The veloepiglottic sphincter and obligate. Nose breathing in the neonate1

Epidemiology has identified an association between the use of pacifiers and protection from sudden infant death syndrome (SIDS). The use of pacifiers for SIDS prevention fails to gain adoption partly because there is no widely accepted physiologic mechanism to explain the epidemiologic association. Additionally, the scientific literature available on pacifier use focuses largely on the probable adverse effects. We hypothesize that pacifier use and all other forms of non-nutritional sucking (specifically digit sucking, also known as thumb sucking) is a life saving defense mechanism meant to splint open and stabilize the collapsible portion of the upper airway in infants. The main objective of this review article is to propose a mechanism to explain how pacifiers might help prevent SIDS. If the medical community accepts this mechanism, it can help promote pacifier use by the public and potentially reduce the incidence of SIDS.

Childhood oral breathing can alter muscular balance and lead to facial deformities. No articles in the literature have reported on the alteration of facial growth patterns in patients who have received tracheotomies. The purpose of this study was to evaluate craniofacial developmental consequences originating from variations in breathing mechanisms in children who are nasal breathers or oral breathers, and those who have been tracheotomized.

The sample was divided into 3 groups of 10 each. The nasal group had a mean age of 13.9 years, the oral group had a mean age of 12.7 years, and the tracheotomy group had a mean age of 12.8 years. The masseter and suprahyoid muscles were evaluated with electromyography. The following measurements were made: facial, maxillary, and mandibular widths; nasion-sella-gnathion angle; and facial index.

The tracheotomized group was similar to the nasal group for greater activity of the masseter muscles than of the suprahyoid muscles during mastication, as well as in the measurements of facial, maxillary, and mandibular widths. The oral group showed reductions in each category. The tracheotomized group was similar to the oral group during maximum dental occlusion for significantly higher activity of the suprahyoid muscles compared with the masseter muscles, with reductions in vertical values.

A childhood tracheotomy might affect facial development in a way comparable with that of oral breathers, including abnormal facial growth variations.