Nasal Airflow and Nasal

Obstruction
 Introduction
Stimulates respiration and upper
airway dilatory muscle tone via
the nasal-ventilatory reflex
Tongue protrusion and improved
Nasal airflow airway patency via the trigemino-
hypoglossal reflex
Stimulates the genioglossus
muscle

Nasal
patency

Alterations
Neurologic
Exercise of body Pressure Temperature Dentistry
syndromes
position

Baraniuk JN, Merck SJ. Nasal reflexes: implications for exercise, breathing, and sex. Current allergy and asthma reports. 2008 Apr;8(2):147-53.
 The genioglossal electromyogram (GGEMG)

Genioglossal Muscle
• Measured with a pair of unipolar intramuscular electrodes
referenced to a single ground, producing a bipolar recording.

Signal-averaged basal genioglossal EMG plus choanal

and epiglottic pressures for multiple breaths from one
subject for no anesthesia and anesthesia conditions
are demonstrated. Note the fall in EMG and increment
in pharyngeal resistance following anesthesia. The
vertical dashed line indicates the onset of inspiratory
flow.

Basner RC, Simon PM, Schwartzstein RM, Weinberger SE, Weiss JW. Breathing route influences upper airway muscle activity in awake normal adults. Journal of Applied Physiology. 1989 Apr 1;66(4):1766-71.
 Trigemino-hypoglossal–facial reflexes

Tankéré F, Maisonobe T, Naccache L, Lamas G, Soudant J, Danziger N, Bouche P, Fournier E, Willer JC. Further evidence for a central reorganisation of synaptic connectivity in patients with hypoglossal–facial anastomosis in man. Brain research. 2000 May 5;864(1):87-94.
 Nasal obstruction
Sinusitis and posterior
nasal and adenoid
inflammation

May reduce the Collapsibility of the downstream

Nasal Leading to
stimulation of these pharyngeal segment of the
obstruction OSA
mechanoreceptors upper airway

Mechanoreceptors of the Nasal obstruction Mechanical vibration

upper airway

Can cause mouth opening

such as snoring
and breathing
Play important roles in reflex
against negative pressure of
the upper airway Cause dryness of the May cause trauma to
mouth upper airway

May change the activity of Might lower the sensitivity Lower the sensitivity of V3
the genioglossus muscle of the V3 afferent afferent

Shintaro C, Park CS. Establishing a patent nasal passage in obstructive sleep apnea. Sleep Medicine Clinics. 2019 Mar 1;14(1):41-50.
 OSA
Sleep-disordered breathing (SDB)
• A wide range of chronic breathing
problems during sleep from flow
limitation to sleep apnea, obstructive
(OSA) or central (CSA)

OSA
• Repeated episodes of partial or complete
cessation of airflow during sleep

Shintaro C, Park CS. Establishing a patent nasal passage in obstructive sleep apnea. Sleep Medicine Clinics. 2019 Mar 1;14(1):41-50.