Active expiratory oscillator regulates nasofacial and oral motor activities in rats.

NEW FINDINGS: What is the central question of this study? Does the parafacial respiratory group (pFRG), which mediates active expiration, recruit nasofacial and oral motoneurons to coordinate motor activities that engage muscles controlling airways in rats during active expiration. What is the main finding and its importance? Hypercapnia/acidosis or pFRG activation evoked active expiration and stimulated the motoneurons and nerves responsible for the control of nasofacial and oral airways patency simultaneously. Bilateral pFRG inhibition abolished active expiration and the simultaneous nasofacial and oral motor activities induced by hypercapnia/acidosis. The pFRG is more than a rhythmic oscillator for expiratory pump muscles: it also coordinates nasofacial and oral motor commands that engage muscles controlling airways. ABSTRACT: Active expiration is mediated by an expiratory oscillator located in the parafacial respiratory group (pFRG). Active expiration requires more than contracting expiratory muscles as multiple cranial nerves are recruited to stabilize the naso- and oropharyngeal airways. We tested the hypothesis that activation of the pFRG recruits facial and trigeminal motoneurons to coordinate nasofacial and oral motor activities that engage muscles controlling airways in rats during active expiration. Using a combination of electrophysiological and pharmacological approaches, we identified brainstem circuits that phase-lock active expiration, nasofacial and oral motor outputs in an in situ preparation of rat. We found that either high chemical drive (hypercapnia/acidosis) or unilateral excitation (glutamate microinjection) of the pFRG evoked active expiration and stimulated motoneurons (facial and trigeminal) and motor nerves responsible for the control of nasofacial (buccal and zygomatic branches of the facial nerve) and oral (mylohyoid nerve) motor outputs simultaneously. Bilateral pharmacological inhibition (GABAergic and glycinergic receptor activation) of the pFRG abolished active expiration and the simultaneous nasofacial and oral motor activities induced by hypercapnia/acidosis. We conclude that the pFRG provides the excitatory drive to phase-lock rhythmic nasofacial and oral motor circuits during active expiration in rats. Therefore, the pFRG is more than a rhythmic oscillator for expiratory pump muscles: it also coordinates nasofacial and oral motor commands that engage muscles controlling airways in rats during active expiration.

Nasal Coarticulation and Prosody in Kakataibo.

This paper presents the first phonetic description of the patterns of nasal coarticulation in Kakataibo. While closely related Panoan languages have been described as having anticipatory nasal coarticulation in VN sequences, there are only a few reports of other types of nasal coarticulation. Based on a detailed investigation of the aerodynamic properties of nasality, we account for the full variety of nasal coarticulation patterns in Kakataibo and discuss their interaction with prosody. This paper shows that nasal coarticulation occurs in all contexts in which there is vowel-nasal contiguity, although the amount and patterns of nasal coarticulation are dependent on the directionality of the process, the presence or absence of a syllable boundary and stress.

Nasal patency and otorhinolaryngologic-orofacial features in children / Patência nasal e características otorrinolaringológicas e orofaciais em crianças

Abstract Introduction: Nasal obstruction is a common symptom in childhood, related to rhinitis and pharyngeal tonsil hypertrophy. In the presence of nasal obstruction, nasal patency may be reduced, and nasal breathing is replaced by mouth breathing. Orofacial and otorhinolaryngologic changes are related to this breathing mode. Objective evaluation of upper airways may be obtained through nasal patency measurement. Objective: To compare nasal patency and otorhinolaryngologic-orofacial features in children. Methods: One hundred and twenty three children, 6-12 year-old, and of both sexes underwent speech therapy evaluation, according to Orofacial Myofunctional Evaluation protocol, clinical and endoscopic otorhinolaryngologic examination and nasal patency measurement, using the absolute and predicted (%) peak nasal inspiratory flow values. Results: Lower values of absolute and estimated peak nasal inspiratory flow values were found in children with restless sleep (p = 0.006 and p = 0.002), nasal obstruction report (p = 0.027 and p = 0.023), runny nose (p = 0.004 and p = 0.012), unsystematic lip closure during mastication (p = 0.040 and p = 0.026), masticatory speed reduced (p = 0.006 and p = 0.008) and altered solid food swallowing (p = 0.006 and p = 0.001). Absolute peak nasal inspiratory flow was lower in children with pale inferior turbinate (p = 0.040), reduced hard palate width (p = 0.037) and altered speech (p = 0.004). Higher absolute values were found in children with increased tongue width (p = 0.027) and, higher absolute and predicted (%) in children with mild everted lip (p = 0.008 and p = 0.000). Conclusions: Nasal patency was lower in children with restless sleep, rhinitis signs and symptoms, hard palate width reduced and with changes in mastication, deglutition and speech functions. It is also emphasized that most of the children presented signs and symptom of allergic rhinitis.

Resumo Introdução: A obstrução nasal é um sintoma comum na infância relacionado a rinite e hipertrofia das tonsilas faríngeas. Na presença de obstrução nasal, a patência nasal pode estar reduzida e a respiração nasal ser substituída por respiração oral. Alterações orofaciais e otorrinolaringológicas estão relacionadas a esse modo de respiração. A avaliação objetiva das vias aéreas superiores pode ser obtida através da medida da patência nasal. Objetivo: Comparar a patência nasal e características otorrinolaringológicas e orofaciais em crianças. Método: Foram submetidas 123 crianças de seis a 12 anos, de ambos os sexos, a avaliação fonoaudiológica, de acordo com o protocolo de avaliação Miofuncional Orofacial, exame clínico e endoscópico otorrinolaringológico e medição da patência nasal, com o uso do pico de fluxo inspiratório nasal em valores absolutos e valores estimados (% pico de fluxo inspiratório nasal). Resultados: Valores mais baixos de pico de fluxo inspiratório nasal e % pico de fluxo inspiratório nasal foram encontrados em crianças com sono agitado (p = 0,006 e p = 0,002), relato de obstrução nasal (p = 0,027 e p = 0,023), rinorreia (p = 0,004 e p = 0,012), fechamento não sistemático dos lábios durante a mastigação (p = 0,040 e p = 0,026), velocidade mastigatória reduzida (p = 0,006 e p = 0,008) e alteração da ingestão de alimentos sólidos (p = 0,006 e p = 0,001). O pico de fluxo inspiratório nasal foi menor em crianças com conchas inferiores pálidas (p = 0,040), redução da largura do palato duro (p = 0,037) e alterações da fala (p = 0,004). Valores maiores foram encontrados em crianças com largura da língua aumentada (p = 0,027). Valores maiores de pico de fluxo inspiratório nasal e % de pico de fluxo inspiratório nasal foram observados em crianças com lábio levemente evertido (p = 0,008 e p = 0,000). Conclusões: A patência nasal foi menor em crianças com sono agitado, sinais e sintomas de rinite, redução da largura do palato duro e alterações nas funções de mastigação, deglutição e fala. Enfatiza-se também que a maioria das crianças apresentava sinais e sintomas de rinite alérgica.

Nasal patency and otorhinolaryngologic-orofacial features in children.

INTRODUCTION: Nasal obstruction is a common symptom in childhood, related to rhinitis and pharyngeal tonsil hypertrophy. In the presence of nasal obstruction, nasal patency may be reduced, and nasal breathing is replaced by mouth breathing. Orofacial and otorhinolaryngologic changes are related to this breathing mode. Objective evaluation of upper airways may be obtained through nasal patency measurement. OBJECTIVE: To compare nasal patency and otorhinolaryngologic-orofacial features in children. METHODS: One hundred and twenty three children, 6-12 year-old, and of both sexes underwent speech therapy evaluation, according to Orofacial Myofunctional Evaluation protocol, clinical and endoscopic otorhinolaryngologic examination and nasal patency measurement, using the absolute and predicted (%) peak nasal inspiratory flow values. RESULTS: Lower values of absolute and estimated peak nasal inspiratory flow values were found in children with restless sleep (p=0.006 and p=0.002), nasal obstruction report (p=0.027 and p=0.023), runny nose (p=0.004 and p=0.012), unsystematic lip closure during mastication (p=0.040 and p=0.026), masticatory speed reduced (p=0.006 and p=0.008) and altered solid food swallowing (p=0.006 and p=0.001). Absolute peak nasal inspiratory flow was lower in children with pale inferior turbinate (p=0.040), reduced hard palate width (p=0.037) and altered speech (p=0.004). Higher absolute values were found in children with increased tongue width (p=0.027) and, higher absolute and predicted (%) in children with mild everted lip (p=0.008 and p=0.000). CONCLUSIONS: Nasal patency was lower in children with restless sleep, rhinitis signs and symptoms, hard palate width reduced and with changes in mastication, deglutition and speech functions. It is also emphasized that most of the children presented signs and symptom of allergic rhinitis.

Sensitivity of nasal airflow variables computed via computational fluid dynamics to the computed tomography segmentation threshold.

Computational fluid dynamics (CFD) allows quantitative assessment of transport phenomena in the human nasal cavity, including heat exchange, moisture transport, odorant uptake in the olfactory cleft, and regional delivery of pharmaceutical aerosols. The first step when applying CFD to investigate nasal airflow is to create a 3-dimensional reconstruction of the nasal anatomy from computed tomography (CT) scans or magnetic resonance images (MRI). However, a method to identify the exact location of the air-tissue boundary from CT scans or MRI is currently lacking. This introduces some uncertainty in the nasal cavity geometry. The radiodensity threshold for segmentation of the nasal airways has received little attention in the CFD literature. The goal of this study is to quantify how uncertainty in the segmentation threshold impacts CFD simulations of transport phenomena in the human nasal cavity. Three patients with nasal airway obstruction were included in the analysis. Pre-surgery CT scans were obtained after mucosal decongestion with oxymetazoline. For each patient, the nasal anatomy was reconstructed using three different thresholds in Hounsfield units (-800HU, -550HU, and -300HU). Our results demonstrate that some CFD variables (pressure drop, flowrate, airflow resistance) and anatomic variables (airspace cross-sectional area and volume) are strongly dependent on the segmentation threshold, while other CFD variables (intranasal flow distribution, surface area) are less sensitive to the segmentation threshold. These findings suggest that identification of an optimal threshold for segmentation of the nasal airway from CT scans will be important for good agreement between in vivo measurements and patient-specific CFD simulations of transport phenomena in the nasal cavity, particularly for processes sensitive to the transnasal pressure drop. We recommend that future CFD studies should always report the segmentation threshold used to reconstruct the nasal anatomy.

Flow and air conditioning simulations of computer turbinectomized nose models.

Air conditioning for the human respiratory system is the most important function of the nose. When obstruction occurs in the nasal airway, turbinectomy is used to correct such pathology. However, mucosal atrophy may occur sometime after this surgery when it is overdone. There is not enough information about long-term recovery of nasal air conditioning performance after partial or total surgery. The purpose of this research was to assess if, based on the flow and temperature/humidity characteristics of the air intake to the choana, partial resection of turbinates is better than total resection. A normal nasal cavity geometry was digitized from tomographic scans and a model was printed in 3D. Dynamic (sinusoidal) laboratory tests and computer simulations of airflow were conducted with full agreement between numerical and experimental results. Computational adaptations were subsequently performed to represent six turbinectomy variations and a swollen nasal cavity case. Streamlines along the nasal cavity and temperature and humidity distributions at the choana indicated that the middle turbinate partial resection is the best alternative. These findings may facilitate the diagnosis of nasal obstruction and can be useful both to plan a turbinectomy and to reduce postoperative discomfort. Graphical Abstract ᅟ.

Modulation of the ultradian human nasal cycle by sleep stage and body position.

OBJECTIVE:: The nasal cycle, which is present in a significant number of people, is an ultradian side-to-side rhythm of nasal engorgement associated with cyclic autonomic activity. We studied the nasal cycle during REM/non-REM sleep stages and examined the potentially confounding influence of body position on lateralized nasal airflow. METHODS:: Left- and right-side nasal airflow was measured in six subjects during an eight-hour sleep period using nasal thermistors. Polysomnography was performed. Simultaneously, body positions were monitored using a video camera in conjunction with infrared lighting. RESULTS:: Significantly greater airflow occurred through the right nasal chamber (relative to the left) during periods of REM sleep than during periods of non-REM sleep (p<0.001). Both body position (p < 0.001) and sleep stage (p < 0.001) influenced nasal airflow lateralization. CONCLUSIONS:: This study demonstrates that the lateralization of nasal airflow and sleep stage are related. Some types of asymmetrical somatosensory stimulation can alter this relationship.

Modulation of the ultradian human nasal cycle by sleep stage and body position / Modulação do ciclo nasal humano ultradiano pelo estágio do sono e a posição corporal

ABSTRACT Objective: The nasal cycle, which is present in a significant number of people, is an ultradian side-to-side rhythm of nasal engorgement associated with cyclic autonomic activity. We studied the nasal cycle during REM/non-REM sleep stages and examined the potentially confounding influence of body position on lateralized nasal airflow. Methods: Left- and right-side nasal airflow was measured in six subjects during an eight-hour sleep period using nasal thermistors. Polysomnography was performed. Simultaneously, body positions were monitored using a video camera in conjunction with infrared lighting. Results: Significantly greater airflow occurred through the right nasal chamber (relative to the left) during periods of REM sleep than during periods of non-REM sleep (p<0.001). Both body position (p < 0.001) and sleep stage (p < 0.001) influenced nasal airflow lateralization. Conclusions: This study demonstrates that the lateralization of nasal airflow and sleep stage are related. Some types of asymmetrical somatosensory stimulation can alter this relationship.

RESUMO Objetivo: O ciclo nasal é um ritmo ultradiano de lado a lado de ingurgitamento associado com o ciclo da atividade autônoma. O objetivo deste estudo foi abordar a questão assim como a relação presente entre o ciclo nasal e os estágios de sono REM/não-REM. Também analisamos a confusão potencial da influência da posição corporal no fluxo de ar nasal. Métodos: Mensuramos o ciclo nasal em seis sujeitos durante um sono de oito horas usando um termistor nasal. Foi realizada uma polissonografia. Simultaneamente, nós monitoramos a posição corporal usando uma câmera de vídeo juntamente com luzes infravermelhas. Resultados: Um fluxo de ar maior ocorreu através da cavidade nasal direita durante as fases de sono REM do que nos períodos de sono não-REM (p < 0,001). Assim como a posição corporal [F(2.2340) = 86,99, p < 0,001] e o estágio de sono [F(1.2340) = 234.82, p < 0,001] influenciaram a lateralização do fluxo de ar nasal. Conclusões: Este estudo evidencia que a lateralização do fluxo de ar nasal e o estágio do sono estão relacionados. Alguns tipos de estimulação somatosensitiva assimétrica podem alterar esta relação.

Variations in peak nasal inspiratory flow among healthy students after using saline solutions / Variações do pico de fluxo inspiratório nasal entre escolares sadios após o uso de soluções salinas

ABSTRACT INTRODUCTION: Nasal hygiene with saline solutions has been shown to relieve congestion, reduce the thickening of the mucus and keep nasal cavity clean and moist. OBJECTIVE: Evaluating whether saline solutions improve nasal inspiratory flow among healthy children. METHODS: Students between 8 and 11 years of age underwent 6 procedures with saline solutions at different concentrations. The peak nasal inspiratory flow was measured before and 30 min after each procedure. Statistical analysis was performed by means of t test, analysis of variance, and Tukey's test, considering p < 0.05. RESULTS: We evaluated 124 children at all stages. There were differences on the way a same concentration was used. There was no difference between 0.9% saline solution and 3% saline solution by using a syringe. CONCLUSION: The 3% saline solution had higher averages of peak nasal inspiratory flow, but it was not significantly higher than the 0.9% saline solution. It is important to offer various options to patients.

RESUMO INTRODUÇÃO: A higiene nasal com soluções salinas tem sido indicada para aliviar a congestão, reduzir o espessamento do muco e manter a cavidade nasal limpa e úmida. OBJETIVO: Avaliar se as soluções salinas melhoram o fluxo inspiratório nasal entre crianças sadias. MÉTODO: Escolares com idades entre 8 e 11 anos foram submetidos a 6 procedimentos com soluções salinas em diferentes concentrações. O pico de fluxo inspiratório nasal foi medido antes e 30 minutos após cada procedimento. A análise estatística foi realizada por meio do teste t, análise de variância e teste de Tukey, considerando p < 0,05. RESULTADOS: Foram avaliadas 124 crianças em todas as etapas. Houve diferenças quanto à forma de uso de uma mesma concentração. Não houve diferença entre solução salina a 0,9% e solução salina a 3% por meio de seringa. CONCLUSÕES: A solução salina a 3% obteve maiores médias do pico de fluxo inspiratório nasal, porém não foi significativamente superior à solução salina a 0,9%. É importante oferecer diferentes opções aos pacientes.

Variations in peak nasal inspiratory flow among healthy students after using saline solutions.

INTRODUCTION: Nasal hygiene with saline solutions has been shown to relieve congestion, reduce the thickening of the mucus and keep nasal cavity clean and moist. OBJECTIVE: Evaluating whether saline solutions improve nasal inspiratory flow among healthy children. METHODS: Students between 8 and 11 years of age underwent 6 procedures with saline solutions at different concentrations. The peak nasal inspiratory flow was measured before and 30 min after each procedure. Statistical analysis was performed by means of t test, analysis of variance, and Tukey's test, considering p<0.05. RESULTS: We evaluated 124 children at all stages. There were differences on the way a same concentration was used. There was no difference between 0.9% saline solution and 3% saline solution by using a syringe. CONCLUSION: The 3% saline solution had higher averages of peak nasal inspiratory flow, but it was not significantly higher than the 0.9% saline solution. It is important to offer various options to patients.

Correlation between peak nasal inspiratory flow and peak expiratory flow in children and adolescents.

BACKGROUND: PEAK nasal inspiratory flow (PNIF) has been proposed as a simple method to evaluate nasal patency. Asthma and allergic rhinitis are commonly associated, and lower airway assessment can provide information concerning an objective interpretation of nasal function. AIMS: TO determine whether the PNIF is correlated with peak expiratory flow (PEF) in children and adolescents. METHODS AND RESULTS: Cross-sectional study carried out in healthy students randomly chosen in 14 public schools of the city of Belo Horizonte. PNIF and PEF were assessed for each subject as the following characteristics: gender, height, weight and age. We created a linear regression model to explain the PNIF, in which we included all the variables with a p value ≤ 0.25 in a univariate analysis, and to calculate the relationship between the maximum PNIF and maximum PEF by the Spearman correlation coefficient. In total, 297 healthy subjects, aged between six and eighteen years were evaluated. A positive and significant correlation between PNIF and PEF was found. CONCLUSIONS: PEF is predictive of PNIF. However, these measures evaluate two distinct segments of the airways and should be both obtained for a more precise assessment of airflow limitation.

Avaliações objetiva e subjetiva da obstrução nasal em crianças e adolescentes com rinite alérgica / Objective and subjective assessments of nasal obstruction in children and adolescents with allergic rhinitis

OBJETIVO: Relacionar a avaliação objetiva da obstrução nasal por rinometria acústica (volume dos cinco primeiros centímetros da cavidade nasal) e rinomanometria anterior ativa (resistência nasal total) com a avaliação subjetiva (escore de obstrução). MÉTODO: Participaram do estudo 30 pacientes (7 a 18 anos) com rinite alérgica persistente e 30 controles. O escore foi referido para cavidade nasal total e narinas em separado. As três variáveis foram mensuradas nos momentos basal e após indução de obstrução nasal. RESULTADOS: Houve correlações significantes e negativas entre resistência e volume nasal em todos os grupos e situações de avaliação, exceto para narina mais obstruída, grupo controle, pós-obstrução. Para a cavidade nasal total, não houve correlação significante entre as variáveis objetivas e subjetiva, exceto entre escore e volume na cavidade nasal total no grupo controle pós-obstrução. Na narina mais obstruída, houve correlação significante e negativa para escore e resistência e significante e positiva para escore e volume nasal no grupo total, momento basal. Não houve diferença nítida nos coeficientes de correlação entre pacientes e controles, e estes não se alteraram após a indução de obstrução nasal. CONCLUSÕES: Avaliação objetiva da obstrução nasal não apresentou correlação significativa com a avaliação subjetiva na cavidade nasal total, mas sim na avaliação unilateral. Houve correlação entre avaliações objetivas. Rinite alérgica ou obstrução nasal aguda não interferiram na correlação entre as avaliações objetiva e subjetiva da obstrução nasal. Sugere-se utilidade no acréscimo de métodos objetivos para avaliação da obstrução nasal em pesquisas e, na sua impossibilidade, avaliação das narinas em separado.

OBJECTIVE: To correlate objective assessment of nasal obstruction, as measured by acoustic rhinometry (volume of the first 5 cm of the nasal cavity) and active anterior rhinomanometry (total nasal airway resistance), with its subjective evaluation (obstruction scores). METHOD: Thirty patients, aged 7 to 18 years, with persistent allergic rhinitis and thirty controls were enrolled. The obstruction score was reported for the whole nasal cavity and for each nostril separately. The three variables were measured at baseline and after induction of nasal obstruction. RESULTS: There were significant and negative correlations between resistance and nasal volume in all groups and scenarios, except for the most obstructed nostril, in the control group, post-obstruction. For the whole nasal cavity, there was no significant correlation between objective and subjective variables except between score and total nasal cavity volume in the control group, post-obstruction. Regarding the most obstructed nostril, we found a significant negative correlation between score and resistance and a significant positive correlation between score and volume for the total group at baseline. There were no clear differences in the correlation coefficients found in patients and controls. The correlation coefficients did not change after induction of nasal obstruction. CONCLUSIONS: Objective assessment of nasal obstruction did not correlate significantly with subjective evaluation for the nasal cavity as a whole, but there was a correlation for unilateral assessments. There was correlation between the objective evaluations. Allergic rhinitis and acute induction of nasal obstruction did not affect the correlation between objective and subjective assessments of nasal obstruction. Addition of an objective method for evaluation of nasal obstruction could be useful in the research setting; if no such method can be used, each nostril should be evaluated separately.

Objective and subjective assessments of nasal obstruction in children and adolescents with allergic rhinitis.

OBJECTIVE: To correlate objective assessment of nasal obstruction, as measured by acoustic rhinometry (volume of the first 5 cm of the nasal cavity) and active anterior rhinomanometry (total nasal airway resistance), with its subjective evaluation (obstruction scores). METHOD: Thirty patients, aged 7 to 18 years, with persistent allergic rhinitis and thirty controls were enrolled. The obstruction score was reported for the whole nasal cavity and for each nostril separately. The three variables were measured at baseline and after induction of nasal obstruction. RESULTS: There were significant and negative correlations between resistance and nasal volume in all groups and scenarios, except for the most obstructed nostril, in the control group, post-obstruction. For the whole nasal cavity, there was no significant correlation between objective and subjective variables except between score and total nasal cavity volume in the control group, post-obstruction. Regarding the most obstructed nostril, we found a significant negative correlation between score and resistance and a significant positive correlation between score and volume for the total group at baseline. There were no clear differences in the correlation coefficients found in patients and controls. The correlation coefficients did not change after induction of nasal obstruction. CONCLUSIONS: Objective assessment of nasal obstruction did not correlate significantly with subjective evaluation for the nasal cavity as a whole, but there was a correlation for unilateral assessments. There was correlation between the objective evaluations. Allergic rhinitis and acute induction of nasal obstruction did not affect the correlation between objective and subjective assessments of nasal obstruction. Addition of an objective method for evaluation of nasal obstruction could be useful in the research setting; if no such method can be used, each nostril should be evaluated separately.

Assessment of nasal patency after rhinoplasty through the Glatzel mirror

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...

Palatal complexity revisited: an electropalatographic analysis of /see text for symbol/ in Brazilian Portuguese with comparison to Peninsular Spanish.

Are palatal consonants articulated by multiple tongue gestures (coronal and dorsal) or by a single gesture that brings the tongue into contact with the palate at several places of articulation? The lenition of palatal consonants (resulting in approximants) has been presented as evidence that palatals are simple, not complex: When reduced, they do not lose their coronal gesture and become dorsals; instead, they manifest reduced linguopalatal contact while retaining their anterior place of articulation. The frequently-reported deocclusivization of the Brazilian Portuguese (BP) palatal nasal may support this claim. However, the linguopalatal configuration of this sound has not been studied directly. Electropalatographic evidence from three speakers of BP (compared with data from three speakers of Peninsular Spanish) demonstrates that the palatal nasal is frequently realized as an approximant. There is no evidence of anterior occlusion in BP's post-palatal, lenited nasal. Under conditions of focus/hyperarticulation, there is no evidence of stronger/more anterior occlusion. We argue that the articulatory target of the BP palatal nasal is neither occluded nor anterior.

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

OBJECTIVES: 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). METHODS: 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). RESULTS: 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. CONCLUSIONS: The CBCT evaluation showed that pharyngeal airway dimensions were significantly greater in nasal-breathers than in mouth-breathers.

Peak nasal inspiratory flow: uma possível ferramenta para a motricidade orofacial? / Peak nasal inspiratory flow: a possible instrument in orofacial myology?

Os fonoaudiólogos que atuam no campo da Motricidade Orofacial atendem com frequência, pacientes com obstrução nasal; entretanto, nem sempre o acesso ao profissional responsável pelo diagnóstico otorrinolaringológico é fácil. O Peak Nasal Inspiratory Flow é um instrumento barato, de fácil manuseio, amplamente citado na literatura internacional, que tem por objetivo avaliar a patência nasal. O objetivo do presente estudo foi realizar uma revisão da literatura acerca do Peak Nasal Inspiratory Flow, fornecendo subsídios para reflexões acerca de seu emprego nos distúrbios miofuncionais orofaciais e cervicais. Para tanto, foi realizada uma revisão da literatura nas bases de dados Medline, Cochrane Library, LILACS e SciELO empregando-se os descritores peak, inspiratory, nasal e flow. O Peak Nasal Inspiratory Flow mostrou-se uma técnica simples, barata, validada e com boa reprodutibilidade. Parece, portanto, tratar-se de um instrumento útil para avaliação da patência nasal, apesar de algumas limitações, fornecendo dados complementares ao diagnóstico miofuncional orofacial e cervical. Entretanto, estudos clínicos precisam ser conduzidos para que se comprove ou refute a hipótese.

The speech-language pathologists that work in the Orofacial Myology field frequently have patients with nasal obstruction; however, the access to the professional responsible for the diagnosis can be difficult at times. The Peak Nasal Inspiratory Flow is a cheap and easy to handle instrument, broadly cited in the international literature, that has the aim to evaluate nasal patency. The aim of this study was to review the current literature regarding the Peak Nasal Inspiratory Flow, enabling considerations about its use in cervical and orofacial myology disorders. The literature review consulted Medline, Cochrane Library, LILACS and SciELO databases, using the keywords: peak, inspiratory, nasal and flow. The results showed that Peak Nasal Inspiratory Flow is a simple, cheap, validated technique with good reproducibility. Thus, it seems to be an useful instrument to be used in nasal patency evaluation, despite some limitations, providing complementary data to orofacial myofunctional diagnosis. However clinical trials are needed to prove this hypothesis.

Nasal valve: anatomy and physiology.

UNLABELLED: The anterior portion of the nasal cavities, from the nostril to the nasal valve (NV), is the place of highest nasal resistance to airflow, paramount to nasal physiology. There are different terminologies for the same anatomic structures in the literature. AIM: The aim of this paper was to study the NV function and define clearly the structures of the anterior portion of the nasal cavities, mainly the region of the NV. CONCLUSION: Internum ostium is the anterior segment and isthmus nasi is the posterior segment of the NV region.