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Rapid maxillary expansion in children with obstructive sleep apnea syndrome
Paola Pirelli1, Maurizio Saponara, Christian Guilleminault
1Department of Odontological Sciences, University Tor Vergata, Rome Italy.
Insights
Rapid maxillary expansion significantly improved nasal breathing and resolved obstructive sleep apnea syndrome in children. This orthodontic treatment offers a potential solution for pediatric sleep-disordered breathing.
Area of Science:
- Pediatric Dentistry
- Orthodontics
- Sleep Medicine
Background:
- Obstructive sleep apnea syndrome (OSAS) in children is often associated with maxillary hypoplasia.
- Nasal breathing is crucial for proper craniofacial development and overall health.
Purpose of the Study:
- To assess the efficacy of rapid maxillary expansion (RME) in treating children diagnosed with OSAS and nasal obstruction.
- To evaluate the impact of RME on nasal airway dimensions and OSAS severity.
Main Methods:
- A cohort of 31 children with maxillary contraction and OSAS underwent RME for 10-20 days, followed by a 6-12 month consolidation and orthodontic phase.
- Pre- and post-treatment assessments included polysomnography, rhinometry, nasal fibroscopy, and cephalometry.
Main Results:
- Following RME, all participants showed a normalized apnea-hypopnea index (<1 event/hour) and improved nasal airflow.
- Significant increases in maxillary width (4.32 mm) and pyriform aperture (1.3 mm) were observed.
Conclusions:
- Rapid maxillary expansion is an effective treatment for improving nasal breathing and resolving obstructive sleep apnea syndrome in children.
- RME presents a viable therapeutic option for pediatric patients with craniofacial abnormalities contributing to sleep-disordered breathing.
Objective:
To evaluate the effect of rapid maxillary expansion on children with nasal breathing and obstructive sleep apnea syndrome.
Method:
Recruitment of children with maxillary contraction, without of adenoid hypertrophy, with a body mass index < 24 kg/m2, with obstructive sleep apnea syndrome demonstrated by polysomnography, and whose parents signed informed consent. Otolaryngologic and orthognathic-odontologic evaluation with clinical evaluation, anterior rhinometry and nasal fibroscopy, panoramic radiographs, anteroposterior and laterolateral telecephalometry were performed at entry and follow-up.
Intervention:
Rapid maxillary expansion (ie, active phase of treatment) was performed for 10 to 20 days; maintenance of device (for consolidation) and orthodontic treatment on teeth lasted 6 to 12 months.
Results:
31 children (19 boys), mean age 8.7 years, participated in the study. The mean apnea-hypopnea index was 12.2 events per hour. At the 4-month follow-up, the anterior rhinometry was normal, and all children had an apnea-hypopnea index < 1 event per hour. The mean cross-sectional expansion of the maxilla was 4.32 +/- 0.7 mm. There was a mean increase of the pyriform opening of 1.3 +/- 0.3 mm.
Conclusion:
Rapid maxillary expansion may be a useful approach in dealing with abnormal breathing during sleep.
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