The Journal
Several years later, little has changed. Many
children probably still have their tonsils and
adenoids remove simply because they have
incompetent lip posture. Afterward, of course,
the common complaint is that, having had
surgery at great expense, they still appear to be
mouth breathing.
Fig 6 : Showing nasal septum
and enlarged inferior turbinate
In marked contrast to the prevailing views,
Ballard 18 (1957) agreed with Brash 18 (1929) in
saying:
“It is now evident that this open lip posture is not
in any way related to chronic nasal obstruction.
It is not a habit pattern activity induced by
chronic nasal obstruction, it is not lack of tone in
the orofacial muscles; it is in fact an inherited
soft tissue morphology which has normal
tone of the muscles.....”
The claim and counterclaims continue, all
without objective, quantified respiratory data.
19
For example, Ricketts (1968) attributed a
variety of abnormalities to nasorespiratory
impairment that he and several physicians
determined subjectively. A study (James
Bosma; 1963) noted that the mechanism of
pharyngeal airway maintenance is a principal
determinant of the anteroposterior relationship
between the tongue tip and incisors. In fact, the
tongue support musculature also participates in
the function of controlling pharyngeal diameter,
20
particularly the genioglossus.
Fig 7 : Position of the pharynx and the direction of airflow
40
Vol. 14 No. 2
May-August 2018