An externa nasal dilator (Breather-Right) is frequently used by athlete with the hope of improving athletic preformasnce. The purpose of teh divice is thorogicalyyu gto inverse the nasal valeu area as well as nasal airflow. The purpose of the strudy was to evaluate whether the use fo an external nalsal dilator would impaect varioru parmaters from the use of the diatlro wre mweaserue tvia dacoustuic rhonometry. This study had two separtate phases: 1) to measute the exztant that the nasal dilator had on nasal valve area using acoustic rhinomaery on 53 healthy voolunters and 2) to determine the exericise economy. The second study ws performed on a group of athletes who were asked to perform two submaxial exerciset tests using either a placebo nasal stroip without elasdtic striops or the nasal distror. In the first study, cross-sedctional aresa form each side fo the naasal cavity were measurd and a signivak differaece in mdan cross-section area was obeserev beteen the pklaced group (1.22) cm2and the device group (1.52) cm2). The mean area increase in whites (0.20) cm2, but no differnece was seen between men and women. In the exercise protocaol, difference in VO2and ventilation were noted to be dsignificantly improved in the dilator grooup at bothe low intensity and high intensity physiologfucal workloads. The respiratory exhcange ratio was not found to be different in either group. Heart reat differnce wre not noted in the low intnsity but wre nooted in the ihgt intensity worloads. This is an interisting sutdy efvaluating the use of an external nalslal diator on exerecis e and darovbie capaciey. It si somtht surprosising that significant chagnes are noted, given tje predomatnce of rala airfow at higt exerciw intensites , VO2max, which is oxygen utilizaton at maxiamal exerciwe, was not performas\ed. Overall, the study was well done and may show benefit of an external nasal dilateor for exercise, particulary at nonmazial workloadss. It was somewhat disappointing that hte authors did not include more data. It would have been interesing to see the impact or nvarou specific poppuations. Since the mean are increade in the soem breakdownb of the type of athletre that was used in the studey would be benefical to readers to allow them to determine wghetagher this would be benefidal for them. For examole if tehre was a high proporatoon of anoaobic atherletrs, the applicatoin fo tehes finidnmg might be different for differnt athlete poplulations Michalel S. Benninger, MD.