(321) Mouth Breathing Correction Reduces Exercise-induced Bronchoconstriction in Adults and Children

Introduction: The premise of this study is that conversion from mouth breathing to nasal breathing will reduce or eliminate the symptoms of exercise-induced bronchospasm in the majority of patients.

Methods: This is a prospective, single arm, non-blinded study involving 50 patients aged 7-64 years who mouth breath during exercise and also have symptoms of exercise-induced asthma. All patients underwent nasal surgery to include uncinectomy, anterior ethmoidectomy, bilateral inferior turbinate reduction, nasal swell body reduction and septoplasty and adenoidectomy as indicated. Pre and 3 month post surgery symptom scores were obtained using NOSE and SNOT-22 scores for Sino-nasal symptoms and the Mini Asthma Quality of Life Questionnaire (Mini-AQLQ) and Exercise-Induced Bronchoconstriction Survey (EIBS) for bronchospasm symptoms scores. The primary outcome measure is the change in the symptom scores of the 4 questionnaires after nasal surgery. Secondary outcome is the correlation between the sino-nasal outcome and bronchospasm symptom scores. Wilcoxon signed rank test and Pearson correlation tests were done using SPSS software.

Results: 33 patients completing the survey; 16 male, 17 female, ages 8-59 (Mean 30 SD 14.8). There is a statistically significant improvement in all 4 metrics after nasal surgery: EIBS (p < 0.001), Mini AQLQ (p < 0.001), SNOT-22 (p < 0.001)and NOSE (p < 0.001). Pearson Correlation testing indicated a statistically significant positive correlation of symptom improvement on EIBS and Mini AQLQ scores with the SNOT-22 and NOSE scores.

Conclusions: Surgical correction of mouth breathing can reduce and/or eliminate symptoms of exercise induced bronchospasm in all ages. There is also a statistically significant correlation between mouth breathing due to nasal obstruction and exercised induced bronchospasm.