced oral breathing. The rats were killed at specific time points after surgery. Plasma samples were taken for biochemical analyses, and cephalometric measurements were performed. Shortly after nasal obstruction, the vertical nasomaxillary complex and the longitudinal skull base proved to be smaller in both sexes of test rats compared with controls. This was maintained in male rats but not in female rats. In female rats, only the longitudinal skull base remained somewhat shorter as the animals grew older. Reversible nasal obstruction was further associated with reduced dimensions of the olfactory bulbs lasting into adulthood and an initial decrease in lung weight. One day after implementing nasal obstruction, basal corticosterone levels had increased (by over 1,000%) and stayed at a high level in female rats. In male rats, however, the corticosterone level seemed to return to normal by day 90. Oral breathing was also associated with a lower level of thyroid hormone, especially at the shorter term intervals in both sexes. We conclude that a 3-d nasal obstruction period in young rats leads to long-term hormonal changes and to craniofacial structural adaptation. © 2011 Eur J Oral Sci.

  20. Supplementation of standard pre-oxygenation with nasal prong oxygen or machine oxygen flush during a simulated leak scenario.

    PubMed

    Russell, T; Ng, L; Nathan, E; Debenham, E

    2014-10-01

    The presence of a facemask leak significantly reduces the effectiveness of pre-oxygenation and increases the risk of post-induction hypoxia. We randomly assigned 24 healthy volunteers to a six-period crossover trial with and without a simulated facemask leak. Pre-oxygenation was performed using a standard anaesthesia machine circuit supplemented either by nasal prong oxygen or by anaesthesia machine flush oxygen. Each intervention was completed with both 3-min tidal breathing and 8 deep breath techniques: end-tidal oxygen fraction was used as the measure of pre-oxygenation effectiveness. The presence of a stimulated mask leak significantly reduced the effectiveness of pre-oxygenation regardless of the breathing method used. With a simulated facemask leak introduced, the mean (SD) end-tidal oxygen fraction with the 3-min tidal breath technique was 74.7 (9.3)% compared with 57.5 (6.2%) for the 8 deep breath technique with 3-min tidal breathing and a leak. End-tidal oxygen fractions increased by 11.0% (95% CI 7.8-14.3%) (p < 0.0001) with the addition of nasal prong oxygenation and 16.8% (13.6-20.0%) (p < 0.0001) with machine oxygen flush compared with standard pre-oxygenation. When a leak is present, 3-min tidal breathing with either nasal prong or anaesthesia machine flush oxygenation is an effective pre-oxygenation method, and preferable to the 8 deep breath method. © 2014 The Association of Anaesthetists of Great Britain and Ireland.

  1. Dosimetry of nasal uptake of water-soluble and reactive gases: a first study of interhuman variability.

    PubMed

    Garcia, Guilherme J M; Schroeter, Jeffry D; Segal, Rebecca A; Stanek, John; Foureman, Gary L; Kimbell, Julia S

    2009-06-01

    Certain inhaled chemicals, such as reactive, water-soluble gases, are readily absorbed by the nasal mucosa upon inhalation and may cause damage to the nasal epithelium. Comparisons of the spatial distribution of nasal lesions in laboratory animals exposed to formaldehyde with gas uptake rates predicted by computational models reveal that lesions usually occur in regions of the susceptible epithelium where gas absorption is highest. Since the uptake patterns are influenced by air currents in the nose, interindividual variability in nasal anatomy and ventilation rates due to age, body size, and gender will affect the patterns of gas absorption in humans, potentially putting some age groups at higher risk when exposed to toxic gases. In this study, interhuman variability in the nasal dosimetry of reactive, water-soluble gases was investigated by means of computational fluid dynamics (CFD) models in 5 adults and 2 children, aged 7 and 8 years old. Airflow patterns were investigated for allometrically scaled inhalation rates corresponding to resting breathing. The spatial distribution of uptake at the airway walls was predicted to be nonuniform, with most of the gas being absorbed in the anterior portion of the nasal passages. Under the conditions of these simulations, interhuman variability in dose to the whole nose (mass per time per nasal surface area) due to differences in anatomy and ventilation was predicted to be 1.6-fold among the 7 individuals studied. Children and adults displayed very similar patterns of nasal gas uptake; no significant differences were noted between the two age groups.

  2. High-flow nasal cannula oxygen therapy in adults.

    PubMed

    Nishimura, Masaji

    2015-01-01

    High-flow nasal cannula (HFNC) oxygen therapy comprises an air/oxygen blender, an active humidifier, a single heated circuit, and a nasal cannula. It delivers adequately heated and humidified medical gas at up to 60 L/min of flow and is considered to have a number of physiological effects: reduction of anatomical dead space, PEEP effect, constant fraction of inspired oxygen, and good humidification. While there have been no big randomized clinical trials, it has been gaining attention as an innovative respiratory support for critically ill patients. Most of the available data has been published in the neonatal field. Evidence with critically ill adults are poor; however, physicians apply it to a variety of patients with diverse underlying diseases: hypoxemic respiratory failure, acute exacerbation of chronic obstructive pulmonary disease, post-extubation, pre-intubation oxygenation, sleep apnea, acute heart failure, patients with do-not-intubate order, and so on. Many published reports suggest that HFNC decreases breathing frequency and work of breathing and reduces needs of escalation of respiratory support in patients with diverse underlying diseases. Some important issues remain to be resolved, such as its indication, timing of starting and stopping HFNC, and escalating treatment. Despite these issues, HFNC oxygen therapy is an innovative and effective modality for the early treatment of adults with respiratory failure with diverse underlying diseases.

  3. A unidirectional breathing pattern improves breathing efficiency in subjects with severe COPD.

    PubMed

    Sulemanji, Demet S; Bao, Fangping; Jiang, Yandong; Kacmarek, Robert M

    2014-10-01

    Unidirectional breathing (UB), nose-in mouth-out (NMB) or vice versa, is thought to create PEEP, stabilize small airways, and increase expiratory flow and exhaled tidal volume (VT) in patients with expiratory obstructive disorders. However, the exact mechanism providing the benefits of UB remains unknown. Our hypothesis was that the benefits of UB are achieved mainly through reduction of upper airway dead space. Sixteen stable COPD patients requiring oxygen use at home were enrolled in this prospective study at a tertiary health care center. A nasal mask and a mouthpiece were used, each having a removable one-way valve to direct the breathing pattern. Four experimentally defined patterns of spontaneous breathing, NMB, mouth-in nose-out (MNB), nose-in nose-out (NNB), and mouth-in mouth-out (MMB), were compared. Each breathing pattern lasted 5 min followed by a 5-min rest period. A NICO device continuously monitored respiratory parameters. The functional anatomical dead space volume (VD) and expired VT values were determined. Breathing efficiency (BE) was calculated as alveolar VT divided by expired volume. Functional anatomical VD was higher in bidirectional breathing (BB) (overall: 207.4 ± 7.9 mL; MMB: 232.5 ± 72.7 mL; NNB: 182.2 ± 75 mL) compared to UB (overall: 178.1 ± 87.2 mL; NMB: 176.9 ± 91.3 mL; MNB: 179.3 ± 83.2 mL) (P < .001). BE achieved with UB (overall: 76.2 ± 6.5%; NMB: 76.8 ± 6.8%; MNB: 75.6 ± 6.3%) was higher than that with BB (overall: 66.2 ± 0.09%; MMB: 64.3 ± 0.10%; NNB: 68.1 ± 0.08%) (P < .001). The difference in BE between UB and BB was more pronounced with small VT values (UB: 73.8 ± 0.08; BB: 49.4 ± 0.09) than with large VT values (UB: 77.3 ± 0.06; BB: 63.0 ± 0.07) (P < .001). Our data suggest that a reduction in functional anatomic VD may be the underlying mechanism for the benefits associated with UB in COPD patients. (ClinicalTrials.gov registration NCT00784004.). Copyright © 2014 by Daedalus Enterprises.

  4. Impact of breathing patterns on the quality of life of 9- to 10-year-old schoolchildren.

    PubMed

    Leal, Rossana B; Gomes, Monalisa C; Granville-Garcia, Ana F; Goes, Paulo S A; de Menezes, Valdenice A

    2016-09-01

    Mouth breathing can cause a set of changes in craniofacial growth and development, with esthetic, functional, and psychological repercussions. To determine the impact of mouth breathing on the quality of life of schoolchildren. A school-based, cross-sectional study was conducted with 1911 children ages 9 and 10 years in the city of Recife, Brazil. The children answered the Mouth Breather Quality of Life questionnaire and a questionnaire that addressed sociodemographic data and health-related aspects. Clinical examinations were performed by an examiner who had undergone a training and calibration process for the diagnosis of mouth breathing (kappa = 0.90). Descriptive statistics were conducted to characterize the sample. Statistical analysis involved the Student's t-test and the F test (analysis of variance) (alpha = 5%). The prevalence of mouth breathing was 54.81%. Children with oral breathing demonstrated a poorer quality of life in comparison with children with nasal breathing (p < 0.001). The following variables were significantly associated with a poorer quality of life among the children with mouth breathing: a younger age (p < 0.001) and the use of medication (p = 0.002). Based on the present findings, children with the mouth-breathing pattern experience a greater negative impact on quality of life in comparison with those with the nose-breathing pattern. Thus, the early diagnosis and treatment of this clinical condition are fundamental to minimizing the consequences of mouth breathing on the quality of life of schoolchildren with respiration disorders.

  5. A comparative study on nasal packing after septoplasty: does it matter in terms of patient comfort, bleeding, and crust or synechia formation?

    PubMed

    Özbal Koç, Ayça E; Türkoğlu Babakurban, Seda; Kibar, Sermin Sayan; Büyüklü, Fuat

    2016-01-01

    This study aims to compare pain, bleeding, nasal obstruction, crust and synechia formation, and anesthesia-related morbidity in patients with and without use of nasal packs after septoplasty. A total of 66 patients (32 women, 34 men; mean age 24 years; range 18 to 48 years) who underwent Cottle's septoplasty under general anesthesia were randomly allocated to three groups in this prospective cohort. Telfa nasal packs were used in sutures + telfa group (n=22) and Merocell nasal packs in merocel alone group (n=22). No packs were administered in sutures alone group (n=22). Three groups were compared in terms of nasal obstruction, bleeding, pain, crust and synechia formation, as well as the amount of secretion, the need for oropharyngeal airway, the presence of laryngospasm, and effort for nasal breathing after anesthesia. The amount of bleeding was higher with lower degree of nasal obstruction in sutures alone group. Pain and secretion were more remarkable in merocel alone group. After the first week, these differences were unable to be differentiated among the groups. There were no differences between three groups with respect to crust and synechia formation two weeks after septal surgery. Nasal packs can be more useful in patients who suffer from bleeding-related morbidity, while septoplasty applied without nasal packs can be more suitable in patients with obstructive sleep apnea. The use of nasal packs in septoplasty should be determined on an individualized basis with respect to the characteristics of each patient.

  6. [The influence of nasal flow aerodynamics on the nasal physiology].

    PubMed

    Betlejewski, Stanisław; Betlejewski, Andrzej

    2008-01-01

    The ability of the human nose to warm and humidify the respiratory air is important to maintaining the internal environment of the lungs, since ambient air is conditioned to nearly alveolar conditions (body temperature and fully saturated with water vapour) upon reaching the nasopharynx. Because of very short time of the inspiratory phase duration, as well as expiratory phase, only the rich vascularization of the nasal mucosa and specific organization of the submucosal vessels are not able to assure such effective physiological activity. Therefore the type of airflow during the respiration is essential to understanding the functional possibilities of the nasal mucosa. Most studies have investigated the airflow only in steady-flow conditions, where the laminar flow was observed. Anatomically accurate physical models of real nasal cavities and particle image velocimetry allow evaluation of the entire flow field in the nasal cavity. In these investigations a partially turbulent flow was observed even at low air velocities in most part of the nasal cavity. From a physiological perspective, a turbulent flow would seem sensible, since it enhances contact between air and the mucosal layer. By doing so, the nasal physiological functions - humidification, cleaning and warming are optimized.

  7. Nasal and oral contribution to inhaled and exhaled nitric oxide: a study in tracheotomized patients.

    PubMed

    Törnberg, D C F; Marteus, H; Schedin, U; Alving, K; Lundberg, J O N; Weitzberg, E

    2002-05-01

    Nitric oxide (NO) is produced at different sites in the human airways and may have several physiological effects. Orally-produced NO seems to contribute to the levels found in exhaled air. Autoinhalation of nasal NO increases oxygenation and reduces pulmonary artery pressure in humans. The aim of this study was to measure the concentration and output of NO during nasal, oral and tracheal controlled exhalation and inhalation. Ten tracheotomized patients and seven healthy subjects were studied. The mean+/-SEM fraction of exhaled NO from the nose, mouth and trachea was 56+/-8, 14+/-4 and 6+/-1 parts per billion (ppb), respectively. During single-breath nasal, oral and tracheal inhalation the fraction of inhaled NO was 64+/-14, 11+/-3 and 4+/-1, respectively. There was a marked flow dependency on nasal NO output in the healthy subjects, which was four-fold greater at the higher flow rates, during inhalation when compared to exhalation. There is a substantial contribution of nasal and oral nitric oxide during both inhalation and exhalation. Nasal nitric oxide output is markedly higher during inhalation, reaching levels similar to those that are found to have clinical effects in the trachea. These findings have implications for the measurement of nitric oxide in exhaled air and the physiological effects of autoinhaled endogenous nitric oxide.

  8. [A computational fluid dynamics study of inner flow through nasal cavity with unilateral hypertrophic inferior turbinate].

    PubMed

    Guo, Yufeng; Zhang, Yuning; Chen, Guang; Liu, Shuhong; Lu, Xiaofeng; Zhu, Min; Cai, Changping; Chen, Xueming

    2009-09-01

    To investigate the anatomical influence of the hypertrophic inferior turbinate on computational fluid dynamics (CFD) model of unilateral hypertrophic inferior turbinate nasal cavity, and to analyze the bilateral detailed nasal airflow simulations under both inspiratory and expiratory phases in CFD model. One male volunteer troubled with unilateral hypertrophic inferior turbinate accepted CT scan. CFD model was built by CT scans through Simplant 10.0 and ANSYS ICEM. Fluent 6.3.26 simulated the airflow of both nasal cavity in breathing rates 200 ml/s. 1) In infraturbinal region, the cross-section area (CSA) of the nasal cavity with hypertrophic inferior turbinate was smaller than that in healthy side and the average area difference between two sides was 1.62 cm2. 2) In both inspiration and expiration phases, the hypertrophic infraturbinal produced a markable reduction in intranasal pressures drop along the full length of the infraturbinal region. The volumetric flow rate in the hypertrophic infraturbinal side was 50 ml/s, which equalled to one third of that in healthy side; Mean air speed in the anterior valve region was estimated to be 0.57 m/s at hypertrophic infraturbinal side and 1.83 m/s at healthy side during inspiration; More vortices happened in the hypertrophic infraturbinal side. The unilateral hypertrophic infraturbinal change the normal anatomy and influence the aerodynamic of nasal cavity, which is harmful to the functions of human nasal in ventilation, temperature accommodation and olfactory sensation.

  9. Effect of the external nasal dilator on adolescent athleteswith and without allergic rhinitis.

    PubMed

    Dinardi, Ricardo Reis; de Andrade, Cláudia Ribeiro; da Cunha Ibiapina, Cássio

    2017-06-01

    The ability to effectively breathe through the nose is an important component of physical exercise. The goal of this study is to evaluate the effect of the external nasal dilator (END) on healthy adolescent athletes and those with allergic rhinitis. Clinical trial, double-blind, crossover, in which we evaluated healthy adolescent athletes with allergic rhinitis, using experimental and placebo ENDs, submitted to a maximum cardio-respiratory test in randomized order. Predicted values for peak nasal inspiratory flow (PNIF%) and nasal resistance (NR) were obtained, and the rating of perceived exertion (RPE) was also assessed after the race test. 65 adolescents participated in the study, 30 of whom had allergic rhinitis. The use of experimental ENDs demonstrated a statistically significant improvement in peak nasal inspiratory flow values (predicted %), nasal resistance, maximal oxygen uptake value (VO2Max.) and rating of perceived exertion, both in the healthy group and the one with allergic rhinitis. Results suggested that END reduces nasal resistance, improves maximal oxygen uptake and rating of perceived exertion after a maximum cardio-respiratory test on healthy adolescents and those with allergic rhinitis. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. [One case of huge cyst at the back end of nasal septum].

    PubMed

    Zang, Jian; Liu, Qian; Jiang, Xuejun

    2014-04-01

    A male of 17 years old complained of bilateral nasal congestion with mouth breathing for half a year. The physical examination showed patency of bilateral nasal cavity. Nasopharyngeal fiberscope revealed a huge spherical smooth reddish mass at the nasopharyngeal posterior wall and the back-end of nasal cavity blocking the entire postnaris and contacting with bilateral tubal tori, the size of which is about 3.5 cm x 2.5 cm. The nasopharyngeal 3D-CT showed a low density cystic mass area in the nasopharynx with smooth edges, and the CT value is approximately 32.4 HU. No exact enhancement was observed. The cystic mass originated from and compressed the back end of nasal septum. A semicircular defect in the leading edge of clivus was observed, and the inferior wall of sphenoid sinus is compressed uplifted upwards. The nasopharyngeal MR showed that the nasopharyngeal lesion presented short T1 and long T2 signals with multiple small wall nodules around. Neither the lesion nor the peripheral nodules can be significantly enhanced by enhancement scan. After a nasal endoscopic surgery, the case was definitely diagnosed as nasal septum back-end huge cyst.

  11. Breathing exercises for dysfunctional breathing/hyperventilation syndrome in children.

    PubMed

    Barker, Nicola J; Jones, Mandy; O'Connell, Neil E; Everard, Mark L

    2013-12-18

    Dysfunctional breathing is described as chronic or recurrent changes in breathing pattern causing respiratory and non-respiratory symptoms. It is an umbrella term that encompasses hyperventilation syndrome and vocal cord dysfunction. Dysfunctional breathing affects 10% of the general population. Symptoms include dyspnoea, chest tightness, sighing and chest pain which arise secondary to alterations in respiratory pattern and rate. Little is known about dysfunctional breathing in children. Preliminary data suggest 5.3% or more of children with asthma have dysfunctional breathing and that, unlike in adults, it is associated with poorer asthma control. It is not known what proportion of the general paediatric population is affected. Breathing training is recommended as a first-line treatment for adults with dysfunctional breathing (with or without asthma) but no similar recommendations are available for the management of children. As such, breathing retraining is adapted from adult regimens based on the age and ability of the child. To determine whether breathing retraining in children with dysfunctional breathing has beneficial effects as measured by quality of life indices.To determine whether there are any adverse effects of breathing retraining in young people with dysfunctional breathing. We identified trials for consideration using both electronic and manual search strategies. We searched CENTRAL, MEDLINE and EMBASE. We searched the National Research Register (NRR) Archive, Health Services Research Projects in Progress (HSRProj), Current Controlled Trials register (incorporating the metaRegister of Controlled Trials and the International Standard Randomised Controlled Trial Number (ISRCTN) to identify research in progress and unpublished research. The latest search was undertaken in October 2013. We planned to include randomised, quasi-randomised or cluster-randomised controlled trials. We excluded observational studies, case studies and studies utilising a cross

  12. Nasal Airway Evaluation After Le Fort I Osteotomy Combined With Septoplasty in Patients With Cleft Lip and Palate

    PubMed Central

    Wang, Zhongying; Wang, Peihua; Zhang, Yixin; Shen, Guofang

    2017-01-01

    Abstract Septal deviation constitutes an important component of both esthetic deformity and airway compromise in patients with cleft lip and palate (CLP). The posterior parts of the nasal septum presented greater deviation than the anterior parts in patients with complete unilateral CLP. Le Fort I down-fracture provides better access to the nasal septum than intranasal incision during rhinoplasty, especially to the posterior part. This study objectively and subjectively evaluated the nasal function after Le Fort I osteotomy combined with septoplasty in patients with complete unilateral CLP. Twenty-three patients with complete unilateral CLP presenting with nasal obstruction and septum deviation were included (12—combined surgery group; 11—control group). Types of septum deviation in the patients were analyzed. Presurgical and 6-month-postsurgical acoustic rhinometry (AR) was performed for objective assessment; and the nasal obstruction symptom evaluation (NOSE) scale was used for subjective assessment. The authors used SPSS to compare the baseline and follow-up results. Acoustic rhinometry assessment showed improvements in the nasal minimal cross-sectional area (MCA), nasal resistance, and nasal volumes in 12 patients who received combined surgery. For the 2 groups, significant improvements in nasal breathing were documented (by NOSE scores) at 6 months after surgery. Simultaneous management of the maxillary dysplasia (Le Fort I osteotomy) and intranasal pathology (septoplasty) were effective for relief of nasal airway obstruction in patients with complete unilateral CLP. The combination of objective (AR) and subjective (NOSE scale) assessments allowed better evaluation of the nasal function. PMID:27930464

  13. The nose and nasal vault.

    PubMed

    Vogelzang, P J; Babbel, R W; Harnsberger, H R

    1991-12-01

    In this article we have reviewed the anatomy of the nose and nasal vault, with emphasis on specific features that are imaged with the SSCT. Important areas of the lateral wall anatomy include the OMU and SER, areas that are key to understanding the obstructive patterns of inflammatory sinonasal disease. Lesions that result in these specific obstructive patterns include anatomic variants and other focal pathological lesions, such as polyps. Other types of sinonasal inflammatory disease include sinonasal polyposis and granulomatous and fungal disease. Congenital lesions of the nose may be understood through a knowledge of the relevant developmental anatomy. These lesions include nasal dermoids and epidermoids, cephaloceles, gliomas, and choanal atresia. Important benign masses include antrochoanal polyps, inverting papillomas, angiomatous polyps, JNAs, and osteomas. Benign nasal masses have characteristic features that distinguish them from malignant lesions. Malignant nasal tumors, such as SSCa, esthesioneuroblastoma, and others, are characterized by their more aggressive and destructive behavior.

  14. [Effect of mouth breathing on the severity of morphological and functional changes of dental system in patients with otolaryngologic pathology].

    PubMed

    Arsenina, O I; Piksaĭkina, K G; Popova, A V; Popova, N V

    2014-01-01

    The study included 282 patients aged 5 to 14 years with pathology of the pharyngeal tonsil. Diagnostic algorithm is presented. The study results allowed elaboration of complex rehabilitation of nasal breathing and miodynamic equilibrium in the maxillofacial region by means of elastopositioner.

  15. Complications of Nasal Bone Fractures.

    PubMed

    Hwang, Kun; Yeom, Seung Han; Hwang, Suk Hyun

    2017-05-01

    The aim of this study was to perform a systematic review of the treatment of nasal bone fractures. The search terms ("nasal bone fracture" AND complication) and ("nasal bone fracture" AND [anosmia OR olfaction OR olfactory nerve OR smell]) and (anosmia AND ["nasal preparation" OR "nasal antiseptics"]) were used to search PubMed and SCOPUS. Of the 500 titles, 40 full papers were reviewed. One paper was excluded, and 3 mined papers were added. Ultimately, 12 papers were analyzed. The overall deformity rate was 10.4% ± 4.8%. No significant differences were found between patients who underwent closed reduction (14.7% ± 7.3%) and those who underwent open reduction (9.4% ± 4.4%), between those who underwent local anesthesia (5.8% ± 4.5%), and those who underwent general anesthesia (8.8% ± 3.8%), or between those who received timely treatment (5.7%) and those whose treatment was delayed (9.0%). Septal deviation occurred in 10.0% of patients as a sequela of nasal bone fracture. The nasal obstruction rate was 10.5% ± 5.3%. Fewer patients of nasal obstruction occurred in the open reduction patients (6.9% ± 4.4%) than in the closed reduction patients (15.2%). One patient of epiphora and 1 patient of diplopia were reportedAmong the 77 patients with nasal bone fractures, 29 (37.7% ± 11.3%) complained of olfactory disturbances. No significant associations were found between the type of fracture and the presence of olfactory disturbances. It is recommended for providers to explain to patients that approximately one-tenth of nasal bone fractures exhibit deformity, septal deviation, or nasal obstruction after surgery. Surgeons should take considerable care to avoid the olfactory mucosa during reduction surgery.

  16. Complications of Nasal Bone Fractures.

    PubMed

    Hwang, Kun; Yeom, Seung Han; Hwang, Suk Hyun

    2017-01-27

    The aim of this study was to perform a systematic review of the treatment of nasal bone fractures. The search terms ("nasal bone fracture" AND complication) and ("nasal bone fracture" AND [anosmia OR olfaction OR olfactory nerve OR smell]) and (anosmia AND ["nasal preparation" OR "nasal antiseptics"]) were used to search PubMed and SCOPUS. Of the 500 titles, 40 full papers were reviewed. One paper was excluded, and 3 mined papers were added. Ultimately, 12 papers were analyzed. The overall deformity rate was 10.4% ± 4.8%. No significant differences were found between patients who underwent closed reduction (14.7% ± 7.3%) and those who underwent open reduction (9.4% ± 4.4%), between those who underwent local anesthesia (5.8% ± 4.5%), and those who underwent general anesthesia (8.8% ± 3.8%), or between those who received timely treatment (5.7%) and those whose treatment was delayed (9.0%). Septal deviation occurred in 10.0% of patients as a sequela of nasal bone fracture. The nasal obstruction rate was 10.5% ± 5.3%. Fewer patients of nasal obstruction occurred in the open reduction patients (6.9% ± 4.4%) than in the closed reduction patients (15.2%). One patient of epiphora and 1 patient of diplopia were reportedAmong the 77 patients with nasal bone fractures, 29 (37.7% ± 11.3%) complained of olfactory disturbances. No significant associations were found between the type of fracture and the presence of olfactory disturbances. It is recommended for providers to explain to patients that approximately one-tenth of nasal bone fractures exhibit deformity, septal deviation, or nasal obstruction after surgery. Surgeons should take considerable care to avoid the olfactory mucosa during reduction surgery.

  17. Breath Sound Intensity during Tidal Breathing in COPD Patients.

    PubMed

    Ishimatsu, Akiko; Nakano, Hiroshi; Nogami, Hiroko; Yoshida, Makoto; Iwanaga, Tomoaki; Hoshino, Tomoaki

    2015-01-01

    There is a discrepancy in the intensity of breath sounds in chronic obstructive pulmonary disease (COPD) patients between subjective studies, which have reported a diminished intensity, and objective studies using airflow-standardized measurements, which have not demonstrated a diminished intensity. We herein evaluated the breath sound intensity in COPD patients during tidal breathing in order to obtain clinically relevant results. The subjects included 20 stable COPD patients and 20 normal controls. Microphones were attached to six sites on the chest wall, and breath sounds at the chest wall and airflow in the mouth were measured during resting tidal and deep tidal breathing. The octave-band power values of the breath sounds were subsequently calculated. 1. During resting breathing, the intensity of breath sounds during both inspiration and expiration was significantly greater in the COPD group than in the control group; the difference was prominent at higher frequency bands (>400 Hz). In addition, the power of the high frequency bands tended to be positively correlated with the CT visual emphysema scores but not the forced expiratory volume in one second, The airflow during resting breathing did not differ between the two groups. 2. During deep breathing, the intensity of inspiratory breath sounds at the dominant frequency band (200-400 Hz) was diminished over the upper and middle lung fields in the COPD group compared to that observed in the control group, while the intensity during expiration was not. The airflow during deep breathing was lower in the COPD group than in the control group. In the present study, the breath sound intensity in the COPD patients was diminished during deep inspiration due to a reduced airflow and increased during both resting inspiration and expiration.

  18. Emergency Response Breathing Apparatus

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Aerospace Design & Development, Inc.'s (ADD's) SCAMP was developed under an SBIR contract through Kennedy Space Center. SCAMP stands for Supercritical Air Mobility Pack. The technology came from the life support fuel cell support systems used for the Apollo and Space Shuttle programs. It uses supercritical cryogenic air and is able to function in microgravity environments. SCAMP's self-contained breathing apparatus(SCBA) systems are also ground-based and can provide twice as much air than traditional SCBA's due to its high-density capacity. The SCAMP system was designed for use in launch pad emergency rescues. ADD also developed a protective suit for use with SCAMP that is smaller and lighter system than the old ones. ADD's SCAMP allows for body cooling and breathing from the supercritical cryogenic air, requiring no extra systems. The improvement over the traditional SCBA allows for a reduction of injuries, such as heat stress, and makes it easier for rescuers to save lives.

  19. Envelope Analysis of the Airflow Signal To Improve Polysomnographic Assessment of Sleep Disordered Breathing

    PubMed Central

    Díaz, Javier A.; Arancibia, José M.; Bassi, Alejandro; Vivaldi, Ennio A.

    2014-01-01

    Study Objectives: Given the detailed respiratory waveform signal provided by the nasal cannula in polysomnographic (PSG) studies, to quantify sleep breathing disturbances by extracting a continuous variable based on the coefficient of variation of the envelope of that signal. Design: Application of an algorithm for envelope analysis to standard nasal cannula signal from actual polysomnographic studies. Setting: PSG recordings from a sleep disorders center were analyzed by an algorithm developed on the Igor scientific data analysis software. Patients or Participants: Recordings representative of different degrees of sleep disordered breathing (SDB) severity or illustrative of the covariation between breathing and particularly relevant factors and variables. Interventions: The method calculated the coefficient of variation of the envelope for each 30-second epoch. The normalized version of that coefficient was defined as the respiratory disturbance variable (RDV). The method outcome was the all-night set of RDV values represented as a time series. Measurements and Results: RDV quantitatively reflected departure from normal sinusoidal breathing at each epoch, providing an intensity scale for disordered breathing. RDV dynamics configured itself in recognizable patterns for the airflow limitation (e.g., in UARS) and the apnea/hypopnea regimes. RDV reliably highlighted clinically meaningful associations with staging, body position, oximetry, or CPAP titration. Conclusions: Respiratory disturbance variable can assess sleep breathing disturbances as a gradual phenomenon while providing a comprehensible and detailed representation of its dynamics. It may thus improve clinical diagnosis and provide a revealing descriptive tool for mechanistic sleep disordered breathing modeling. Respiratory disturbance variable may contribute to attaining simplified screening methodologies, novel diagnostic criteria, and insightful research tools. Citation: Díaz JA; Arancibia JM; Bassi A

  20. Cleft Nasal Deformity and Rhinoplasty

    PubMed Central

    Kaufman, Yoav; Buchanan, Edward P.; Wolfswinkel, Erik M.; Weathers, William M.; Stal, Samuel

    2012-01-01

    The cleft nasal deformity is a complex challenge in plastic surgery involving the skin, cartilage, mucosa, and skeletal platform. Ever since Blair and Brown first described the intricacies of the cleft pathology in 1931, the appropriate approach has been extensively debated in the literature with respect to timing, technique, and extent of surgical intervention. In this article, the authors review the literature and summarize the various modalities for achieving a successful rhinoplasty in the patient with a cleft nasal deformity. PMID:24179452

  1. Breathing pattern and ventilatory control in chronic tetraplegia.

    PubMed

    Spungen, Ann M; Bauman, William A; Lesser, Marvin; McCool, F Dennis

    2009-01-01

    Blunted ventilatory responses to carbon dioxide indicate that respiratory control is impaired when ventilation is stimulated in individuals with tetraplegia; however, respiratory control during resting breathing has not been extensively studied in this population. Our objective was to evaluate respiratory control and sigh frequency during resting breathing in persons with tetraplegia. A prospective, two-group comparative study was performed. Breathing pattern was assessed in ten outpatients with chronic tetraplegia and eight age- and gender-matched able-bodied controls. Subjects were noninvasively monitored for 1 h, while seated and at rest. Tidal volume (V(T)) was calculated from the sum of the anteroposterior displacements of the rib cage and abdomen and the axial displacement of the chest wall. Inspiratory time (T(I)), V(T), and the ratio of V(T) to inspiratory time (V(T)/T(I)) were calculated breath by breath. A sigh was defined as any breath greater than two or more times an individual's mean V(T). Minute ventilation, V(T)/T(I), and sigh frequency were reduced in tetraplegia compared with controls (5.24 +/- 1.15 vs. 7.16 +/- 1.29 L/min, P < 0.005; 208 +/- 45 vs. 284 +/- 47 ml/s, P < 0.005; and 11 +/- 7 vs. 42 +/- 19 sighs/h, P < 0.0005, respectively). V(T)/T(I) was associated with sigh frequency in both groups (tetraplegia: R = 0.88; P = 0.001 and control: R = 0.70; P < 0.05). We concluded that reductions in minute ventilation, V(T)/T(I), and sigh frequency suggest that respiratory drive is diminished during resting breathing in subjects with tetraplegia. These findings extend prior observations of disordered respiratory control during breathing stimulated by CO(2) in tetraplegia to resting breathing.

  2. Nasal nitric oxide levels in healthy pre-school children.

    PubMed

    Piacentini, G L; Bodini, A; Peroni, D G; Sandri, M; Brunelli, M; Pigozzi, R; Boner, A L

    2010-12-01

    The evaluation of nasal nitric oxide (nNO) has been proposed as a screening tool in children with clinically suspectable primary ciliary dyskinesia. Nevertheless, normal values have been reported for school-aged children. This study was designed to identify normal nNO levels in pre-school children. nNO was assessed in 300 healthy children aged between 1.5 and 7.2. Two hundred and fifty of them were unable to fulfill the guideline requirements for nNO measurement and were assessed by sampling the nasal air continuously with a constant trans-nasal aspiration flow for 30 s during tidal breathing. For those children who were able to cooperate, the average nNO concentration was calculated according to guidelines. A statistically significant relationship between nNO level and age was demonstrated in this study group of pre-school children (p < 0.001). An increase in nNO of about 100 ppb was observed in children older than 6 yr vs. those aged < 3. This study presents a description of normal nNO values in pre-school children. The effect of the age and the eventual presence of rhinitis and snoring need to be considered whenever nNO is evaluated in the clinical practice, in particular in non-cooperative children. © 2010 John Wiley & Sons A/S.

  3. CPAP and High-Flow Nasal Cannula Oxygen in Bronchiolitis.

    PubMed

    Sinha, Ian P; McBride, Antonia K S; Smith, Rachel; Fernandes, Ricardo M

    2015-09-01

    Severe respiratory failure develops in some infants with bronchiolitis because of a complex pathophysiologic process involving increased airways resistance, alveolar atelectasis, muscle fatigue, and hypoxemia due to mismatch between ventilation and perfusion. Nasal CPAP and high-flow nasal cannula (HFNC) oxygen may improve the work of breathing and oxygenation. Although the mechanisms behind these noninvasive modalities of respiratory support are not well understood, they may help infants by way of distending pressure and delivery of high concentrations of warmed and humidified oxygen. Observational studies of varying quality have suggested that CPAP and HFNC may confer direct physiologic benefits to infants with bronchiolitis and that their use has reduced the need for intubation. No trials to our knowledge, however, have compared CPAP with HFNC in bronchiolitis. Two randomized trials compared CPAP with oxygen delivered by low-flow nasal cannula or face mask and found some improvements in blood gas results and some physiologic parameters, but these trials were unable to demonstrate a reduction in the need for intubation. Two trials evaluated HFNC in bronchiolitis (one comparing it with headbox oxygen, the other with nebulized hypertonic saline), with the results not seeming to suggest important clinical or physiologic benefits. In this article, we review the pathophysiology of respiratory failure in bronchiolitis, discuss these trials in detail, and consider how future research studies may be designed to best evaluate CPAP and HFNC in bronchiolitis.

  4. [TMJ, eating and breathing].

    PubMed

    Cheynet, F

    2016-09-01

    The study of the relationship between temporomandibular joints (TMJ), mastication and ventilation and the involvement of these two functions in the genesis of primary Temporomandibular Disorders (TMD) and in some dentofacial deformities, was initiated in France, more than 30years, by Professor Raymond Gola. Once criticized the weakness of the scientific literature in this domain, the originality of the TMJ within the masticatory system is recalled with its huge adaptation potential to very different biomechanical constraints according to the age and masticatory activities during the day. But the biomechanics of the masticatory system does not stop at night and the positions of the mandible and head during sleep should be studied carefully. In case of nocturnal mouth breathing with open mouth, the predominant sleeping position (generating small but long-term strengths) may be deleterious to the condyle-disc complex, to the surrounding muscles and the occlusal relationships. Some condyle-disc displacements and asymmetric malocclusions occur in this long portion of life what sleep, especially as oral breathing leads to a lot of dysfunctions (low position of the tongue, labio-lingual dysfunctions, exacerbation of bruxism sleep…). The aim of this work was to share our multidisciplinary experience of the biomechanical consequences of the nocturnal mouth breathing on the face involving orthodontists, maxillofacial surgeons, ENT, allergists, speech therapists, physiotherapists and radiologists. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  5. Angioleiomyoma of the Nasal Cavity

    PubMed Central

    Arruda, Milena Moreira; Monteiro, Daniela Yasbek; Fernandes, Atilio Maximino; Menegatti, Vanessa; Thomazzi, Emerson; Hubner, Ricardo Arthur; Lima, Luiz Guilherme Cernaglia Aureliano de

    2014-01-01

    Introduction Vascular leiomyoma of the nasal cavity is an extremely rare tumor that represents less than 1% of all vascular leiomyomas. It is more prevalent in women between the fourth and sixth decades, reaching primarily the inferior nasal turbinates. Objectives Reporting and assisting the systematization of more accurate diagnostic methods in clinical and complementary investigation of vascular leiomyoma in the nasal cavity. Resumed Report We present the case of a 49-year-old woman diagnosed with vascular leiomyoma in the nasal cavity, which manifested mainly with nasal obstruction. During investigation, computer tomography was not diagnostic, the cytologic study was not conclusive, and according to the biopsy, it was a squamous papilloma. Conclusion We suggest that the technical difficulty in obtaining an adequate amount of material for preoperative biopsy, associated with the topography of the lesion in the vestibular nasal region, may have contributed to changing the postoperative diagnosis. Thus, pathologic study of the surgical fragment is the more accurate method for diagnosis. PMID:25992133

  6. Measuring exhaled nitric oxide in infants during tidal breathing: methodological issues.

    PubMed

    Franklin, Peter J; Turner, Stephen W; Mutch, Raewyn C; Stick, Stephen M

    2004-01-01

    Exhaled nitric oxide (FENO) may provide a tool for identifying infants at risk of developing allergic disease in childhood. In infants there is no standardized collection technique; however, the easiest method is to measure FENO during tidal breathing. In this study we investigated various methodological issues for tidal breathing (TB) FENO in infants. These included the effect of ambient NO, oral or nasal breathing, sedation, and tidal expiratory flow. Furthermore, we compared TB FENO in 88 infants with and without wheeze. Ambient NO greater than 5 ppb significantly affected FENO. There was no significant difference between NO levels measured during either oral or nasal breathing; however, there was a significant difference between levels collected from infants before and after sedation (P < 0.001). Tidal breathing FENO decreased with increasing tidal flows (P < 0.001) and increased with age (P = 0.002). There was no significant difference in mixed expired NO between healthy and wheezy children, but children with doctor-diagnosed eczema had significantly raised levels (P = 0.014). There seem to be important methodological limitations for measuring FENO in infants during TB. Copyright 2004 Wiley-Liss, Inc.

  7. The effect of adenoidectomy or adenotonsillectomy on occlusal features in mouth-breathing preschoolers.

    PubMed

    Mattar, Sara E M; Matsumoto, Miriam A N; Valera, Fabiana C P; Anselmo-Lima, Wilma T; Faria, Gisele

    2012-01-01

    The purpose of this study was to evaluate mouth-breathing and nasal-breathing children prior to surgical intervention and 28 months postoperatively, comparing the occlusal features obtained pre- and postoperatively through orthodontic study casts. The mouth-breathing (MB) group consists of 33 MB children who underwent surgery and presented a nasal-breathing (NB) pattern after surgery. The control group comprised 22 NB children. The orthodontic examinations were accomplished prior to surgery (T1) and an average of 28 months postoperatively (T2). At T1, the MB and NB children presented no statistically significant difference in any analyzed occlusal features and measurements. At T2, the MB presented larger overjet comparing to NB children (P<.05). MB and NB groups presented statistically similar results (P>.05) concerning intercanine and intermolar distances, second primary molar terminal plane and canine relationship, overbite, crossbite, and open bite. From T1 to T2, the MB and NB groups showed a statistically significant difference in the molar terminal plane. Neither the breathing pattern nor the surgery had any effect on occlusal features in 3- to 6- year-olds.

  8. Breathing exercises for dysfunctional breathing/hyperventilation syndrome in adults.

    PubMed

    Jones, Mandy; Harvey, Alex; Marston, Louise; O'Connell, Neil E

    2013-05-31

    Dysfunctional breathing/hyperventilation syndrome (DB/HVS) is a respiratory disorder, psychologically or physiologically based, involving breathing too deeply and/or too rapidly (hyperventilation) or erratic breathing interspersed with breath-holding or sighing (DB). DB/HVS can result in significant patient morbidity and an array of symptoms including breathlessness, chest tightness, dizziness, tremor and paraesthesia. DB/HVS has an estimated prevalence of 9.5% in the general adult population, however, there is little consensus regarding the most effective management of this patient group. (1) To determine whether breathing exercises in patients with DB/HVS have beneficial effects as measured by quality of life indices (2) To determine whether there are any adverse effects of breathing exercises in patients with DB/HVS SEARCH METHODS: We identified trials for consideration using both electronic and manual search strategies. We searched CENTRAL, MEDLINE, EMBASE, and four other databases. The latest search was in February 2013. We planned to include randomised, quasi-randomised or cluster randomised controlled trials (RCTs) in which breathing exercises, or a combined intervention including breathing exercises as a key component, were compared with either no treatment or another therapy that did not include breathing exercises in patients with DB/HVS. Observational studies, case studies and studies utilising a cross-over design were not eligible for inclusion.We considered any type of breathing exercise for inclusion in this review, such as breathing control, diaphragmatic breathing, yoga breathing, Buteyko breathing, biofeedback-guided breathing modification, yawn/sigh suppression. Programs where exercises were either supervised or unsupervised were eligible as were relaxation techniques and acute-episode management, as long as it was clear that breathing exercises were a key component of the intervention.We excluded any intervention without breathing exercises or

  9. Laser reshaping of nasal septum cartilage: clinical results for 40 patients

    NASA Astrophysics Data System (ADS)

    Sobol, Emil N.; Sviridov, Alexander P.; Bagratashvili, Victor N.; Omelchenko, Alexander I.; Ovchinnikov, Yuriy M.; Shekhter, Anatoliy B.; Svistushkin, Valeriy M.; Shinaev, Alexander N.

    2000-05-01

    Clinical results on sparing laser reshaping of nasal septum cartilage are reported for the first time. Forty patients have been treated with holmium laser to correct a deformed cartilage. The laser reshaping is a bloodless, painless procedure which takes few minutes to straighten nasal septum. The stability of the new shape and possible side effects have been examined during twelve months. The headache and other negative symptoms have disappeared, as a result of laser treatment for the most of patients. Rhinoscopic examination show an excellent long-term reshaping effects for nasal septum of 23 patients, and, also, good results for other 12 patients. For 5 patients only a little effect takes place. Our rhinomanometric examinations demonstrate a pronounced improvement of the breathing for 35 patients. No visible undesirable side effects were observed for all patients underwent to laser reshaping procedure.

  10. [Computational fluid dynamics simulations of the airflow in the human nasal cavity].

    PubMed

    Castro Ruiz, P; Castro Ruiz, F; Costas López, A; Cenjor Español, C

    2005-11-01

    This study represents an attempt to simulate the complex three-dimensional airflow pattern in the human nasal passageways. In the present study the computational Fluid Dynamics (CFD) have been used. The CFD solved numerically the flow governing equations. The CFD demonstrated to be a very efficient tool for researching on nasal flow. By means of CT scan, an anatomic accurate three-dimensional representation of the human nasal cavity was obtained. Based on this model the influence of the inspiration and at the expiration at the flow pattern has been reviewed. The flow pattern is visualized by the velocity, pressure and turbulence intensity fields. The flow patterns show the channel effect of turbinates and the influence of the breathing phase.

  11. Mask versus Nasal Tube for Stabilization of Preterm Infants at Birth: Respiratory Function Measurements.

    PubMed

    van Vonderen, Jeroen J; Kamlin, C Omar; Dawson, Jennifer A; Walther, Frans J; Davis, Peter G; te Pas, Arjan B

    2015-07-01

    To compare the nasal tube with face mask as interfaces for stabilization of very preterm infants at birth by using physiological measurements of leak, obstruction, and expired tidal volumes during positive pressure ventilation (PPV). In the delivery room, 43 infants <30 weeks gestation were allocated to receive respiratory support by nasal tube or face mask. Respiratory function, heart rate, and oxygen saturation were measured. Occurrence of obstruction, amount of leak, and tidal volumes were compared using a Mann-Whitney U test or a Fisher exact test. The first 5 minutes after initiation of PPV were analyzed (1566 inflations in the nasal tube group and 1896 inflations in the face mask group). Spontaneous breathing coincided with PPV in 32% of nasal tube and 34% of face mask inflations. During inflations, higher leak was observed using nasal tube compared with face mask (98% [33%-100%] vs 14 [0%-39%]; P < .0001). Obstruction occurred more often (8.2% vs 1.1%; P < .0001). Expired tidal volumes were significantly lower during inflations when using nasal tube compared with face mask (0.0 [0.0-3.1] vs 9.9 [5.5-12.8] mL/kg; P < .0001) and when spontaneous breathing coincided with PPV (4.4 [2.1-8.4] vs 9.6 [5.4-15.2] mL/kg; P < .0001) but were similar during breathing on continuous positive airway pressure (4.7 [2.8-6.9] vs 4.8 [2.7-7.9] mL/kg; P > 0.05). Heart rate was not significantly different between groups, but oxygen saturation was significantly lower in the nasal tube group the first 2 minutes after start of respiratory support. The use of a nasal tube led to large leak, more obstruction, and inadequate tidal volumes compared with face mask. Trial registration Registered with the Dutch Trial Registry (NTR 2061) and the Australia and New Zealand Clinical Trials Register (ACTRN 12610000230055). Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Hard palate dimensions in nasal and mouth breathers from different etiologies.

    PubMed

    Berwig, Luana Cristina; Silva, Ana Maria Toniolo da; Côrrea, Eliane Castilhos Rodrigues; Moraes, Anaelena Bragança de; Montenegro, Márlon Munhoz; Ritzel, Rodrigo Agne

    2011-12-01

    To compare the hard palate dimensions of nasal-breathing children, mouth breathers from obstructive etiology, and habitual mouth breathers. The sample comprised 76 children, 37 boys and 39 girls, with mean age of 9.32±1.16 years, distributed according to the diagnosis of breathing mode and to the etiology of mouth breathing. Plaster cast models of the subjects' superior dental arch were obtained in order to measure the hard palate with a digital caliper. Measurements of transverse, vertical and anteroposterior palatal length were taken. The hard palate measures were compared among the groups through statistical analysis. The comparison of hard palate dimensions observed in nasal and mouth breathers showed differences regarding the distance and depth of second premolars, and the distance of first molars. Differences were also found between the groups of mouth breathers regarding the hard palate depth at the level of canines. Mouth breathers showed narrower hard palate at the level of second premolars and first molars, and deeper palate in the level of second premolars, when compared to nasal breathers. It is evidenced that habitual mouth breathers presented deeper hard palate at the level of canines, when compared to mouth breathers from obstructive etiology.

  13. Nasal Reconstruction and Repair of Secondary Nasal Deformities Following Treatment of Nasal Hemangiomas.

    PubMed

    Lu, Xiaona; Fan, Fei; Wang, Huan; You, Jianjun

    2017-03-01

    Secondary nasal deformities and retardation of development due to treatment of nasal hemangioma during infancy are a challenge when it comes to nasal reconstruction. In order to evaluate nasal repair and reconstruction in these patients, the authors compared the ease and outcomes of using expanded forehead, nasolabial sulcus, and medial upper arm tube flaps. According to the deformities and patients' wishes, flaps were selected; using autogeneic rib cartilage, auricle cartilage, or silica gel as a scaffold or without framework; the inner lining were made by the residual scar tissue or the distal end of transferred flap. The esthetical and functional scores were recorded by the Nasal Appearance and Function Evaluation Questionnaire score to evaluate the effectiveness of the methods. From January 2010 to December 2015, 34 patients were included. Postoperative follow-up went for 12 to 36 months. The expanded forehead flap was used in 28 patients, the nasolabial sulcus flap in 5 patients, and the medial upper arm tube flap in 1 patient. Regarding framework, 20 patients used rib cartilage, 8 patients used auricle cartilage, 1 patient used silicone, and 5 patients did not use any framework. All patients reported the increasing nasal appearance and function evaluation. Repair of secondary nasal defects following treatment of hemangiomas in infants and young children using an expanded frontal flap and autogenous cartilage framework is a reliable method with great long-term esthetic results. The nasolabial sulcus flap is a relatively simple method, especially for patients with a unilateral nasal alar defect. Supporting structure is needed and appropriate overcorrection is necessary.

  14. Effect of unilateral nasal obstruction on tongue protrusion forces in growing rats.

    PubMed

    Uchima Koecklin, Karin Harumi; Kato, Chiho; Funaki, Yukiha; Hiranuma, Maya; Ishida, Takayoshi; Fujita, Koichi; Yabushita, Tadachika; Kokai, Satoshi; Ono, Takashi

    2015-05-01

    Mouth breathing caused by nasal obstruction affects the normal growth and development of craniofacial structures, including changes in the orofacial muscles. Tongue muscles play an important role in patency of the pharyngeal airway, and changes in the breathing pattern may influence tongue function. The purpose of this study was to evaluate the effect of unilateral nasal obstruction during growth on contractile properties of the tongue-protruding muscles. Sixty 6-day-old male Wistar albino rats were divided randomly into control (n = 30) and experimental (n = 30) groups. Rats in the experimental group underwent a unilateral nasal obstruction after cauterization of the external nostril at the age of 8 days, and muscle contractile characteristics were measured at 5, 7, and 9 wk of age. The specific parameters measured were twitch force, contraction time, half-decay time, tetanic force, and fatigue index. Repeated-measures multivariate analysis of variance was used for intergroup and intragroup statistical comparisons. Twitch contraction force and half-decay time were significantly increased in the experimental group at all ages. Tetanic forces at 60 and 80 Hz were significantly higher in the experimental group at all ages. The fatigue index was decreased significantly in the experimental group at the age of 5 wk. These results suggest that early unilateral nasal obstruction may increase the contraction force of the tongue-protruding muscles and prolong the duration of muscle contraction, which may influence the shape and development of the craniofacial complex. Copyright © 2015 the American Physiological Society.

  15. Equivalence of Nasal and Oronasal Masks during Initial CPAP Titration for Obstructive Sleep Apnea Syndrome

    PubMed Central

    Teo, Ming; Amis, Terence; Lee, Sharon; Falland, Karina; Lambert, Stephen; Wheatley, John

    2011-01-01

    Study Objective: Continuous positive airway pressure (CPAP) titration studies are commonly performed using a nasal mask but some patients may prefer a full-face or oronasal mask. There is little evidence regarding the equivalence of different mask interfaces used to initiate treatment. We hypothesized that oronasal breathing when using an oronasal mask increases upper airway collapsibility and that a higher pressure may be required to maintain airway patency. We also assessed patient preferences for the 2 mask interfaces. Design: Prospective, randomized, cross-over design with 2 consecutive CPAP titration nights. Setting: Accredited laboratory in a university hospital. Patients or Participants: Twenty-four treatment-naive subjects with obstructive sleep apnea syndrome and respiratory disturbance index of greater than 15 events per hour. Interventions: CPAP titration was performed using an auto-titrating machine with randomization to a nasal or oronasal mask, followed by a second titration night using the alternate mask style. Measurements and Results: There was no significant difference in the mean pressures determined between nasal and oronasal masks, although 43% of subjects had nasal-to-oronasal mask-pressure differences of 2 cm H2O or more. Residual respiratory events, arousals, and measured leak were all greater with the oronasal mask. Seventy-nine percent of subjects preferred the nasal mask. Conclusions: Patients with obstructive sleep apnea syndrome can generally switch between nasal and oronasal masks without changing machine pressure, although there are individual differences that may be clinically significant. Measured leak is greater with the oronasal mask. Most patients with obstructive sleep apnea syndrome prefer a nasal mask as the interface for initiation of CPAP. Clinical Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN: ACTRN12611000243910. URL: http://www.ANZCTR.org.au/ACTRN12611000243910.aspx Citation: Teo M

  16. Successful treatment of obstructive sleep apnea with use of nasal continuous positive airway pressure in three patients with mucosal hemangiomas of the oral cavity.

    PubMed

    Kimura, K; Adlakha, A; Staats, B A; Shepard, J W

    1999-02-01

    Cysts and benign tumors are uncommon causes of obstructive sleep apnea (OSA), and surgical removal is usually favored. In patients in whom an operation poses a high risk, however, nasal continuous positive airway pressure (CPAP) may prove beneficial. We describe three patients with hemangiomas of the oral cavity in whom polysomnography revealed moderate to severe OSA. In all three patients, nasal CPAP effectively decreased sleep-related disordered breathing events and dramatically improved their sleep. To our knowledge, this is the first report of OSA associated with hemangiomas involving the upper airway. Our experience suggests that nasal CPAP therapy is effective and well tolerated in such patients.

  17. Bilateral cleft lip nasal deformity

    PubMed Central

    Singh, Arun Kumar; Nandini, R.

    2009-01-01

    Bilateral cleft lip nose deformity is a multi-factorial and complex deformity which tends to aggravate with growth of the child, if not attended surgically. The goals of primary bilateral cleft lip nose surgery are, closure of the nasal floor and sill, lengthening of the columella, repositioning of the alar base, achieving nasal tip projection, repositioning of the lower lateral cartilages, and reorienting the nares from horizontal to oblique position. The multiplicity of procedures in the literature for correction of this deformity alludes to the fact that no single procedure is entirely effective. The timing for surgical intervention and its extent varies considerably. Early surgery on cartilage may adversely affect growth and development; at the same time, allowing the cartilage to grow in an abnormal position and contributing to aggravation of deformity. Some surgeons advocate correction of deformity at an early age. However, others like the cartilages to grow and mature before going in for surgery. With peer pressure also becoming an important consideration during the teens, the current trend is towards early intervention. There is no unanimity in the extent of nasal dissection to be done at the time of primary lip repair. While many perform limited nasal dissection for the fear of growth retardation, others opt for full cartilage correction at the time of primary surgery itself. The value of naso-alveolar moulding (NAM) too is not universally accepted and has now more opponents than proponents. Also most centres in the developing world have neither the personnel nor the facilities for the same. The secondary cleft nasal deformity is variable and is affected by the extent of the original abnormality, any prior surgeries performed and alteration due to nasal growth. This article reviews the currently popular methods for correction of nasal deformity associated with bilateral cleft lip, it's management both at the time of cleft lip repair and also secondarily

  18. Association between breastfeeding and breathing pattern in children: a sectional study.

    PubMed

    Lopes, Teresinha S P; Moura, Lúcia F A D; Lima, Maria C M P

    2014-01-01

    to determine the prevalence of mouth breathing and to associate the history of breastfeeding with breathing patterns in children. this was an observational study with 252 children of both genders, aged 30 to 48 months, who participated in a dental care program for mothers and newborns. As an instrument of data collection, a semi-structured questionnaire was administered to the children's mothers assessing the form and duration of breastfeeding and the oral habits of non-nutritive sucking. To determine the breathing patterns that the children had developed, medical history and clinical examination were used. Statistical analysis was conducted to examine the effects of exposure on the primary outcome (mouth breathing), and the prevalence ratio was calculated with a 95% confidence interval. of the total sample, 43.1% of the children were mouth breathers, 48.4% had been breastfed exclusively until six months of age or more, and 27.4% had non-nutritive sucking habits. Statistically significant associations were found for bottle-feeding (p<0.001) and oral habits of non-nutritive sucking (p=0.009), with an increased likelihood of children exhibiting a predominantly oral breathing pattern. A statistically significant association was also observed between a longer duration of exclusive breastfeeding and a nasal breathing pattern presented by children. an increased duration of exclusive breastfeeding lowers the chances of children exhibiting a predominantly oral breathing pattern. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  19. Evaluation of polyvinylidene fluoride nasal sensor to assess deviated nasal septum in comparision with peak nasal inspiratory flow measurements.

    PubMed

    Manjunatha, Roopa G; Rajanna, K; Mahapatra, D Roy; Prakash, Surya

    2014-01-01

    Deviated nasal septum (DNS) is one of the major causes of nasal obstruction. Polyvinylidene fluoride (PVDF) nasal sensor is the new technique developed to assess the nasal obstruction caused by DNS. This study evaluates the PVDF nasal sensor measurements in comparison with PEAK nasal inspiratory flow (PNIF) measurements and visual analog scale (VAS) of nasal obstruction. Because of piezoelectric property, two PVDF nasal sensors provide output voltage signals corresponding to the right and left nostril when they are subjected to nasal airflow. The peak-to-peak amplitude of the voltage signal corresponding to nasal airflow was analyzed to assess the nasal obstruction. PVDF nasal sensor and PNIF were performed on 30 healthy subjects and 30 DNS patients. Receiver operating characteristic was used to analyze the DNS of these two methods. Measurements of PVDF nasal sensor strongly correlated with findings of PNIF (r = 0.67; p < 0.01) in DNS patients. A significant difference (p < 0.001) was observed between PVDF nasal sensor measurements and PNIF measurements of the DNS and the control group. A cutoff between normal and pathological of 0.51 Vp-p for PVDF nasal sensor and 120 L/min for PNIF was calculated. No significant difference in terms of sensitivity of PVDF nasal sensor and PNIF (89.7% versus 82.6%) and specificity (80.5% versus 78.8%) was calculated. The result shows that PVDF measurements closely agree with PNIF findings. Developed PVDF nasal sensor is an objective method that is simple, inexpensive, fast, and portable for determining DNS in clinical practice.

  20. Breath-by-breath measurement of particle deposition in the lung of spontaneously breathing rats.

    PubMed

    Karrasch, S; Eder, G; Bolle, I; Tsuda, A; Schulz, H

    2009-10-01

    A number of deposition models for humans, as well as experimental animals, have been described. However, no breath-by-breath deposition measurement in rats has been reported to date. The objective of this study is to determine lung deposition of micrometer-sized particles as a function of breathing parameters in the adult rat lung. A new aerosol photometry system was designed to measure deposition of nonhygroscopic, 2-mum sebacate particles in anesthetized, intubated, and spontaneously breathing 90-day-old Wistar-Kyoto rats placed in a size-adjusted body plethysmograph box. Instrumental dead space of the system was minimized down to 310 microl (i.e., approximately 20% of respiratory dead space). The system allows continuous monitoring of particle concentration in the respired volume. Breathing parameters, such as respiratory rate (f), tidal volume (Vt), as well as inspiration/expiration times, were also monitored at different levels of anesthesia. The results showed that Vt typically varied between 1.5 and 4.0 ml for regular breathing and between 4.0 and 10.0 ml for single-sigh breaths; f ranged from 40 to 200 breaths/min. Corresponding deposition values varied between 5 and 50%, depending on breath-by-breath breathing patterns. The best fit of deposition (D) was achieved by a bilinear function of Vt and f and found to be D = 11.0 - 0.09.f + 3.75.Vt. We conclude that our approach provides more realistic conditions for the measurement of deposition than conventional models using ventilated animals and allows us to analyze the correlation between breath-specific deposition and spontaneous breathing patterns.

  1. Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty.

    PubMed

    Ishii, Lisa E; Tollefson, Travis T; Basura, Gregory J; Rosenfeld, Richard M; Abramson, Peter J; Chaiet, Scott R; Davis, Kara S; Doghramji, Karl; Farrior, Edward H; Finestone, Sandra A; Ishman, Stacey L; Murphy, Robert X; Park, John G; Setzen, Michael; Strike, Deborah J; Walsh, Sandra A; Warner, Jeremy P; Nnacheta, Lorraine C

    2017-02-01

    variations, and clinical concerns associated with this surgical procedure; it is not intended to be a comprehensive reference for improving nasal form and function after rhinoplasty. Recommendations in this guideline concerning education and counseling to the patient are also intended to include the caregiver if the patient is <18 years of age. Action Statements The Guideline Development Group made the following recommendations: (1) Clinicians should ask all patients seeking rhinoplasty about their motivations for surgery and their expectations for outcomes, should provide feedback on whether those expectations are a realistic goal of surgery, and should document this discussion in the medical record. (2) Clinicians should assess rhinoplasty candidates for comorbid conditions that could modify or contraindicate surgery, including obstructive sleep apnea, body dysmorphic disorder, bleeding disorders, or chronic use of topical vasoconstrictive intranasal drugs. (3) The surgeon, or the surgeon's designee, should evaluate the rhinoplasty candidate for nasal airway obstruction during the preoperative assessment. (4) The surgeon, or the surgeon's designee, should educate rhinoplasty candidates regarding what to expect after surgery, how surgery might affect the ability to breathe through the nose, potential complications of surgery, and the possible need for future nasal surgery. (5) The clinician, or the clinician's designee, should counsel rhinoplasty candidates with documented obstructive sleep apnea about the impact of surgery on nasal airway obstruction and how obstructive sleep apnea might affect perioperative management. (6) The surgeon, or the surgeon's designee, should educate rhinoplasty patients before surgery about strategies to manage discomfort after surgery. (7) Clinicians should document patients' satisfaction with their nasal appearance and with their nasal function at a minimum of 12 months after rhinoplasty. The Guideline Development Group made recommendations

  2. Nasal and cutaneous aspergillosis in a goat.

    PubMed

    do Carmo, P M S; Portela, R A; de Oliveira-Filho, J C; Dantas, A F M; Simões, S V D; Garino, F; Riet-Correa, F

    2014-01-01

    Nasal and cutaneous aspergillosis is reported in an adult goat. The clinical signs were severe respiratory distress due to partial nasal obstruction, bilateral mucopurulent nasal discharge, skin nodules on the ears and dorsal nasal region and focal depigmentation of the ventral commissure of the right nostril. At necropsy examination, sagittal sectioning of the head revealed a yellow irregular mass extending from the nasal vestibule to the frontal portion of the nasal cavity. Microscopically, there was pyogranulomatous rhinitis and dermatitis, with numerous intralesional periodic acid-Schiff-positive fungal hyphae morphologically suggestive of Aspergillus spp. Aspergillus niger was isolated by microbiological examination.

  3. Replacement of Missing Anterior Teeth in a Patient with Chronic Mouth Breathing and Tongue Thrusting

    PubMed Central

    Haralur, Satheesh B.; Al-Qahtani, Ali Saad

    2013-01-01

    The loss of anterior teeth has serious functional, esthetic disabilities, in addition to compromising the patients' quality of life. Various etiologies can be attributed to the anterior tooth loss, including trauma, caries, and periodontal diseases. The chronic mouth breathing due to nasal adenoids is known to enhance the gingival and periodontal diseases. The dental literature proves the association of nasal breathing, tongue thrusting, and anterior open bite. Arch shape and tooth position are primarily determined by the equilibrium of the forces from tongue and perioral musculature. Increased force from tongue musculature in the tongue thrusting patient leads to flaring of anterior teeth, making them susceptible for periodontal and traumatic tooth loss. Replacement of the anterior teeth in this patient will also help in restoration of anterior guidance, which is critical for the health of temporomandibular joint, posterior teeth, and musculature. PMID:24490091

  4. Influence of nasal structure on the distribution of airflow in nasal cavity.

    PubMed

    Yu, Shen; Liu, Yingxi; Sun, Xiuzhen; Li, Shouju

    2008-06-01

    Numerical simulation of the nasal cavity is essential in order to understand the relationship between nasal structure and airflow characteristics. Since the structure of the nasal cavity varies significantly, the relationship between nasal structure and airflow characteristics will be investigated by numerical simulation of airflow in twenty-four nasal models in this paper. Twenty-four three-dimensional models of the nasal cavity structure have been reconstructed on the basis of Computed Tomography medical images collected from twenty-four healthy volunteers. Modification of the turbinate has been applied to one of these models in order to simulate an operation. The results from this variant model have been compared with the original model. The numerical simulation for the airflow in the nasal cavity was performed by the finite element method. Pressure drop and the airflow distribution in nasal models are presented quantitatively in flow field. Main airflow will pass through the common nasal meatus. The nasal airway resistance in the region of nasal valve and nasal vestibule (flow limiting structure) accounts for 52.6%-78.3% of total nasal airway resistance. The numerical results show that differences in patients' nasal cavity structure may lead to different airflow distributions. Changes of nasal structure lead to variation of airflow in both sides of the nasal cavity as well as airflow redistribution in each side of the nasal cavity.

  5. Investigation on the nasal airflow characteristics of anterior nasal cavity stenosis.

    PubMed

    Wang, T; Chen, D; Wang, P H; Chen, J; Deng, J

    2016-08-01

    We used a computational fluid dynamics (CFD) model to study the inspiratory airflow profiles of patients with anterior nasal cavity stenosis who underwent curative surgery, by comparing pre- and postoperative airflow characteristics. Twenty patients with severe anterior nasal cavity stenosis, including one case of bilateral stenosis, underwent computed tomography (CT) scans for CFD modelling. The pre- and postoperative airflow characteristics of the nasal cavity were simulated and analyzed. The narrowest area of the nasal cavity in all 20 patients was located within the nasal valve area, and the mean cross-sectional area increased from 0.39 cm2 preoperative to 0.78 cm2 postoperative (P<0.01). Meanwhile, the mean airflow velocity in the nasal valve area decreased from 6.19 m/s to 2.88 m/s (P<0.01). Surgical restoration of the nasal symmetry in the bilateral nasal cavity reduced nasal resistance in the narrow sides from 0.24 Pa.s/mL to 0.11 Pa.s/mL (P<0.01). Numerical simulation of the nasal cavity in patients with anterior nasal cavity stenosis revealed structural changes and the resultant patterns of nasal airflow. Surgery achieved balanced bilateral nasal ventilation and decreased nasal resistance in the narrow region of the nasal cavity. The correction of nasal valve stenosis is not only indispensable for reducing nasal resistance, but also the key to obtain satisfactory curative effect.

  6. Investigation on the nasal airflow characteristics of anterior nasal cavity stenosis

    PubMed Central

    Wang, T.; Chen, D.; Wang, P.H.; Chen, J.; Deng, J.

    2016-01-01

    We used a computational fluid dynamics (CFD) model to study the inspiratory airflow profiles of patients with anterior nasal cavity stenosis who underwent curative surgery, by comparing pre- and postoperative airflow characteristics. Twenty patients with severe anterior nasal cavity stenosis, including one case of bilateral stenosis, underwent computed tomography (CT) scans for CFD modelling. The pre- and postoperative airflow characteristics of the nasal cavity were simulated and analyzed. The narrowest area of the nasal cavity in all 20 patients was located within the nasal valve area, and the mean cross-sectional area increased from 0.39 cm2 preoperative to 0.78 cm2 postoperative (P<0.01). Meanwhile, the mean airflow velocity in the nasal valve area decreased from 6.19 m/s to 2.88 m/s (P<0.01). Surgical restoration of the nasal symmetry in the bilateral nasal cavity reduced nasal resistance in the narrow sides from 0.24 Pa.s/mL to 0.11 Pa.s/mL (P<0.01). Numerical simulation of the nasal cavity in patients with anterior nasal cavity stenosis revealed structural changes and the resultant patterns of nasal airflow. Surgery achieved balanced bilateral nasal ventilation and decreased nasal resistance in the narrow region of the nasal cavity. The correction of nasal valve stenosis is not only indispensable for reducing nasal resistance, but also the key to obtain satisfactory curative effect. PMID:27533764

  7. It Takes a Mouth to Eat and a Nose to Breathe: Abnormal Oral Respiration Affects Neonates' Oral Competence and Systemic Adaptation

    PubMed Central

    Trabalon, Marie; Schaal, Benoist

    2012-01-01

    Mammalian, including human, neonates are considered to be obligate nose breathers. When constrained to breathe through their mouth in response to obstructed or closed nasal passages, the effects are pervasive and profound, and sometimes last into adulthood. The present paper briefly surveys neonates' and infants' responses to this atypical mobilisation of the mouth for breathing and focuses on comparisons between human newborns and infants and the neonatal rat model. We present the effects of forced oral breathing on neonatal rats induced by experimental nasal obstruction. We assessed the multilevel consequences on physiological, structural, and behavioural variables, both during and after the obstruction episode. The effects of the compensatory mobilisation of oral resources for