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Rapid maxillary expansion in pediatric patients with obstructive sleep apnea: an umbrella review

Denise Fernandes Barbosa1, Laura Fernandes Bana2, Maria Cristina Buta Michel3

  • 1Universidade de Campinas (UNICAMP), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil.

Brazilian Journal of Otorhinolaryngology
|March 9, 2023
PubMed

Insights

Rapid Maxillary Expansion (RME) is not recommended for treating Obstructive Sleep Apnea (OSA) in children due to a lack of consistent evidence. Further high-quality studies are needed to explore RME

Area of Science:

  • Pediatric Sleep Medicine
  • Orthodontics
  • Craniofacial Development

Background:

  • Obstructive Sleep Apnea (OSA) in children can cause significant craniofacial changes during critical growth periods.
  • Mouth breathing during childhood presents clinical challenges and is associated with OSA.
  • Rapid Maxillary Expansion (RME) is being investigated as a potential treatment for pediatric OSA.

Approach:

  • An umbrella review systematically searched major electronic databases for systematic reviews with meta-analysis.
  • Seven studies measuring the Apnea-Hypopnea Index (AHI) via polysomnography were selected from 40 identified studies on RME for pediatric OSA.
  • Data were extracted and analyzed to determine the evidence supporting RME for pediatric OSA treatment.

Key Points:

  • No consistent evidence supports the long-term efficacy of RME for treating pediatric OSA.
  • Significant heterogeneity was observed across studies, attributed to variations in patient age and follow-up duration.
  • The current evidence base necessitates methodologically rigorous studies to clarify RME's role in pediatric OSA.

Conclusions:

  • Rapid Maxillary Expansion is not currently recommended for treating Obstructive Sleep Apnea in children.
  • Improved study designs are crucial for establishing reliable evidence regarding RME's effectiveness.
  • Further research is required to identify early indicators of OSA and standardize treatment practices.
Abstract

Keywords:
ChildrenMeta-analysisObstructive sleep apneaRapid maxillary expansionSystematic review

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