Breathing

Lots of young patients and parents don't seem to realise that the nose should be used for breathing.

Breathing must be exclusively naso-nasal (TALMANT, FOURNIER) and must involve the diaphragm. This also applies to night-time, during sleep.

Breathing must not require any effort or tightening of the lips.

Newborns breathe in a completely naso-nasal way. They don't know how to breathe through their mouths and can't breathe if they have a blocked nose. Nasal breathing takes place when the mouth is closed, but children who can easily put their lips together during the day, may breathe through their mouth during the night. On the other hand, an open mouth may be the sign of incompetent lips.

When the air inhaled through the nose comes into close contact with the mucous surfaces of the nasal cavities and the sinuses this leads to:

• the inhaled air becoming moist with the nasal mucous membranes drying out,
• the inhaled air being warmed while the venous blood in the turbinate cools down; this venous blood plays a part in cerebral thermoregulation, mainly during phases of deep sleep when the brain is at its most exothermic (TALMANT quoted by COURTY).

Tongue posture is associated with breathing.

Nasal breathing is obstructed if the tongue is between the arches as its mid section closes the upper intersection of the airways; however, in cases of rhinitis, the tongue must be lowered onto the floor of the mouth because if the tip of the tongue is in an upper position this hinders breathing through the mouth.

Two simple tests can be used for breathing diagnosis:

• the ROSENTHAL test,
• the nostril reflex.