Park Jason, Benitez Luz, Hamanaka Amethyst, Abbas Ghulam Husain, Faluade Emmanuel, Pouwels Sjaak, Eller Jamie
College of Osteopathic Medicine, Sam Houston State University, Conroe, TX 77304, USA.
Faculty of Medicine, Ala-Too International University, Bishkek 720048, Kyrgyzstan.
J Clin Med. 2025 Jun 25;14(13):4494. doi: 10.3390/jcm14134494.
Even with advanced management involving pharmacologic and ventilatory strategies, respiratory dysfunction increases morbidity and reduces the quality of life. This narrative review examines how craniofacial and cervical manipulative interventions-including nasomaxillary skeletal expansion, breathing re-education, and structural techniques-may holistically optimize airway function by enhancing neurological and lymphatic dynamics, modulating vagal tone, reducing pharyngeal collapsibility, and supporting immune regulation across diverse clinical settings. To explore manual techniques that influence respiratory and autonomic function and to evaluate their reported clinical efficacy and supporting evidence, particularly in the context of airway disorders such as asthma and pneumonia. A narrative review of the literature from PubMed and Google Scholar was conducted using search terms related to airway function and osteopathic manipulative techniques (OMTs). The inclusion criteria spanned 2010-2025 English-language peer-reviewed full-text articles on airway function, OMT, and emergency airway maneuvers. Clinical trials, observational studies, and reviews were included; non-peer-reviewed content and animal studies (unless mechanistically relevant) were excluded. Chapman's reflexes related to respiratory function were incorporated to highlight somatic-visceral correlations. The techniques reviewed included frontal lift, vomer manipulation, maxillary and zygomatic balancing, and cervical adjustments. Thoracic OMT methods, such as diaphragm doming and lymphatic pump techniques, were also addressed. Emergency techniques, such as the BURP and Larson maneuvers, prone positioning, and high-frequency chest wall oscillation, were presented as comparative strategies to OMTs for acute airway management. Craniofacial and cervical manipulations can be a promising adjunct for enhancing airway function. However, the current literature displays heterogeneity and lack of large-scale randomized trials, which emphasize the necessity for standardized research and the establishment of clinical guidelines with the collected evidence.
即使采用包括药物治疗和通气策略在内的先进管理方法，呼吸功能障碍仍会增加发病率并降低生活质量。本叙述性综述探讨了颅面和颈椎手法干预措施，包括鼻上颌骨骨骼扩张、呼吸再教育和结构技术，如何通过增强神经和淋巴动力学、调节迷走神经张力、降低咽部可塌陷性以及在不同临床环境中支持免疫调节，从整体上优化气道功能。旨在探索影响呼吸和自主神经功能的手法技术，并评估其已报道的临床疗效和支持证据，特别是在哮喘和肺炎等气道疾病的背景下。使用与气道功能和整骨手法技术（OMT）相关的搜索词，对来自PubMed和谷歌学术的文献进行了叙述性综述。纳入标准涵盖2010年至2025年的英文同行评审全文文章，内容涉及气道功能、OMT和紧急气道操作。纳入了临床试验、观察性研究和综述；排除了非同行评审内容和动物研究（除非具有机制相关性）。纳入了与呼吸功能相关的查普曼反射，以突出躯体-内脏相关性。所综述的技术包括额部提升、犁骨操作、上颌和颧骨平衡以及颈椎调整。还讨论了胸部OMT方法，如膈肌圆顶提升和淋巴泵技术。介绍了紧急技术，如BURP和拉森手法、俯卧位和高频胸壁振荡，作为与OMT用于急性气道管理的比较策略。颅面和颈椎手法操作可能是增强气道功能的有前景的辅助手段。然而，目前的文献显示出异质性且缺乏大规模随机试验，这强调了标准化研究的必要性以及根据收集到的证据制定临床指南的必要性。
