Analysis of conductive olfactory dysfunction using computational fluid dynamics

Conductive olfactory dysfunction (COD) is caused by an obstruction in the nasal cavity and is characterized by changeable olfaction. COD can occur even when the olfactory cleft is anatomically normal, and therefore, the cause in these cases remains unclear. Herein, we used computational fluid dynamics to examine olfactory cleft airflow with a retrospective cohort study utilizing the cone beam computed tomography scan data of COD patients. By measuring nasal–nasopharynx pressure at maximum flow, we established a cut-off value at which nasal breathing can be differentiated from combined mouth breathing in COD patients. We found that increased nasal resistance led to mouth breathing and that the velocity and flow rate in the olfactory cleft at maximum flow were significantly reduced in COD patients with nasal breathing only compared to healthy olfactory subjects. In addition, we performed a detailed analysis of common morphological abnormalities associated with concha bullosa. Our study provides novel insights into the causes of COD, and therefore, it has important implications for surgical planning of COD, sleep apnea research, assessment of adenoid hyperplasia in children, and sports respiratory physiology.

Changes in head posture after rapid palatal expansion in mouth-breathing children.

Introduction. It is well known that previously has been demonstrated a correlation between respiratory function and the harmonious craniofacial development and head posture respectively. Aim of the study. The purpose of this study was to investigate the correlation between rapid maxillary expansion (RME) and the change in natural head position (NHP) resulting from the consequent change in airway resistance and to elucidate how RME influences NHP in terms of cephalometric angles in children with nasal obstruction. Material and methods. The study included 12 girls and 8 boys who had a history of mouth breathing, as confirmed by the parents and ORL specialist and due to this fact, they underwent RME as part of orthodontic treatment. Dental casts, clinical photographs and lateral skull radiographs exposed in natural head position were obtained at the first visit (T1) and 8-10 months (T2) later for all subjects. In order to evaluate the patient’s lateral skull radiographs, I used AudaxCeph software, within which I created a new type of analysis. Student T test and Pearson correlation test were used to statistically analyze the results. Results. Our findings demonstrate that no significant changes in any of the variables are observed in patients treated with rapid maxillary expansion, however a positive correlation was observed in the variables measured before and after the treatment, respectively between the anomaly and the measured values. Positivity can also be detected when examining the correlation between the patient’s gender and the measured values. Conclusions. Based on the obtained results, we cannot state that there is a correlation between rapid maxillary expansion and cervical posture.

Evaluation of endoscopic assisted suction coagulation adenoidectomy versus traditional curettage technique

Background Adenoidal hypertrophy is a common condition in children and can cause symptoms such as mouth breathing, nasal discharge, snoring, sleep apnea, and hyponasal speech. The curettage adenoidectomy has some disadvantages, especially the intranasal extension of the adenoid tissue that makes this technique inadequate. This study is conducted to evaluate and compare between assisted suction coagulation adenoidectomy and traditional curettage techniques. Results One hundred twenty-two patients with symptomatic adenoid hypertrophy such as nasal obstruction, snoring, and mouth breathing were included in our study. Patients underwent adenoidectomy either traditional curettage adenoidectomy (60 patients as group A) or endoscopic assisted suction coagulation adenoidectomy (62 patients as group B). Patients were scheduled for follow-up visits with respect to operative time, operative and postoperative complications. The mean age of groups A and B were 6.57+2.8 and 7+2.8 ranging from 3 to12 years. There was a statistically significant difference between groups as regard intraoperative blood loss, trauma, postoperative complications as neck stiffness and bad odor plus postoperative endoscopic and radiological grading after the operation. Conclusions Suction coagulation diathermy adenoidectomy is alternative to cold adenoidectomy with significantly fewer intraoperative complications such as blood loss and trauma of prevertebral muscle plus post-operative complications such as primary or secondary bleeding and rhinolalia aperta.

Mouth breathing – A predictor for patient satisfaction after nasal septoplasty?

Background: No reliable marker exists to predict septoplasty outcome. Most patients suffering from nasal airway obstruction (NAO) caused by a deviation of the nasal septum report a bothersome mouth breathing and dryness. In this study our aim was to assess, whether mouth breathing could be objectified in these patients and whether mouth breathing could predict septoplasty outcome. Methods: A monocentric, prospective case-control study of 21 patients was conducted. The proportion of mouth breathing was measured in a blinded manner. As a measurement of patient satisfaction, subjective symptoms pre- and postoperatively, were assessed by using VAS, NOSE and SNOT-20 score. In the patient group an additional acoustic rhinometry and a clinical examination of the nose were performed. Results: With a mean of 25% (SD = 20%) the proportion of mouth breathing in patients with NAO did not differ significantly from the proportion in controls without NAO, with a mean of 27% (SD = 23%). Analysis of subjective scores revealed a significant reduction of subjective symptoms after septoplasty. A higher preoperative proportion of mouth breathing correlated with more remaining postoperative NAO. Conclusions: The percentage of mouth breathing is no different in patients with symptomatic septal deviation than in control patients. Mouth breathing in patients with NAO, evaluated for septoplasty, could be a negative predictive factor for patient satisfaction after nasal septoplasty. Mouth breathing in these patients should be observed carefully because more preoperative mouth breathing should make one more hesitant to consider septoplasty.

Public attitudes towards cardiopulmonary resuscitation training and performance in Singapore

Background Bystander cardiopulmonary resuscitation (CPR) rates remain fairly low through most communities despite multiple interventions through the years. Understanding the attitudes and fears behind CPR training and performance would help target education and training to raise the rates of bystander CPR and consequently survival rates of victims. 7909 participants at a single-day mass CPR training session in Singapore were given survey questionnaires to fill out. 6473 people submitted completed forms upon the conclusion of the training session. Some issues looked at were the overall level of difficulty of CPR, difficulty levels of specific skills, attitudes towards refresher training, attitudes towards performing CPR, and fears when doing so. Results The mean level of difficulty of CPR was rated 3.98 (scale of 1–10), with those with previous CPR training rating it easier. The skills rated most difficult were performing mouth-to-mouth breathing and chest compressions, while the easiest rated was recognizing non-responsiveness. A majority (69.7%) would agree to go for refresher training every 2 years and 88.7% felt everyone should be trained in CPR. 71.6% would perform full CPR for a member of the public in cardiac arrest and only 20.7% would prefer to only do chest compressions. The most cited fear was a low level of confidence, and fears of acquiring infections or aversion to mouth-to-mouth breathing were low. Conclusions The survey results show that most participants in Singapore are keen to perform conventional CPR for a member of the public and can help to target future CPR training accordingly.

Prevalence of Parafunctional Habits among Preschool Children and its Correlation to Parental Education Status

Background: Parafunctional habit has been associated in the literature with alterations of dental occlusion; it could be a predisposing factor for malocclusion. This cross-sectional study is aimed to assess the prevalence of parafunctional habits and its relation to parent’s education. Subjects and Methods: Convenience sample of 500 children aged between 4 and 6 years of both gender 262 boys and 238 girls receiving their medical care in primary health-care centers and in Raparin Pediatric Hospital of Erbil city to study parafunctional habits and its relation to parents education. Results: Mouth breathing and nail biting were more prevalent habits in the included children than lip sucking and bruxism. The former habits prevalence showed no significant differences in children whose their parents education background are different (high, middle, or low education). Conclusion: Mouth breathing and nail biting were highly prevalent habits among preschool children in Erbil city. No significant association was found between the prevalence of bad oral habits and parents education.

Mouth Breathing and Atypical Swallowing in Adult Orthodontic Patients at Egas Moniz Dental Clinic: A Pilot Study

Background: Mouth breathing and atypical swallowing are myofunctional problems, emerging as a pathological adaptation. This exploratory study was aimed to investigate the possible relation between breathing and swallowing patterns in adults. Methods: A total of 58 patients referred to the Orthodontic Department at Egas Moniz Dental Clinic were enrolled. Results: Atypical swallowing was more prevalent in women (78.0%) than in men (47.1%). A significantly higher proportion of patients exhibiting both mouth breathing and atypical swallowing were identified (46.6%). Swallowing pattern was found to be significantly associated with gender and breathing pattern.