Nasal Airway in Breathing and Speech

Abstract

Clefts of the lip and palate frequently produce nasal deformities that tend to reduce the size of the nasal airway. Approximately 70% of the cleft population have nasal airway impairment and about 80% "mouth-breathe" to some extent. Surgical correction of nasal, palatal, and pharyngeal structures may further compromise breathing. Type of cleft appears to affect airway size, with unilateral clefts demonstrating the smallest airway. Although a pharyngeal flap may further decrease airway size, some individuals do not notice a postoperative change because of airway compromise prior to flap placement. Speech is a modified breathing behavior that uses the respiratory system to provide an energy source and involves structures within the respiratory tract to modulate this energy into meaningful sounds. The oral, nasal, and pharyngeal structures that are affected by cleft lip and palate during breathing are often compromised for speech as well. The nasal airway plays an important role in controlling speech pressures when velopharyngeal function is impaired. A "good" nose for breathing is often a "bad" nose for speech under such circumstances.

Current methods of treating nasal breathing problems in infants and children

“…''Biology has a dimension of complexity that physics does not 16 . The classical definition of breathing at normal rest, moreover, is so conventional that the mixed mode, oro-nasal, has been proposed as the norm; leaving only the extent of the oral portion of this modality to be established; some 25 propose an approximate value of 15%, while others 40 consider that as much as 30% of the so-called normal population use ''use oral breathing up to a certain point''.…”

Dimensões nasofaríngeas em indivíduos sem anomalias craniofaciais: dados normativos

“…Even after primary surgical repair of the lip and palate, nasal deformities are common, leading to a reduction of nasal cavity dimensions (1,2) and an increase of the proportion of oral breathers in this population (3,4) . According to literature, it is estimated that 60% of individuals with cleft lip and palate present with a compromised nasal airway leading to an oral breathing that may influence the craniofacial development, lower airway performance and speech, chewing and swallowing functions (5) .…”

Upper airway resistance during growth: A longitudinal study of children from 8 to 17 years of age

“…9 Oral breathing may also complicate treatment of sleep apnea due to difficulties of using continuous positive airway pressure (CPAP) therapy. 10 In children with cleft palate, an obstructed nasal airway may be of some help in producing plosive consonants during speech 11 but has been reported to increase risk for upper airway and ear infections.…”