Respiratory mode, nasal patency and palatine dimensions

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

doi:10.1590/2317-1782/20152014177

Abstract

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.

Highlights

The sample consisted of 77 volunteers, 39 (28 women, 11 men) in the Nasal breathing (NB) group and 38 (25 women, 13 men) in the mouth breathing (MB) group
According to the otorhinolaryngological examination, all the members of the MB group were classified as functional MBs of nonorganic cause, primarily allergic problems, and parafunctional habits
The measures of the transversal and vertical distances of the palate in the MB and NB groups are a result of the arithmetic mean of intra- and interexaminers results

Summary

Introduction

Alterations in the vertical and transversal dimensions of the hard palate in MB[7,8,9,10] adults induce other adaptations of form and function, such as malocclusion, high arched, narrow, and deep palate, lack of lip closure, tongue lowered on the mouth floor or with interdental placement, flaccid orofacial muscles, and atypical swallowing[11]. These alterations contribute to the increase in the resistance to nasal airflow and to the reduction in the peak nasal inspiratory flow (PNIF)(12,13). It is a commonly used method for evaluating the effectiveness of drugs or treatments, as well as for home monitoring the variations in circadian rhythms or the environmental effects on nasal patency[12]

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Conclusion