A comparison between anamnestic, rhinomanometric and radiological methods of diagnosing mouthbreathing

Abstract

SUMMARY Three methods of evaluating the mode of breathing were applied in 119 children aged 7-15 years who were to start orthodontic treatment for various malocclusions. The three methods were: the history, rhinomanometric recording of the nasal airflow and determination of the size of the airway on profile and frontal cephalograms. The variables describing the mode of breathing were correlated with the facial morphology and the natural position of the head and the cervical spine as recorded with profile cephalometry.There were no correlations between the results of the evaluation of the mode of breathing obtained with the three methods. Nor were there any correlations between these and the position of the head or the cervical spine. A history of mouth-breathing, the rhinomanometrically determined airflow through the nose and the size of the airway on the profile cephalogram were, however, correlated with the long face morphology characteristic of mouth-breathing.A diagnosis of mouth-breathing should be based on different supplementary methods, the history and the size of the airway on the profile cephalogram being at least as valuable as the rhinomanometric recording.

Estudo cefalométrico comparativo entre respiradores nasais e predominantemente bucais

“…A direct cause and effect relationship between nasal and mouth breathing obstruction and altered dento-facial morphology and a precise diagnosis of the breathing pattern are necessary for the airway obstruction to be indicated as a significant etiological factor responsible for some specific dento-facial deformity, Schulhof (1978 39 . Videoendoscopy has been considered a revolutionary diagnostic method, because with the use of flexible or rigid telescopes we can have a direct viewing of the pharyngeal tonsils, the nasal cavity, palatine tonsils, and the very size of the free space on the nasopharynx region.…”

Craniofacial skeletal pattern: is it really correlated with the degree of adenoid obstruction?

“…One of the main causes of mouth breathing is adenoid hypertrophy, 12 In addition, several studies have demonstrated a significant correlation between long face morphology and anatomical reduction in the nasopharyngeal airway. 1 , 7 , 8 , 13 , 14 , 16 - 19 Class II malocclusion or mandibular retrognathia have also been frequently related to smaller dimensions of the nasopharynx. 13 , 20 - 23 Therefore, some of these studies 7 , 14 , 16 , 18 , 24 suggest that dimensional reduction of the nasopharynx, due to hyperdivergent craniofacial pattern or mandibular retrusion, might predispose patients to an obstructive breathing status derived from adenoid hypertrophy.…”

A influência da redução do espaço nasofaringeano na morfologia facial de pré-adolescentes

“…Dentre os métodos de avaliação do padrão respiratório, a história clínica e o tamanho do espaço aéreo em radiografias cefalométricas de perfil têm demonstrado boa correlação entre si e mostraram ser de grande utilidade no diagnóstico da obstrução nasofaringeana 9 . A radiografia cefalométrica lateral, segundo Thuer et al 24 , fornece informação equivalente ao exame rinomanomé-trico, que é um método de avaliação do padrão respiratório mais objetivo. A distância do palato mole à parede faringeana posterior obtida na radiografia cefalométrica lateral tem mostrado ser superior a outros métodos radiográficos na determinação do tamanho da adenóide e do espaço nasofaringeano 24,28,30 .…”

“…A radiografia cefalométrica lateral, segundo Thuer et al 24 , fornece informação equivalente ao exame rinomanomé-trico, que é um método de avaliação do padrão respiratório mais objetivo. A distância do palato mole à parede faringeana posterior obtida na radiografia cefalométrica lateral tem mostrado ser superior a outros métodos radiográficos na determinação do tamanho da adenóide e do espaço nasofaringeano 24,28,30 . Segundo Vig et al 28 , a especificidade deste método no diagnóstico da respiração bucal é de 83,3%, a sensibilidade de 31,8%, enquanto que a precisão de uma predição negativa é de 50% e positiva de 70%.…”