Archive
2020, Volume 6
2019, Volume 5
2018, Volume 4
2017, Volume 3
2016, Volume 2
2015, Volume 1




Volume 6, Issue 1, June 2020, Page: 10-15
Assessment of Nasal Breathing Using Lip Taping: A Simple and Effective Screening Tool
Soroush Zaghi, The Breathe Institute, Los Angeles, CA, USA
Cynthia Peterson, The Breathe Institute, Los Angeles, CA, USA
Shayan Shamtoob, The Breathe Institute, Los Angeles, CA, USA
Brigitte Fung, Kwong Wah Hospital, Hong Kong SAR
Daniel Kwok-keung Ng, Hong Kong Sanatorium & Hospital, Hong Kong SAR
Triin Jagomagi, University of Tartu, Institute of Dentistry, Unimed United Clinics, Estonia
Nicole Archambault, Minds in Motion, Santa Monica, CA, USA
Bridget O’Connor, O’Connor Dental Health, Ballincollig, Cork, Ireland
Kathy Winslow, Independent Researcher, Halfmoon Bay, USA
Zahra Peeran, Happy Kids Dental Planet, Agoura Hills, CA, USA
Miche’ Lano, South County Pediatric Speech, Mission Viejo, USA
Janine Murdock, South County Pediatric Speech, Mission Viejo, USA
Sanda Valcu-Pinkerton, The Breathe Institute, Los Angeles, CA, USA
Lenore Morrissey, Be Well Collaborative Care, Huntington Beach, CA
Received: Jan. 15, 2020;       Accepted: Feb. 12, 2020;       Published: Feb. 24, 2020
DOI: 10.11648/j.ijo.20200601.13      View  292      Downloads  164
Abstract
Objectives: Subjective assessment of nasal obstruction with patient-reported outcome measures such as visual analogue scale and NOSE score may be limited in chronic mouth breathing subjects who are not consciously aware of nasal breathing difficulties. This study investigates a simple objective screening tool to assess the capacity for comfortable nasal breathing that is based on sealing the lips and mouth with tape and assessing whether the subject can breathe comfortably through the nose for up to three minutes. Method: Cross-sectional, multi-center cohort study with 663 participants (ages: 3-83 years, 50.5% female). Lips were gently sealed using MicroPore paper tape; timer was used to assess how long the participants were able to breathe comfortably through the nose for up to 180 seconds. Other measures included subjective rating of perceived difficulty with nasal breathing (VAS, 0-100) as well as self-assessed reports of mouth breathing. Results: There were 9.3% of patients with subjective reports of moderate to severe nasal obstruction (VAS> 50) and 17.2% of patients with predominance of self-reported mouth breathing in this series. Overall, 93.4% of participants successfully passed the nasal breathing test. Among patients with habitual mouth breathing, 83.5% (91/109) were able to breathe comfortably through the nose when instructed to do so for the entire 3-minute duration tested. Similarly, there were 67% (40/59) patients with VAS score >50 who could breathe comfortably through the nose for >180 seconds despite subjective reports of moderate to severe nasal obstruction. Participants unable to breathe exclusively through the nose for 180 seconds had increased likelihood of mouth breathing while awake (OR 4.12, 95% confidence interval 2.14-7.89, p<.0001) as well as increased odds of mouth breathing while asleep (OR 3.05, 95% confidence interval 1.61-5.72, p=0.0003). Conclusion: Objectively testing whether a subject can breathe through the nose with the lips and mouth taped for three minutes can identify patients at risk of mouth breathing and is a simple and effecting screening tool to distinguish organic nasal obstruction from functional mouth breathing habit and or nasal resistance.
Keywords
Nasal Breathing, Assessment Tool, Nasal Obstruction, Mouth Breathing, Lip Taping, Lip Seal Test
To cite this article
Soroush Zaghi, Cynthia Peterson, Shayan Shamtoob, Brigitte Fung, Daniel Kwok-keung Ng, Triin Jagomagi, Nicole Archambault, Bridget O’Connor, Kathy Winslow, Zahra Peeran, Miche’ Lano, Janine Murdock, Sanda Valcu-Pinkerton, Lenore Morrissey, Assessment of Nasal Breathing Using Lip Taping: A Simple and Effective Screening Tool, International Journal of Otorhinolaryngology. Vol. 6, No. 1, 2020, pp. 10-15. doi: 10.11648/j.ijo.20200601.13
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Torre C, Guilleminault C. Establishment of nasal breathing should be the ultimate goal to secure adequate craniofacial and airway development in children. Jornal de pediatria 2018; 94: 101-103.
[2]
Harari D, Redlich M, Miri S, Hamud T, Gross M. The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients. The Laryngoscope 2010; 120: 2089-2093.
[3]
Chambi-Rocha A, Cabrera-Domínguez ME, Domínguez-Reyes A. Breathing mode influence on craniofacial development and head posture. Jornal de Pediatria (Versão em Português) 2018; 94: 123-130.
[4]
Juliano ML, Machado MAC, Carvalho LBCd, Prado LBFd, Prado GFd. Mouth breathing children have cephalometric patterns similar to those of adult patients with obstructive sleep apnea syndrome. Arquivos de neuro-psiquiatria 2009; 67: 860-865.
[5]
Elad D, Wolf M, Keck T. Air-conditioning in the human nasal cavity. Respiratory physiology & neurobiology 2008; 163: 121-127.
[6]
Griffin MP, McFadden E, Ingram RH. Airway cooling in asthmatic and nonasthmatic subjects during nasal and oral breathing. Journal of Allergy and Clinical Immunology 1982; 69: 354-359.
[7]
Friedman M, Tanyeri H, Lim JW, Landsberg R, Vaidyanathan K, Caldarelli D. Effect of improved nasal breathing on obstructive sleep apnea. Otolaryngology—Head and Neck Surgery 2000; 122: 71-74.
[8]
Michels DdS, Rodrigues AdMS, Nakanishi M, Sampaio ALL, Venosa AR. Nasal involvement in obstructive sleep apnea syndrome. International journal of otolaryngology 2014; 2014.
[9]
Sivasankar M, Fisher KV. Oral breathing increases Pth and vocal effort by superficial drying of vocal fold mucosa. Journal of Voice 2002; 16: 172-181.
[10]
Brown RP, Gerbarg PL. Sudarshan Kriya Yogic breathing in the treatment of stress, anxiety, and depression: part II—clinical applications and guidelines. Journal of Alternative & Complementary Medicine 2005; 11: 711-717.
[11]
Ciprandi G, Mora F, Cassano M, Gallina AM, Mora R. Visual analog scale (VAS) and nasal obstruction in persistent allergic rhinitis. Otolaryngology—Head and Neck Surgery 2009; 141: 527-529.
[12]
Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hannley MT. Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngology—Head and Neck Surgery 2004; 130: 157-163.
[13]
Lipan MJ, Most SP. Development of a severity classification system for subjective nasal obstruction. JAMA facial plastic surgery 2013; 15: 358-361.
[14]
Chaaban M, Corey JP. Assessing nasal air flow: options and utility. Proceedings of the American Thoracic Society 2011; 8: 70-78.
[15]
Quadrio M, Pipolo C, Corti Set al. Review of computational fluid dynamics in the assessment of nasal air flow and analysis of its limitations. European Archives of Oto-Rhino-Laryngology 2014; 271: 2349-2354.
[16]
Pacheco MCT, Casagrande CF, Teixeira LP, Finck NS, Araújo MTMd. Guidelines proposal for clinical recognition of mouth breathing children. Dental press journal of orthodontics 2015; 20: 39-44.
[17]
Camacho M, Zaghi S, Certal Vet al. Predictors of nasal obstruction: quantification and assessment using multiple grading scales. Plastic surgery international 2016; 2016.
[18]
Villwock JA, Kuppersmith RB. Diagnostic Algorithm for Evaluating Nasal Airway Obstruction. Otolaryngologic Clinics of North America 2018.
[19]
Spataro E, Most SP. Measuring Nasal Obstruction Outcomes. Otolaryngologic Clinics of North America 2018.
[20]
Rhee JS, Weaver EM, Park SSet al. Clinical consensus statement: Diagnosis and management of nasal valve compromise. Otolaryngology-Head and Neck Surgery 2010; 143: 48-59.
[21]
Haye R, Tarangen M, Shiryaeva O, Døsen LK. Evaluation of the nasal surgical questionnaire for monitoring results of septoplasty. International journal of otolaryngology 2015; 2015.
[22]
Stewart MG, Smith TL, Weaver EMet al. Outcomes after nasal septoplasty: results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study. Otolaryngology–Head and Neck Surgery 2004; 130: 283-290.
[23]
Pacheco MCT, Fiorott BS, Finck NS, Araújo MTMd. Craniofacial changes and symptoms of sleep-disordered breathing in healthy children. Dental press journal of orthodontics 2015; 20: 80-87.
[24]
Brescovici S, Roithmann R. Modified glatzel mirror test reproducibility in the evaluation of nasal patency. Revista Brasileira de Otorrinolaringologia 2008; 74: 215-222.
[25]
Pochat VDd, Alonso N, Mendes RRdS, Gravina PR, Cronenberg EV, Meneses JVL. Assessment of nasal patency after rhinoplasty through the Glatzel mirror. International archives of otorhinolaryngology 2012; 16: 341-345.
[26]
Lee S-Y, Guilleminault C, Chiu H-Y, Sullivan SS. Mouth breathing,“nasal disuse,” and pediatric sleep-disordered breathing. Sleep and Breathing 2015; 19: 1257-1264.
[27]
Guilleminault C, Huang Y, Monteyrol P, Sato R, Quo S, Lin C. Critical role of myofascial reeducation in pediatric sleep-disordered breathing. Sleep medicine 2013; 14: 518-525.
[28]
Levrini L, Lorusso P, Caprioglio Aet al. Model of oronasal rehabilitation in children with obstructive sleep apnea syndrome undergoing rapid maxillary expansion: Research review. Sleep Science 2014; 7: 225-233.
[29]
Gwynne-Evans EDB, A. Discussion on the Mouth-Breather. Proceedings of the Royal Society of Medicine 1958; 51: 279-285.
[30]
Gallo J, Campiotto AR. Myofunctional therapy in children with oral breathing. Revista CEFAC 2009; 11: 305-310.
[31]
Govardhan C, Jabara M, Sendek Get al. Lip-Taping to Improve Nasal Breathing: Practice Patterns and Preferences in Orofacial Myofunctional Therapy. International Archives of Otorhinolaryngology 2019.
[32]
Huang T-W, Young T-H. Novel porous oral patches for patients with mild obstructive sleep apnea and mouth breathing: a pilot study. Otolaryngology–Head and Neck Surgery 2015; 152: 369-373.
Browse journals by subject