CC BY 4.0 · Int Arch Otorhinolaryngol
DOI: 10.1055/s-0044-1785199
Systematic Reviews

The Use of Rhinomanometry in Mouth Breathing: A Systematic Review of the Literature[*]

1   Human Communication Health Post-Graduate Program, Universidade Federal de Pernambuco, Recife, PE, Brazil
2   Department of Speech Therapy, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil
2   Department of Speech Therapy, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil
3   Department of Dentistry, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil
3   Department of Dentistry, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil
4   Department of Otorhinolaryngology, Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, PE, Brazil
2   Department of Speech Therapy, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil
› Author Affiliations
Funding The authors declare that they have not received funding from agencies in the public, private or non-profit sectors for the conduction of the present study.


Introduction Mouth breathing generates imbalances in the musculature, in craniofacial morphofunctionality, and in the stomatognathic system. Therefore, it is essential to make a diagnosis of mouth breathing through the quantitative assessment of nasal permeability, which can be performed through rhinomanometry.

Objective To investigate the effectiveness of rhinomanometry in the diagnosis of mouth breathing in pediatric patients through a systematic review of the literature.

Data synthesis The guiding question was: “Is the use of rhinomanometry as an assessment tool effective in the diagnosis of mouth breathing in pediatric patients?”. We conducted a search on the following databases: Latin American and Caribbean Center on Health Sciences Information (BIREME), Latin American and Caribbean Health Sciences Literature (LILACS), PubMed/Medical Literature Analysis and Retrieval System Online (MEDLINE), Scientific Electronic Library Online (SciELO), Web of Science, and Science Direct. The Health Sciences Descriptors (Descritores em Ciências da Saúde, DECS, in Portuguese) and Medical Subjects Headings (MESH) were combined with the Boolean operator AND in the search strategy: rhinomanometry AND mouth breathing AND diagnosis AND nasal pressure AND nasal airflow AND nasal resistance. Observational cohort and cross-sectional studies that addressed the effectiveness of rhinomanometry in the diagnosis of mouth breathing were included. The reviewers independently extracted the information and scored the review quality based on the Physiotherapy Evidence Database (PEDro) scale and the grading of evidence levels according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Of the 1,536 articles identified, only 3 were selected for the present review after the application of the eligibility criteria.

Conclusion There is great concern regarding the assessment of nasal function. There was a lack of standardization of rhinomanometry to test the effectiveness of nasal resistance as an aid in the diagnosis of breathing mode.

* The data used in this article were taken from the Master's Thesis by CASTELLANOS, Merly Fernanda Illera, entitled “Effect of nasal cleaning and massage maneuver on the permeability of the upper airways of children with mouth breathing,” available at

Publication History

Received: 20 October 2022

Accepted: 22 February 2024

Article published online:
27 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (

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