Background
Mouth breathing (MB) is defined as breathing through the mouth alone or the mouth and the nose for more than six months. Unfortunately, after managing its mechanical causes, MB may continue due to habit, obscuring the results of surgical correction of nasal breathing and misleading to unnecessary or aggressive maneuvers.
Objective
to develop and evaluate a new test to define children of habitual MB.
Materials and methods
Design: a prospective observational study conducted from May 2022 to February 2023.
Setting
multicenter; outpatient university clinics and a private ENT center.
Participants
577 children aged 2–12 years and complaining of MB during sleep (±daytime) for ≥6 months were assessed for eligibility, 340 were excluded due to a lack of inclusion criteria, 29 declined or discontinued participation, and 208 were enrolled. Of these, 180 gave reliable data.
The test
After about 1 h of the child's sleep, the parent applies one warmed hand to close the child's open mouth recording his awakeness time (AT) for a maximum of 3 min for three nights. On the next visit, the child's examination started for obstruction causes, including endoscopy, and the test results were collected.
Main Outcome and Measures: The AT was compared to examination results aiming to find a significant diagnostic relation. Children with no abnormality in the clinical and endoscopic examination were considered habitual mouth breathers.
Results
Among 94 males and 86 females aged 2–12 years, MB duration ranged from 6 to 42 months, with a mean of 15.9. The home test results were presented by the mean AT in seconds. The awakeness time (AT) could discriminate patients' abnormalities at a cut-off level of