Glossopharyngeal breathing

PURPOSE: Trained breath-hold divers hyperinflate their lungs by glossopharyngeal insufflation (GPI) to prolong submersion time and withstand lung collapse at depths. Pulmonary hyperinflation leads to profound hemodynamic changes. METHODS: Thirteen divers performed preparatory breath-holds followed by apnea with GPI. Filling of extrathoracic veins was determined by ultrasound and magnetic resonance imaging and peripheral extravasation of fluid was assessed by electrical impedance...

OBJECTIVE: To verify the short-time remolding of upper airway in patients diagnosed with obstructive sleep disordered breathing after Uvulopalatopharyngoplasty (UPPP). METHODS: Twenty-one male adult patients aged 27 to 52 years followed up ranged from preoperation to 6 months after the operation. Lateral cephalometric radiographs (conventional and when pronouncing "i") were obtained 2 weeks preoperatively, 3 days postoperatively, and 1, 2, 3, 6 months after the surgery...

Dive-related injuries are relatively common, but almost exclusively occur in recreational or scuba diving. We report 2 children with acute central nervous system complications after breath-hold diving. A 12-year-old boy presented with unilateral leg weakness and paresthesia after diving beneath the water surface for a distance of ∼25 m. After ascent, he suddenly felt extreme thoracic pain that resolved spontaneously. Neurologic examination revealed right leg weakness and sensory deficits with a sensory level at T5...

OBJECTIVE: The glossopharyngeal insufflation maneuver (lung packing) is largely performed by competitive breath-hold divers to improve their performance, despite observational evidence of fainting and loss of consciousness in the first seconds of apnea. METHODS: We describe here the time course of hemodynamic changes, induced by breath-holding with and without lung packing, in 2 world-class apnea competitors. RESULTS: When compared with apnea performed after a deep breath (100% vital capacity), lung packing leads to a decrease in cardiac output, blood pressure, and cerebral blood flow during the first seconds after the beginning of apnea...

The purpose of this article is to describe noninvasive respiratory management for patients with neuromuscular respiratory muscle dysfunction (NMD) and spinal cord injury (SCI) and the role of electrophrenic pacing (EPP) and diaphragm pacing (DP) in this respect. Long term outcomes will be reviewed and the use of noninvasive intermittent positive pressure ventilation (NIV), MAC, and EPP/DP to prevent pneumonia and acute respiratory failure, to facilitate extubation, and to avoid tracheotomy will be evaluated...

OBJECTIVE: To measure the upper airway of obstructive sleep apnea-hypopnea syndrome by speed CT. We can predict the airway obstruction plane with the airway plane data and compliance in OSAHS patients. Through this measurement, we can provide assistance for clinical diagnosis and treatment. METHOD: This study randomly selected 82 patients diagnosed with OSAHS and 45 cases non-snoring healthy people as control group by the PHILIPS 256-slice CT. The zone volume, sagittal diameter, coronary diameter and cross-sectional area of the narrowest plane in nasopharyngeal area, velopharyngeal area, glossopharyngeal area, hypopharynx area in two groups of quiet respiration and Müller's status were measured...

OBJECTIVE: The purpose of the present study was to compare the unassisted cough peak flow (CPF) of patients affected by muscular dystrophy with CPF augmented by various techniques, including maximal depth glossopharyngeal breathing (GPB) combined with a subsequent self-induced thoracic or abdominal thrust. DESIGN: All of the motorized wheelchair-dependent patients with muscular dystrophy who had previously mastered GPB were trained at home to increase their cough efficacy...

Breath-hold divers report transient, severe neurological symptoms that could be caused by arterial gas embolism after glossopharyngeal insufflation. This technique is often used to overinflate the lungs and stretch the chest prior to breath-holding and can increase the transpulmonary pressure to around 7-8 kPa, so introducing risk of pulmonary barotrauma. Airway pressure, blood pressure and static spirometry (nitrogen dilution) were measured simultaneously in ten subjects attempting to identify individuals at risk...

This article describes noninvasive acute and long-term management of the respiratory muscle paralysis of high spinal cord injury (SCI). This includes full-setting, continuous ventilatory support by noninvasive intermittent positive pressure ventilation (NIV) to support inspiratory muscles and mechanically assisted coughing (MAC) to support inspiratory and expiratory muscles. The NIV and MAC can also be used to extubate or decannulate 'unweanable' patients with SCI, to prevent intercurrent respiratory tract infections from developing into pneumonia and acute respiratory failure (ARF), and to eliminate tracheostomy and resort to costly electrophrenic/diaphragm pacing (EPP/DP) for most ventilator users, while permitting glossopharyngeal breathing (GPB) for security in the event of ventilator failure...

This case report describes the effects of glossopharyngeal breathing on respiration and speech in a patient with tetraplegia due to multiple sclerosis. Glossopharyngeal breathing is a technique where air is insufflated with the glossopharyngeal muscles, to increase vital capacity. Results from follow-up assessments up to 20 months after intervention showed that (1) the patient's speech and respiratory function with glossopharyngeal breathing improved over time, (2) the patient's respiratory function without glossopharyngeal breathing deteriorated over time (possibly because of a severe cold), and (3) at each assessment, the patient's speech and respiratory function was better with glossopharyngeal breathing than without it...

Pierre-Robin syndrome (PRS) is often associated with difficulty in endotracheal intubation. We present the use of percutaneous dilational tracheotomy (PDT) for airway management of a newborn with PRS and a glossopharyngeal web. A 2-day-old term newborn with PRS and severe obstructive dyspnea was evaluated by the anesthesiology team for airway management. A direct laryngoscopy revealed a glossopharyngeal web extending from the base of the tongue to the posterior pharyngeal wall. The infant was spontaneously breathing through a 2 mm diameter fistula in the center of this web...

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Lung volume recruitment can improve peak cough flows and respiratory compliance in patients who either do or do not require mechanical ventilation. There are several lung volume recruitment techniques: air stacking, glossopharyngeal breathing and mechanical insufflation-exsufflation with cough assist devices. The principle of lung volume recruitment is based on the insufflation of air in the lungs after maximal inspiration. In air stacking, a manual resuscitation bag is used for insufflation. Glossopharyngeal breathing requires the use of oropharyngeal and laryngeal muscles by the patient...

PURPOSE: Apnea divers hyperinflate the lung by taking a deep breath followed by glossopharyngeal insufflation. The maneuver can lead to symptomatic arterial hypotension. We tested the hypotheses that glossopharyngeal insufflation interferes with cardiac function further reducing cardiac output (CO) using cardiac magnetic resonance imaging (MRI) to fully sample both cardiac chambers. METHODS: Eleven dive athletes (10 men, 1 woman; age = 26 ± 5 yr, body mass index = 23...

PURPOSE: Extensive breath-hold (BH) diving imposes high pulmonary stress by performing voluntary lung hyperinflation maneuvers (glossopharyngeal insufflation, GI), hyperinflating the lung up to 50% of total lung capacity. Breath-hold durations of up to 10 min without oxygen support may also presume cerebral alterations of respiratory drive. Little is known about the long-term effects of GI onto the pulmonary parenchyma and respiratory adaptation processes in this popular extreme sport...

Punctate reopening of the lung from subresidual volumes (sub-RV) is commonly observed in excised lung preparations, either degassed or collapsed to zero transpulmonary pressure, and in the course of reinflation of human lungs when the chest is open, secondary to traumatic or surgical pneumothoraxes. In the course of physiological studies on two elite breath-hold divers, who are able to achieve lung volumes well below traditional RV with glossopharyngeal exsufflation, we used MRI lung imaging with inhaled hyperpolarized (129)Xe to visualize ventilatory patterns...

Glossopharyngeal insufflation (lung packing) is a common maneuver among experienced apnea divers by which additional air is pumped into the lungs. It has been shown that packing may compromise cardiovascular homeostasis. We tested the hypothesis that the packing-mediated increase in intrathoracic pressure enhances the baroreflex-mediated increase in muscle sympathetic nerve activity (MSNA) in response to an exaggerated drop in cardiac output (CO). We compared changes in hemodynamics and MSNA (peroneal microneurography) during maximal breath-holds without and with prior moderate packing (0...

The aim of the present study was to determine the roles that externally versus internally oriented CO(2)/H(+)-sensitive chemoreceptors might play in promoting cardiorespiratory responses to environmental hypercarbia in the air-breathing fish, Hoplerythrinus unitaeniatus (jeju). Fish were exposed to graded hypercarbia (1, 2.5, 5, 10 and 20% CO(2)) and also to graded levels of environmental acidosis (pH approximately 7.0, 6.0, 5.8, 5.6, 5.3 and 4.7) equal to the pH levels of the hypercarbic water to distinguish the relative roles of CO(2) versus H(+)...

Apnea divers increase intrathoracic pressure voluntarily by taking a deep breath followed by glossopharyngeal insufflation. Because apnea divers sometimes experience hypotension and syncope during the maneuver, they may serve as a model to study the mechanisms of syncope. We recorded changes in hemodynamics and sympathetic vasomotor tone with microneurography during breath holding with glossopharyngeal insufflation. Five men became hypotensive and fainted during breath holding with glossopharyngeal insufflation within the first minute...

BACKGROUND AND OBJECTIVE: Glossopharyngeal insufflation (GI) is a technique practised by competitive breath-hold divers to enhance their performance. Using the oropharyngeal musculature, air is pumped into the lungs to increase the lung volume above physiological TLC. Experienced breath-hold divers can increase their lung volumes by up to 3 L. Although the potential for lung injury is evident, there is limited information available. The aim of this study was to examine whether there is any evidence of lung injury following GI, independent of diving...