Nasopharyngeal Manipulation Techniques

Endonasal Balloon Therapy

"Neurocranial Restructuring" (NCR) is often used as an umbrella term for the practice of inflating finger cots through the meatuses of the nose past the turbinates into the nasopharynx. But this is a proprietary eponym like "Kleenex," "Band-aid," and "Jell-O." NCR is a type of endonasal balloon therapy, but not all endonasal balloon therapy is NCR. Within this community, practitioners like Ian Hedley ( http://www.ncr-uk.com/ ), who collaborated with Dr. Mew, and Plato ( http://ncrnyc.com/ ) have popularized the technique developed by Dean Howell ( http://drdeanhowell.com/ ) in the 1980s. However, methods of inflating small balloons through the nose have been around since the 1930s variously called “nasal specific,” “cranial facial release,” “endonasal release,” etc. Howell added proprioceptive testing and body positioning that is supposed to optimize the process. Many conventional chiropractors offer basic endonasal balloon therapy. Self-treatment is possible, but there are real risks including reported cases of bone fractures and asphyxiation on balloon fragments.

From the book Cranial Manipulation Theory and Practice by Leon Chaitow (posted by TGW https://wholebodybreathing.com/community/community/main-forum/cranial-manipulation-theory-and-practice-volume-2/#post-879  ), pages 205-206

The balloon method (‘nasal specific technique’)

A method involving the inflation of small balloons (finger cots) within the nose was developed in the 1930s as a means of altering intranasal deviations or obstructions.

This method employs a minimum of two finger cots (one inside the other), which are inserted into the nasal cavity with the outer one lubricated. The first is secured to the nipple on the bulb of a blood pressure cuff, which is used to inflate them. The inflated cots follow the path of least resistance posteriorly into the nasopharynx.

Dr Douglas Lewis, past head of the Department of Physical Medicine at Bastyr University in Seattle, USA, describes the effect as equivalent to ‘a high-velocity, low-amplitude thrust’ commonly employed in osteopathic or chiropractic manipulation. Lewis has used this method for a variety of problems, including sinusitis as well as opening the nasal passages to enhance breathing. This treatment is ‘not pleasant at the moment of inflation’, according to Lewis, but due to its efficacy, patients frequently request, however reluctantly, for him to repeat it (reported in Myers 2001).

According to Folweiler & Lynch (1995):
It is common for the patient to hear ‘cracking’ or
‘popping’ sounds within the skull during the
technique. Occasionally, they can be perceived by
the practitioner. Tenderness following the
treatment along the median palatine suture and
other facial sutures is common, persisting for a few
days after treatment. Epistaxis (nose bleed) can
occur, but is not commonly long in duration nor
large in volume.

The ‘balloon’ treatment is primarily employed for chronic sinusitis and other nasal complaints. ‘The nasal specific technique, when used in conjunction with other therapies, may be useful in treating chronic sinus inflammation and pain,’ speculate Folweiler & Lynch. They go on to hypothesize as to the mechanism of such relief:

Numerous theories could be used to explain the
benefits of the nasal specific technique for chronic
sinusitis. One such explanation may be the direct
elimination of mucus from the nasal passages by
the force of the inflated cot, thus reducing pressure
and pain and allowing increased sinus and nasal
drainage. It is also possible that pressure against
the thin, slightly pliable bones surrounding the
sinuses allows equalization of pressure in the sinus
to that of the atmosphere. It is also possible that a
neural reflex exists by which the nasal specific
technique causes mucous thinning and/or altered
discharge. Manually compressing edematous
tissues may result in a vascular response that leads
to normalization of function. 

Additional Links:

http://www.observedimpulse.com/2014/12/the-benefits-of-craniofacial-release.html

https://wholebodybreathing.com/community/community/case-discussions/endonasal-technique-1st-session-complete/#

https://wholebodybreathing.com/community/community/main-forum/may-need-to-stop-endonsal-acute-pain/#

http://www.nasalspecific.com/

http://breakthematrix.createaforum.com/therapies/cp%27s-ncr-endo-nasal-balloon-results/

http://breakthematrix.createaforum.com/therapies/attempted-nasal-release/

http://breakthematrix.createaforum.com/therapies/guide-to-self-ncr-and-face-pulling-anyone/msg2712/#msg2712

https://www.youtube.com/watch?v=oizUlEBT7YM

Manual Myofascial Release

The only place I have seen this practice described is this blog post ( http://www.observedimpulse.com/2015/05/intraoral-myofacial-release-for.html ) at Observed Impulse by Dr. Jared Edward Reser, recommended by @greensmoothies (  https://wholebodybreathing.com/community/community/case-discussions/a-better-anchor-for-the-whole-tongue-for-mewing-imho-it-will-cut-by-half-or-less-the-time-it-takes-to-seeing-result/#post-10622 ). Using fingers and thumbs to press through the mouth on the soft palate and beyond the uvula into the nasopharynx is clearly less recognized than endonasal balloon therapy, but I think it might be a better place to start for many people since it is less fiddly and you feel more in control than using the pressure bulb and finger cots. I began experimenting with it after I had already gotten proficient with self-treatment using endonasal balloons. However, I found that consistent manual work has helped desensitize my gag reflex, making it less reactive during endonasal balloon inflations, allowing for better expansion.

Myofascial Release for the Nasopharynx, and Soft Palate

The Tension Behind Your Face

You have a large muscular knot behind your face. This knot becomes tighter every time you feel stressed. It also becomes tighter when you are in social situations. It makes you wince and grimace and it gets worse every day because it is never touched, massaged or released. Worse yet, the tension accumulated from years of misuse makes the muscles ache, sending pain and panic signals to your brain. Ischemic compression, soft tissue mobilization and myofascial release are very popular remedies now. Here I am advocating that you perform this specifically for your nasopharynx. It is painful at first but it is easier every time and it only takes a few weeks to completely get rid of the pain. Afterwards your face feels amazing, you feel much calmer and have much more social composure.  Here, I will explain how to provide myofascial release for the tonsils, the uvula, the palatopharyngeal sphincter, and the nasopharynx.

 

How to Get the Knot Out

I recommend that you provide compression and self-massage to your nasopharynx. You do this by donning a plastic glove, putting your thumb into your mouth and up into your nasopharyngeal opening in the back of your throat. To find this opening you want to feel the roof of your mouth, traveling away from the teeth and towards the area where the hard roof of the mouth (hard palate) turns soft (soft palate). An inch posterior to this border is the uvula, the hanging fleshy structure and just behind the uvula is the opening of the nasopharynx. The nasopharynx is an invagination that you want to explore and massage using either your left or right thumb. You insert the finger into the mouth, with the fist pointed to the sky, as if you were sucking on your thumb. If you have never done this before the opening will feel tight and painful, and pressing against it will initiate a gag reflex. The best way to get through this is to always perform the soft tissue release while breathing diaphragmatically, preferably to a breath metronome. The discomfort that you feel when stimulating this area is proportionate to the pain signals that this area sends you every day, throughout the day. This was the single tightest and most painful muscle in my body, and it was also the easiest and quickest to rehabilitate. Suck it up, and massage it, you will be glad that you did.

With your thumb inside your nasopharynx you can place strong pressure on many muscles and soft tissues throughout the nasopharynx, and nasal cavity. You want to press against each of the walls and folds of the nasopharynx and even up into the nasopharyngeal ceiling. When you start out, simply insert the thumb past the first knuckle and keep it still. It will be uncomfortable and it will feel sore as if you have an infection. It feels like an itchy, scratchy sore throat. Next try to swallow a few times and feel the nasopharyngeal sphincter tighten and loosen around your thumb. The first few times this is very uncomfortable but it should be painless within a week. Next you want to gently press your thumb into different areas, massaging the soft tissues, stimulating the nerves, reducing tension in the accompanying muscles and brining needed blood to the area. I recommend doing this for five minutes a day, five days a week. Within the first week you will notice that it is less painful, that your face feels calmer all the time, that you breathe better, that mucus clearance is easier, and that your face actually looks more aesthetically pleasing.

The main muscle that you want to rehabilitate is the nasopharyngeal sphincter. The padded side of your thumb (without the finger nail) will come into contact with this anterior muscle. You want to grab it firmly and flex it rhythmically in order to exercise it and gain conscious access to it. Doing this helps you know how to use it and how to relax it. Do this at the most inferior portion (near the opening of the nasopharynx) and the most superior portion (a lip of muscle near the roof of the nasopharynx). For me the superior portion was the most painful and it took a week to remove all of the pain from it.

 

Why This is Helpful

While reading about orofacial pain disorders I began to think about the tension behind my own nose and eyes. I figured that a strong form of stimulation could increase the circulation to my nasal tissues, alleviate the trauma that they held, and help reduce the tone in my facial musculature. My nose was broken 15 years prior (at age 17) and was numb and painful at times. I really felt like my nasopharynx was a tense rock in the middle of my head, and I hoped that myofacial release could help me better incorporate it into a calm, healthy facial posture.

I am convinced that soft tissues in this area can become traumatized due to stress, cold, physical injury, sickness, or undue tension and then remain excessively tonic (tense) so that: 1) circulation decreases and inflammation increases, 2) the muscles atrophy and undergo “adaptive muscle shortening,” 3) the neurons in the area relay pain messages to the brain, and 4) this causes the muscles to become excessively tense further exacerbating the psychological stress. I am also convinced that reduced circulation diminishes the immunological response rendering these tissues more susceptible to upper respiratory tract infection. I believe that firm pressure, applied to these soft tissues (that are rarely, if ever, stimulated), reverses these four degenerative processes.

The stimulation and physical compression of the tissues helps to reduce past trauma, and in my opinion is much like massaging a sprained ankle. Massage and isometric stretching is really the only way to return the ankle to its premorbid state. Of course it is painful to massage, but compressing the muscles is the best way to reduce their tone. The fact that the muscles and soft tissues deep in our nasal cavity are never stimulated allows them to “remember” past trauma. They become a “somatic anchor” deep within the face for pain. Each time you do this the treatment becomes less painful. One of the reasons we hold tension here is because we are afraid to breathe through our nose and mouth at the same time in front of other people. We are afraid that we will look “too” calm to others. Once the area is no longer painful, this look becomes authentic and breathing using both the nose and mouth simultaneously becomes preferable.

 

I believe that this technique has the potential to help anyone, but may produce the best results for people that focus concertedly on remaining calm before, during and afterwards. Influencing how your brain interprets intense forms of stimulation is incredibly important to how your body copes with them. The way that you breathe surrounding an injury helps the body to appraise the injury and determine how best to deal with it. I recommend making calm a priority after the procedure and attempting to breathe diaphragmatically, employing deep breathing exercises. I would recommend doing this at home, before sleep or a rest. I do it a few times a week and it is the last thing I do before I go to bed.

After applying pressure to these areas you become aware of muscles and tissues behind your face that you never noticed before. The first time I laid down for several hours with my eyes closed in order to focus on the accompanying sensations. You feel these muscles tighten and release after the procedure. While this happened I tried my best to memorize what it felt like for these areas to release and I tried to keep them relaxed. Simply turning your attention to these sensations builds somatotopic and musculotopic maps in the cortex which help you sense and control these areas. I believe that after using the technique people want to build these cortical maps so that they can notice when these areas become tight later. As I did this I used other facial muscles, flaring and constricting my nostrils, in an attempt to link these new cortical maps to existing ones. It would be interesting to follow the efferent nerve pathways from these areas up into the brain. Pain signals originating in the nasal cavity are probably sent to subcortical threat/stress areas such as the amygdala, and end up in cortical ones such as the anterior cingulate cortex, and the insula.

After the procedure I went on a long walk and I noticed that my face felt surprisingly calm. As I passed people on the street I was worried that perhaps I would appear “too” calm. I realized that I should embrace the calmness and try to take full advantage of my current state and really focus on allowing my face to remain placid. I focused on breathing deeply and evenly, with eyes wide while looking upwards. I figured that if I practiced this over the course of a few days it would look natural. It really did. I no longer have a perpetual pained and fearful expression on my face and I no longer look like someone who had their nose broken violently. It does have a cosmetic or aesthetic component and definitely helped me to develop a more relaxed countenance.

Try probing your nose with q-tips. Again, at first this was very uncomfortable but became much less painful with time. I didn’t press very far but would make circles with the q-tips just past my nostrils while breathing deeply. Afterwards you want to think about how to build this relaxed nasopharyngeal posture into your normal day-to-day facial posture.

 

Comments

JustAYogini May 27, 2015 at 6:41 PM
I'm just a Yogini, sharing my experience:

Re: Getting the Knot out

I find that the use of a plastic glove is inhibiting, so just to be a rebel I continued this exercise without it. Once I got to the hanging fleshy section I didn’t feel any pain, I felt a repetitive pressure and gentle release. Very similar to a deep yawn; my eyes would lightly water, and my ears would, for a lack of better words, “pop”! Mind you, I haven’t done this exercise before, so I was expecting a bit more discomfort. As soon as I started pranayama (with my thumb in position) I began to salivate. The pressure would become less intense, but I would get a little light headed (a similar kind of euphoria I would experience if I was high on an Indica).
While moving my thumb around against walls of the nasopharyngeal I definitely feel an itching sensation. I wouldn't describe it like a sore throat, as I do usually experience intense pain associated with the sore throats I get. Again, no pain while doing this exercise. Swallowing was a challenge for me. It was almost as if my mind didn’t trust my body for putting it in this position. It took a while (like 3 whole minutes of pranayama), but I finally relaxed enough to swallow and really feel my thumb be kissed by the nasopharyngeal sphincter. However, after the third swallow my gag reflex would kick in and I’d pull my thumb out and start over.
Attempting to grab the nasopharyngeal sphincter with my thumb (in which I was simply using more force in pushing that area while bending my thumb knuckle was extremely painful, mainly because my nail (though on the south end) extended past my finger and when I bend my knuckle deeper it would (basically) feel like a sharp and piercing stabbing sensation. I’m too vain (or practical) to cut my nails (I got a manicure last week); they will however, break in a week or two and I will try again then.

Re: why this is helpful
I find that I don’t fear appearing too calm to others, as I do hearing others say to me, “what’s wrong”, when my face is calm. Don’t they know, to hold the face in a smile or frown takes more energy and causes more tension? So of course to combat the “what’s wrong?”, I systematically smile and (usually) kindly respond with, “Nothing, why?”. I often get a response like, “you just looked, I don’t know, quiet.” To which I respond with “I’m wonderful, thank you” or honestly tell them what I’m feeling in that moment; which they usually don’t really what the answer to. I then almost automatically take a several deep diaphragmatic breaths, to get back to a state in which I am most comfortable…peace.

 

christopher tracy March 16, 2017 at 1:17 AM
Ding ding ding!! Bravo. Once in a blue moon I'll google related terms to see if anyone's caught onto this yet. And you're the first! 🙂 Only, it can be taken much, much further.

Long story short, I've been doing this going on ten years. But deeper. More thorough. There are all sorts of goodies in there once you train them to let you in.

First off, I'll echo what someone else mentioned. Ditch the rubber glove. This is what you'll need:
Nails clipped down to nothing.
A cloth to wipe up your slobber (eww but whatever).
Your thumb, middle and index fingers moistened with your own saliva.
That's it.

You're going to need to gain the trust of those internal muscles (especially if you're going deeper), and the gloves will get in the way of that. It's also easier to gain a more intimate feel/knowledge skin-on-skin. (as Def Leppard probably put it).

The other thing not mentioned, and to me it was the motivating force and is easily the greatest gain from these techniques, even beyond the stress relief, is the benefit to the speaking/singing voice. An mis/undiagnosed major voice disorder/structural issue took my voice from me for many years. After an adjustment (long story) it was regained, but I was left with major tension throughout my nasopharynx, face and throat. It was through sheer desperation that I eventually stuck my finger in as far as I had to, to find the source of the bruised, tense, gripping feeling deep inside my head. From there it was a learning process.

I fully restored my voice to almost effortless perfect pitch, from very deep to high falsetto without need of additional exercise or even warm-ups. The richness that can be restored to, or gained by, a voice using these techniques cannot be overstated. Range as well.

Without getting into it the whole of it, there is one giant element I will share with everybody. It takes time, but eventually you'll want to use your index finger and thumb, to go up PAST the uvula (index further deepest) to be able to squeeze the entire soft palette between your thumb and index finger, including the uvula. Yoweee it will hurt. And it'll take some training and time... but oh my goodness. As some of you may know, any time you can get around to both/all sides of a muscle and squeeze it... you can do a tremendous amount of good. Again, baby steps.

But there's more to be done to get the full benefits.

Dr. Reser, if you'd be interested in hearing more of the details, in an effort to further your studies and spread the word on this, I'd be glad to share with you what I've discovered over my many years of experimentation.

My few attempts to enlighten a person or two on this have fallen on deaf ears. One myofascial guy I was seeing was really intrigued and interested and had a patient who would benefit, but I'm not even sure he passed what I told him along, and certainly didn't come back to me for any more info. I'd love for more people to know about this, but I don't exactly have the credentials to advance the cause.

People who've never sung a day in their life, or think they're tone deaf, may in fact be able to sing like little angels. Naturally. Intuitively. By simply softening up all of these tense, overworked, never-ever-thought-about-let-alone-paid-attention-to muscles. In addition to the stress relief described in the article.

And bravo, as well, for the descriptions of the pain processes in dealing with these areas. Very accurate.

So Dr. Reser, let me know if you'd like to be in touch. Glad to see someone in your position addressing this.

Thanks.

 

christopher tracy March 16, 2017 at 1:41 AM
I'll add a couple more things...

Fascinated by your article regarding tension in the lower eye lid. ( http://www.observedimpulse.com/2012/10/ideal-eye-posture-relaxing-lower-eyelid.html) A revelatory way to look at it.

Similarly, related to the intraoral, many people are aware of tension in the jaw. But I've come to realize the importance of what I call the "top jaw"; the muscles/tissues/etc holding the palette from above. It's a similar experiential epiphany, and helps in letting go of some of that internal unconscious "holding", and allows an awareness that helps in getting a good stretch of these neglected areas.

And along the same lines, and again in particular to voice function, I've come to think of the soft palette as almost a "second tongue". As odd as that sounds. But once it's softened (and mine needs near CONstant attention), and once you can hear and feel its implications for voice, you really begin to understand how the two of them work together (or can) to produce and shape sound. It's almost a new instrument, with the amount of subtlety that can be gained.

The way you described the lower eye lid and its tensions made me think you'd understand these aspects of this subject.

Again, thanks.

Additional Links:

https://wholebodybreathing.com/community/community/case-discussions/my-routine/paged/5/#post-11414  

Structural Integration

Structural Integration was developed by Ida Rolf, and like Mewing, her name became a verb. Rolfing is a form of body work that uses deep manual therapy intended to effect body posture and structure over the long term. I've never had it done. Each of the ten sessions in the classic series has a different structural goal. The seventh session in the series is typically the last of the "core" sessions before moving on to the "integration" sessions, and is devoted to the shoulders, neck, and head, including mouth and nose work. The intranasal component involves insertion of the practitioner's little finger in the client's nostril very gradually, allowing the structures to open up. The blog Theresa's Ramblings (  http://www.theresazordan.com/blog2/?p=84 ) has a good description:

You can pick your friends. You can pick your nose. But you can’t pick your friend’s nose. Unless you’re a Rolfer.

Hey there! Today we’re talking about the weirdest thing Rolfers do, which is saying a lot, considering just how weird Rolfers are. And that strange thing is nose work, or intranasal work. Traditionally, this is done in the 7th hour of the 10-series, along with some work inside the mouth.

First, let’s talk a bit about the 7th session. This session is devoted to the “upper pole” or the top of the thorax, the neck, and the head. The goal is to create space front to back, differentiating the visceral cranium, or the face and the associated tongue, throat, and viscera (guts), from the neural cranium, or the back of the skull and the associated brain and spine. This session is the last of the four “core sessions” before we move on to the “integration sessions” of 8, 9, and 10. And since it’s the last core session, we Rolfers decided to go out with a bang and stick our pinky fingers into our clients’ noses.

We wear gloves for this, but let’s be honest, that doesn’t really make it any less strange. While the mouth work is odd, we’ve all been to the dentist and are somewhat familiar with having someone else’s fingers inside our mouths. Nose work, on the other hand… What can I say? It’s just plain weird.

Also, in my opinion (again, I’m a Rolfer), it’s totally awesome. I love receiving nose work. It makes my head feel spacious and open. It feels like my sinuses are cleared out afterwards. I feel like my peripheral vision has just been polished and shined and I can see twice as much. I can breathe easier. In fact, I want some nose work right now. Too bad the dog isn’t a Rolfer. But I digress.

Mouth and nose work can also be emotionally intense. Our face is where we express to the world all of our emotions. Sadness, grief, anger, joy, excitement, fear, nervousness, regret, apathy, frustration, and the like all come out, hopefully, through our face. Every issue we have around eating, or not eating, starts here, at the mouth. The throat chakra is smack in between the heart chakra and the third eye, or the head chakra. It’s where your will rests, and until you can get your head and your heart to agree, your will is going to have a hard time making itself known.

It’s not all emotional roller coasters and sinus clearing, though. Intranasal work can be super helpful for people suffering from chronic headaches and migraines. The intraoral (mouth) work can be great for TMJ sufferers. And since you already know, as an A+ Rolfing client, that everything in the body is connected via the fascia, you also know that work in the cranium can affect everything else in the body, all the way down to the bottoms of your feet. Which is pretty crazy. But not as crazy as having someone else stick their fingers in your nose.

From the book Cranial Manipulation Theory and Practice by Leon Chaitow (posted by TGW https://wholebodybreathing.com/community/community/main-forum/cranial-manipulation-theory-and-practice-volume-2/#post-879 ), pages 204-205 

Intranasal work is a method which is sometimes applied during the 10-session series of structural integration processing developed by Dr Ida Rolf (Rolf 1976). Rolfing has an objective of ‘whole-body’ structural integration and would not focus specifically on a region (such as the nasal/sinus structures), but would commonly include such structures in its overall approach.

Other schools, including some neuromuscular therapy (NMT) training organizations, are developing this work, according to Rolfer Tom Myers (2001). Myers writes:

Dr Rolf died in 1979 and the history of how
intranasal work came to be included in the Rolfing
series is not clear. Dr Rolf herself acknowledged
yoga and osteopathy as the two main taproots for
her work. Yoga, as she practiced it earlier in her life,
included ‘kriyas’ or cleansing practices, one of
which reportedly involved passing a cloth through
the nasal passages. More likely the source of the
nasal work was seminars that Ida Rolf took with
William Sutherland DO, the founder of cranial
osteopathy.

Myers suggests that employing intranasal techniques should ideally involve prior preparation of the client’s connective tissues and that the technique may be contraindicated in cases of current acute sinus or other pharyngeal infection, recent facial trauma, the use of anticoagulant drugs, hemophilia or patients on the extreme end of psychophysiological sensitivity, as well as anyone habitually using (‘snorting’) cocaine. Additionally anyone employing any technique which enters any body orifice needs to confirm their legal scope of practice in the state/country in which they work. For example, it is illegal for some therapists, in some areas of the United States, to enter any body orifice of the patient, with or without consent. Description of these methods should not be seen as a recommendation for their use without specific training.

The structural integration method Myers (2001) reports:

In structural integration [i.e. Rolfing] practice, intranasal
work is done with the little finger, gloved and
lubricated, with great sensitivity and concentration,
with ultimate slowness and client communication
and only after the entire rest of the body has been
prepared for this work by detailed myofascial
processing. The direct purpose in introducing a
finger into the nose is to widen, open and loosen
the soft tissues surrounding the nasal cavity.

Once into the vestibule, the finger encounters the
‘gate’ around the nasal passage, formed by the
maxillary bones laterally and inferiorly and the
nasal septum medially. When the vestibular gate
has ‘melted’ open (forcing is neither called for nor
advisable), the fingertip emerges into the wider
chamber of the nasal cavity. In the deeper part of
the nasal passage, the vomer bone, rather than the
cartilaginous nasal septum, forms the medial wall
and the palatine bone forms the floor behind the
maxilla. Superior to this are the nasal conchae as
well as the nasal and lacrimal bones. None of these
bones are touched directly. It is the contention of
structural integration and the rationale for this part
of its technique library, that the tendency is for
these turbinates to migrate medially, thus reducing
such contact and rendering the inner passages,
between the turbinates and the septum, less open.
This compels more reliance on the outermost passage,
between the first turbinate and the maxilla, though
this passage may also be reduced in the general
narrowing of the facial structure. Thus the idea in
the intranasal work is to move the turbinates laterally
away from the septum. The turbinates are located
not only one above the other but one behind the
other, so that they would be encountered
sequentially by the practitioner’s finger.

An additional focus of the method is evaluation of the position of the turbinates, ‘the doors to the facial sinuses’. The (anecdotally) reported efficacy of enhanced sinus drainage by means of intranasal work is a principal justification for its application.

Myers also reports that he:
… has found many deviated septa to be responsive
to treatment, with the results of increased opening
being very gratefully received by clients. The
cartilage, we must admit, occasionally crackles
disconcertingly when directed toward the midline,
but we have had no reports of post-session pain or
disturbance related to these sounds. Intraosseous
strain within the vomer caused by cranial torque or
shear forces can also be eased by sustained
attention in this direction.

Particular caution also applies to such treatment methods when they involve the extremes of very young or elderly nasal structures, where immature or degraded cartilage may make such an approach unwise or even dangerous.

Khechari Mudra

Khechari mudra is an advanced yoga practice that involves extending the tongue behind the uvula above the soft palate into the nasopharynx. For most people, this is impossible without months to years of exercises that stretch the lingual frenulum, and some resort to frenectomy procedures. The first stage of khechari mudra, sometimes called nabho mudra, is more achievable for most practitioners, and involves tenting the tip of the tongue up against the soft palate behind the posterior edge of the hard palate. This is as far as I have gotten. With practice it gets easier to reach farther back without strain. Talabya Kriya is an exercise to increase the reach of your tongue, which involves clicking the tongue on the palate with the mouth open and then extending the tongue down toward the chin. There are also recommendations to hold the tongue with a cloth and stretch it in various directions, or to use a "milking" motion with the fingers to elongate the tongue.

Here is a basic explanation from Advanced Yoga Practices ( https://www.aypsite.org/108.html ):

Kechari mudra is a subject of increasing discussion and debate these days. It is a good sign. It means it is coming out of the shadows of esoteric yoga and into the early morning sunshine of this rising new age of enlightenment.

What is kechari mudra? Let's put it in terms that we can easily relate to. A centimeter or two above the roof of our mouth is located one of the most ecstatically sensitive organs in our whole body. It can be reached relatively easily with our tongue. It is located on the back edge of our nasal septum, and when the nervous system is purified enough through advanced yoga practices, our tongue will roll back and go up into the cavity of our nasal pharynx to find the sensitive edge of our septum. When this happens, it is like a master switch is closed in our nervous system, and all of our advanced yoga practices and experiences begin to function on a much higher level. When kechari is entered naturally, we come on to the fast track of yoga. It is the major league of yoga, if you will.

Ramakrishna said, "When the divine goddess comes up, the tongue rolls back."

Many have experienced this natural phenomenon at times in their yoga practices. When the nervous system is ready, it just happens. The tongue wants to go back. But few are able to follow though, and this is just a matter of education. If strong bhakti is there and the tongue is rolling back, it is a short trip to make the connection in the pharynx to a higher level of spiritual experience.

Not many people on earth today have made this important transition in yoga. However, it is likely that the number of people entering kechari will increase dramatically in the coming years. As this happens, it will be a giant leap forward for humankind, for it will mark humanity's shift to a predominantly spiritual mode of functioning of the nervous system. This will bring with it the many benefits of rising enlightenment spreading out through our modern society. Kechari is that significant, that powerful, and that indicative of where the human race is heading. Only a few yogis and yoginis in kechari can have a huge effect on the spiritual energies in everyone. They radiate energy that quickens the rise of the enlightenment process in all. So, while kechari is an individual phenomenon on the road to human spiritual transformation, it has global implications, as do all of our advanced yoga practices. As Jesus said, "You are the light of the world."

But enough about the spiritual destiny of the human race. What about each of us, and our relationship with kechari?

Since kechari was first mentioned in the lessons some time ago, several have written about having the early symptoms of it, wondering what to do. "Should I stop the tongue from rolling back?" "Should I proceed? And, if so, how?" These are the questions that have been asked.

If the tongue is rolling back and we feel we are getting ahead of ourselves, there is no rush. If we have doubts or excessive kundalini experiences, it may be best to wait. It is the application of self-pacing, you know. Only you can know when the time is right. No one can tell you when it is time to go for kechari, or for any other advanced yoga practice. Your experiences and your bhakti will be your guides.

Even though we are talking about a journey of a couple of centimeters, kechari is a big undertaking. Not so much physically, though there is some physical challenge, but more so in the psyche and the emotions. Kechari is a big deal. It goes to the core of our spiritual identity. Are we ready to close a neurological switch that will transport us to a higher plane of existence? It is not that we are changed instantly and forever. It is not like that. The day after we enter kechari for the first time, we are still the same person. We may even stop doing kechari if we entered prematurely. No harm done. Kechari has its "clunky" stage, just as all advanced yoga practices do. It takes some determination to get through the awkward beginnings of kechari.

We are not instantly a different person the minute we start kechari. Only in time with daily practice are we changed, and this will be a substantial change. In a real way, we have become a different person before we enter kechari. The decision to do it is the crossover as much as the act is. In this sense, kechari is more than a physical act. Deciding to do kechari is a recognition of the nervous system being ready for the next level. The nervous system tells us when it is ready. We have become kechari even before we enter it. Isn't this true with all advanced yoga practices we undertake? We feel ready. We begin the practice. If we are in tune with our nervous system, the practice will stick. If we are premature, there will be roughness and we will have to back off. This is okay. It is how we test and find our openings to move forward in yoga. Kechari is like that too. Only with kechari, we are doing a bit more to get into it, and the experience is pretty dramatic, so it requires strong motivation to do it - strong bhakti.

Kechari means, "To fly through inner space."

This sounds poetic and dramatic. Yet, kechari is much more that that. It is much more personal than that. Regular practice of kechari takes us into a permanent lovemaking of polarities within us. The effects of kechari exceed those of tantric sexual relations as discussed in the tantra group. This is amazing because kechari involves no external sexual activity at all. Kechari is one of the great secrets of enlightened celibates. Not that celibacy and kechari have to go together. Anyone can do kechari and continue in normal sexual relations. But if one chooses a path of celibacy, then kechari, along with other advanced yoga practices, will provide more than enough cultivation of sexual energy upward in the nervous system. It is a
natural internal process that comes up in us.

With kechari do we "fly though inner space?" The greatest part of the kechari experience is the rise of ecstatic bliss. The senses are naturally drawn in and it is like we are flying inside. Our inner dimensions are vast, and we soar through them in a constant reverie.

The connection we make near the top of the sushumna, ida, and pingala in kechari is an ecstatic one that brings ecstatic conductivity up in the nervous system more than any other practice. Every other advanced yoga practice then becomes increasingly effective at doing the same thing - raising ecstatic conductivity. So kechari is an ecstatic connection that illuminates our entire nervous system. The sensitive edge of the nasal septum is an altar of bliss. The more time we spend there, the more bliss we experience. Kechari is the perfect companion for sambhavi. The two practices complement each other. Together, sambhavi and kechari draw divine ecstasy up, filling us with divine light.

Advanced yogis and yoginis use kechari continuously throughout their sitting practices, and often during the day when not engaged in conversation. In other words, kechari is home for the advanced yogi and yogini. We do not even know that they are in kechari. Only the subtle glow of divine light gives them away. Inside, they are in the constant play of divine lovemaking.

We will cover four stages of kechari here (see Image for sketches), all pertaining to the location of the tip of the tongue:

Stage 1 - To the point on the roof of the mouth where the hard and soft palates meet. This is the line of demarcation that must be crossed before stage 2 can be entertained.

Stage 2 - Behind the soft palate and up to the nasal septum. It is a short trip, but a momentous one. Initially this is done with help from a finger pushing back under the tongue, going to the left or right side of the soft palate where entry is easiest. This may require "breaking the hymen" of the membrane under the tongue. See below for more on this.

Stage 3 - Gradually working to the top of the nasal pharynx and septum. This takes us to the bony structure containing the pituitary gland.

Stage 4 - Entering the nasal passages from inside and moving upward beyond the top of the pharynx toward the point between the eyebrows. It is not as far for the tongue to go as it seems. Put your thumb on the hinge of your jaw and put your index finger at the tip of your tongue extended straight out. Then pivot the fixed length to your index finger up on your thumb to the point between your eyebrows. See? It is not so far for the tongue to go straight up from its root.

Many years may pass between stage 1 and stage 4. Kechari is a long-term evolution, not an overnight event, though it certainly has its dramatic moments of transition, especially between stages 1&2 and stages 3&4. Now let's look at the four stages in more detail.

Stage 1 puts us in contact with the bottom of the septum through the roof of our mouth. This has already been suggested as a goal to work toward in the lesson on yoni mudra kumbhaka. Some ecstatic response can be felt at the point where the hard and soft palates meet if the nervous system is rising in purity. Stage one is not easy, as it takes some effort for most people to keep the tongue on the roof of the mouth and work it gradually back over time. A habit gradually develops. Once the tip of the tongue passes the point where the hard and soft palates meet, and the soft palate can be pushed up with the tongue, then stage 2 is close at hand.

Stage 2 is very dramatic. The tongue is pushed back with a finger to the left or right side of the soft palate. These are the shortest pathways leading behind the soft palate. One of these will be shorter than the other. At some point you will experiment and see for yourself. The long way in is up the middle. The soft palate has an elastic tendon running across the back edge. When the tip of the tongue gets behind it for the first time, the elastic tendon can slip quickly around the bottom of the tongue as though grabbing it. Then the tongue is suddenly in the nasal pharynx and touching the edge of the nasal septum for the first time.

The first reaction is surprise, and the tongue will probably come out quickly. It is easy to pull out. No finger help is needed. It is also easy to breathe through the nose with the tongue in the nasal pharynx. On the first entry, the eyes and nose may water, there could be sneezing, there could be sexual arousal, and strong emotions. All of these things are temporary reactions to the event of entering stage 2 kechari for the first time. Upon repeated entries, things settle down. In time, the finger will no longer be needed to get behind the soft palate. The elastic tendon across the edge of the soft palate stretches out and stage 2 kechari becomes quite comfortable. In fact, it is easier to stay in stage 2 kechari than to stay in stage 1 kechari. The tongue rests very easily in the nasal pharynx with no effort at all, making it simple to use during pranayama and meditation. The tongue is obviously designed to rest blissfully in the nasal pharynx.

There are two practical matters to consider once in stage 2 kechari. First is lubrication in the pharynx. Second is the accumulation of saliva in the mouth.

The pharynx can be a little fickle. Usually, it is naturally moist and well lubricated for the tongue. Occasionally it is dry and not so well lubricated. In the former situation, kechari can be practiced practically indefinitely. In the latter situation, only sparingly. When the pharynx is dry there can be a stinging sensation when the tongue is in there. So, this is not the time to do kechari. We just go to stage 1 when that happens. Interestingly, the pharynx will almost always be moist during practices. But there is no telling for sure. We just go in when we are welcome, which is most of the time. And when we are not welcome, we honor the situation and refrain. Like that.

When we are up in stage 2 kechari, saliva will accumulate in the mouth down below. Since we can't swallow what is in our mouth with our tongue going up into the nasal pharynx, and we don't want to drool, then we come out of kechari as necessary to swallow the saliva in our mouth. In the early adjustment period to stage 2 kechari there can be a lot of saliva, so we will have to swallow more often. In time, the saliva goes back to normal levels, and coming out of kechari to swallow will become infrequent.

So, in stage 2 kechari, we are just letting our tongue rest easily on the edge of the nasal pharynx, and that sets spiritual processes in motion everywhere in our body.

In the beginning of stage 2 kechari we will be curious. We are in a new place and want to find out what is in the pharynx. There is the sensitive septum, the "altar of bliss." We have no problem finding that, and realizing that the best way to do pranayama and meditation is with our tongue resting on the septum. It is like having a powerful siddhasana working simultaneously on the other end of the spinal nerve, awakening our entire nervous system from the top end. When we are not enjoying bliss at the septum, we will no doubt explore, finding the prominent "trumpets" of the eustachian tubes on either side of the nasal passages. We also can't miss the entrances to the nasal passages on either side of the septum, and quickly find the extremely sensitive erectile tissues inside them. Too much. Better stay away from those for a while. So, we go up the septum on our journey to the top of the pharynx, to stage 3. For some this is a short journey. For others, it can take a long time. In going there we expose the full length of the edge of the septum to our tongue, and prepare ourselves to eventually enter the nasal passages and go higher.

A practice that can help as we go beyond stage 2 kechari is the so-called "milking of the tongue." It consists of gently pulling on the tongue with the fingers of both hands, alternating hands, as though milking a cow. A good time to do this is for a few minutes while standing in the shower each day. That way you can get the benefit of it without slobbering all over your clothes. Over time, the tongue can be lengthened by this method. This is not a very useful practice for getting into stage 2. Dealing with the frenum is most important for that, as discussed below. Milking the tongue is helpful for going beyond stage 2 kechari, especially in stage 4.

Stage 4 is another dramatic step. It could be years away from stage 2&3. Everyone will be different in approaching it. There is a trick to it. The nasal passages are tall and narrow and the tongue is narrow and wide, so the tongue can only go into the nasal passages by turning on its side. But which side? One way works better than the other. The tongue can naturally be turned with the top to the center by following the channel on top of the trumpet of each eustachian tube into its adjacent nasal passage. This naturally turns the top of the tongue to the center and allows it to slide up the side of the septum into the nasal passage. Turning the tongue inward to the center is the way up into the passages. Entering stage 4 is as dramatic as entering stage 2, because the tissues in the nasal passages are extremely sensitive, and connecting with them in the way described takes the nervous system to yet a higher level. Stage 4 provides extensive stimulation of the upper ends of the sushumna, ida, and pingala, and this has huge effects throughout the nervous system, especially when combined with our pranayama and its associated bandhas and mudras.

Going to stage 4 is natural once stages 2&3 have been mastered and become second nature. Before then we are not much attracted due to the sensitivity in the nasal passages. Our opening nervous system and rising bhakti take us to stage 4 when we are ready.

Once the nasal passages have been entered, the tongue can be used to do "alternate passage" breathing during pranayama and yoni mudra kumbhaka. This provides alternating stimulation in the nasal passages, which produces additional purifying effects in the sushumna, ida, and pingala. Our pranayama and kumbhaka become supercharged in stage 4 kechari.

The four stages of kechari foster major neurological openings in the head, and throughout the entire nervous system. Kechari is one of the most pleasurable and far-reaching of all the advanced yoga practices. Kechari represents a major transition in our advanced yoga practices to a much higher level.

Now let's talk about the membrane/tendon under the tongue called the "frenum."

For most of us, the frenum will be the limiting factor in moving through the stages of kechari. There is debate on whether the frenum should be trimmed or not. Some say that we are deserving or not deserving of kechari according to what kind of frenum we have under our tongue, and that the only way into kechari is by stretching the frenum. If we can't stretch it far enough to get into kechari, it is "God's will."

In these lessons, we don't subscribe to that limited point of view. The view here is that, "God helps those who help themselves."

In these lessons we view the frenum as a tether to be trimmed back when the time is right. It keeps us out of kechari until we are ready. When we are ready, and each of us knows when that is, the frenum can be trimmed. It is like a "hymen." When a woman is ready for sexual intercourse, the hymen goes. Until then it serves to provide protection. This breaking of the hymen can be a stressful and painful event if it is forced. Sooner or later the frenum will be forced open too, because going into kechari is as natural as going into sexual intercourse. It is biologically preordained. It happens when the nervous system is mature enough. Advanced yoga practices bring us closer to the transition with each day of daily practices.

Kechari results from a second puberty in us - our spiritual puberty. As our nervous system becomes pure, our bhakti increases. More than anything else it is bhakti that sends us into kechari. When every fiber of our being wants God, then we will go there. The tongue will roll back and go up. Like that.

Once our bhakti is hurling our tongue back into kechari, breaking the hymen of the frenum does not have to be stressful and painful. It can be very easy and gentle. Above all, it can and should be gradual. It is done with very tiny snips. Tiny snips, each as small as a hair or a very thin string. A sterilized, sharp cuticle snipper (like a small wire cutter) can be used to do the job, bit by bit. When we lift our tongue up, we can see right away where the point of greatest stress on the frenum is. If we take a tiny snip there, not bigger than a hair, it probably won't even bleed. Maybe one drop. If more than one drop, we did too much. The tiny snip will heal in a day or two. The tissues of the mouth heal very quickly. Then maybe in a week or a month, whatever we are comfortable with, we will be ready to do it again. And then, in another week or more, do it again. If we are sensitive, a little ice can be used to numb the edge of the frenum, and we won't even feel a little pinch when we snip. Don't use ice to take a big snip though. That is too much, and brings in some risk of infection. We should not snip if we have any kind of infection in the body. With tiny snips, the frenum will be allowing the tongue to go further back in no time, and before we know it we will be using our finger to push our tongue behind our soft palate.

We can continue with the tiny snips once we are in stage 2 kechari, and this will help us move on to stage 3. Then we can continue with the tiny snips once we have gotten to the top of the nasal pharynx, and this will help us move on through stage 4. It will take years. There is no rush. We may go for many months, or even years, with no snipping at all, content to enjoy the level of kechari we have attained so far, and the steady spiritual growth that comes with it. Then we may become inspired to continue going up with the tongue, and do some more snipping.

As the snipping progresses past stage 2 kechari, it becomes very easy to do it. As the frenum gives way slowly, the edge it presents when stretched becomes like a callus. There is no pain snipping it, and no blood. It is not difficult to trim it back so the tongue can go further up into more advanced stages of kechari. It is a long journey in time, and a fulfilling one. It can take decades to complete stages 1 through 4. There is no rush. The nervous system knows what must happen. When it knows, we know through our bhakti.

Everyone's frenum is different. A few will enter kechari with no snipping necessary. Others will need a lot of snipping. The rest of us will fall somewhere in-between. Whatever the case many be, we will know what to do when our bhakti comes up. No one else can tell us what to do when. Everything in this lesson is offered as information so you will have a better idea on what your options are as your bhakti comes up.

Some will have medical concerns about snipping the frenum. Most doctors will not be for it. Is there risk? There is always some risk when we undertake new things. That is life. The practice of trimming the frenum for kechari has been around for thousands of years - at least as long as circumcision, body piercing and tattooing. Not that any of these other types of body alterations are in the same class as kechari. They are not. Kechari is one of the most advanced yoga practices on the planet. When we know we are ready for it, we will be willing to accept whatever risk may be associated with entering it. We each choose our own path according to the feelings rising in our heart.

This lesson is not to promote stage 2 kechari and beyond for everyone. It is to provide useful information for those who are experiencing kechari symptoms and finding themselves stretching naturally past stage 1. What you do with the information here is your choice. Remember to always pace yourself according to your capacity and experiences.

The guru is in you.

Additional Links:

https://wholebodybreathing.com/community/community/case-discussions/a-better-anchor-for-the-whole-tongue-for-mewing-imho-it-will-cut-by-half-or-less-the-time-it-takes-to-seeing-result/#

https://formlessart.wordpress.com/2013/01/05/secret-of-the-immortals-khechari-mudra/

http://www.tarpitboss.com/Lingual_Exploration.html

Helpful Hints:

1) Squeezing your left thumb within your fist can help suppress your gag reflex during nasopharyngeal manipulation.

2) Use of a neti pot can be incorporated with any of these practices to help clear mucus, reduce inflammation, and clean up any lubrication used for intranasal insertions.

3) The nasal cycle is an alternation of congestion and decongestion of the nasal concha. You can monitor this by closing your nostrils one at a time with your fingers while blowing out through the nose to determine which side has more resistance, before attempting intranasal insertions, to decide which side to treat at that time.

Great work. I managed to loosen up the nasopharynx with some of these techniques, and it feels a lot better. Is nasopharyngeal mewing going to become the new thing?

Posted by: James

Great work. I managed to loosen up the nasopharynx with some of these techniques, and it feels a lot better. Is nasopharyngeal mewing going to become the new thing?

Hi James, I think these strategies are supplements rather than replacements for practicing good oral posture, but I hope they have potential to expedite the process. Endonasal balloon therapy got a lot more attention over on the BTM forum. More than a year ago, I completed two rounds of endonasal treatment for several consecutive days. I didn't notice a significant effect, but I also wasn't able to maintain good tongue posture at that time because my palate was too narrow. I'm currently experimenting with manual myofascial release and stage 1 of khechari mudra. I'll try another endonasal balloon session soon. I have a few exciting ideas for variations on the methods in this thread, but I want to test them out before recommending them, and I need to order some supplies first.

I have been wondering about what type of lubricant is best to use for intranasal work including endonasal balloon inflations and structural integration. In the past, I have typically used petroleum jelly for my endonasal balloon sessions, and I believe this is a common practice. However, I have read that it is not the best option because its viscosity prevents normal secretion and absorption through the mucosa. Although I typically rinse with a neti pot after treatment, I'd still like to find an option that isn't petroleum based. Vitamin E (alpha-tocopherol) oil is often recommended as an alternative to vasoline to prevent mucosal cracking for those who suffer from epistaxis, and it might provide adequate lubrication for intranasal insertions. I suppose various water-based personal lubricants, which are typically made from plant polymers, could also work, but they tend to dry out faster and require application of additional moisture to restore their friction-reducing properties. I watched a rolfing video where the practitioner used a combination of vaseline and eucalyptus oil, and while eucalyptus oil is know to have decongestant, anti-inflammatory, and analgesic properties, I'm concerned that the essential oil is too concentrated for much internal use, as systemic toxicity can result at higher doses. "Nasya" is an Ayurvedic practice that involves applying oil or ghee (clarified butter) with or without medicinal herbs to the nasal passages. Reminiscent of Structural Integration's intranasal treatment, "Marsha Nasya" involves massaging the inside of the nostrils with the little finger dipped in ghee or oil. One brand of Nasya oil I looked at has the following ingredients: Refined Sesame Oil, Olive Oil, Brahmi/Gotu Kola, Calamus, Skullcap, Eucalyptus essential oil. I don't think that I would want large doses of the herbs in such Nasya oil, but the culinary oils it uses might be an option. I worry that Olive Oil and sesame oil might be too pungent to tolerate without sneezing or irritation, but I could try them. I've also read suggestions to use coconut oil to moisturize the nostrils, but it is solid at room temperature. I might start with melted coconut oil. I also have olive oil and ghee available and I'd like to order some organic unrefined sesame oil to try.

"Pratimarsha" is the daily application of Marsha. From an article titled Probable Mode of Action of Nasya - An Overview by S. Lokhande, et al.:

Pratimarshya (Daily Oil Nasya):- This type of therapy is administered by dipping the clean little finger in ghee or oil and inserting into each nostril. After inserting the clean finger (dipped in ghee or oil) into the nostril, the nasal passage is lubricated and given a gentle massage. By doing this, the deep nasal tissues are opened up. By doing Pratimarshya on a regular basis, stress can be released to a great extent. Generally it can be given in weak persons, in old age, child, in delicate persons, timid persons etc. It can be administered in unseasonable time. It is also given in persons who had injury to chest, dryness of oral cavity.

I wish I could remember what my chiropractor used for endonasal release. It was either olive oil or coconut oil that had been processed to stay in liquid form.

Try animal fats (tallow, lard, duck fat). They will be less toxic because they are the same stuff your body is made out of. It's just a matter of finding one with the right viscosity.

Plant oils are damaging to the gut due to plant defense chemicals, so I wouldn't want them in my nose either.

Posted by: Sclera

I wish I could remember what my chiropractor used for endonasal release. It was either olive oil or coconut oil that had been processed to stay in liquid form.

The melting point for coconut oil is just above room temperature, so it will melt in a warm environment or with application of minimal heat. It should be easy enough to warm the jar to be able to dip a finger or implement. I think I'll start with coconut oil and see how it works. 

Posted by: James

Try animal fats (tallow, lard, duck fat). They will be less toxic because they are the same stuff your body is made out of. It's just a matter of finding one with the right viscosity.

Plant oils are damaging to the gut due to plant defense chemicals, so I wouldn't want them in my nose either.

I have to confess that the idea of leaving a residue of animal fats in my nasal passages makes me a little squeamish for some reason. I admit that this probably isn't rational. The sources describing Nasya recommend ghee (clarified cow butter) as a good option, and I might try it. If I'm left with any lingering odor in my nose, I feel like coconut oil might be the most mild and agreeable.

Hmmm, that is a rather interesting post actually, however I am not really sure how to react to it. I mean, what are this kind of manipulations actually good for?! It actually sounds like something very interesting to me, however I do not really understand what is it, and why would I do that. Someone told me that it would help you to perceive the smells in a more powerful way. I guess that would be really nice, as I have found some amazing viagra alternatives on www.laweekly.com/otc-viagra-alternatives/ which are having some very powerful smells.

Posted by: @apollo

...I thought of them as skeletal adjustments, encouraging mobility and release of tension along cranial sutures like the earth's tectonic plates. Manipulating the sphenoid bone can be a linchpin for cranial adjustments because it borders eight other bones and forms part of the connection between the neurocranium and the facial skeleton. However, as I kept researching and experimenting, I came to appreciate that skeletal mobilization is only part of the story. Muscular tension within the nasopharynx and the resulting inflammation of the mucosal tissue is also released through these methods, the airway is opened, and nasal breathing is improved. Some suggest that even hormonal and neurological changes are possible outcomes by adjusting the structure around the pituitary gland and stimulating the network of sensitive nerves in the area.

@karenfishers