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Updated: Jul 18, 2025
Author Spotlight: Development of a Novel Finite Element Analysis Model for Improved Orthognathic Surgical Techniques
Published on: October 20, 2023
Randomized clinical trial of surgically assisted rapid maxillary expansion with two and three segments for nasal
Alexandre Augusto Ferreira da Silva1, Gabriela Pereira Ribeiro Prado1, Max Domingues Pereira2
1Postgraduate Program in Translational Surgery, Federal University of São Paulo, Rua Botucatu, 740, 2º Andar, Vila Clementino, São Paulo, SP, 04023-062, Brazil.
Objectives:
To evaluate surgically assisted rapid maxillary expansion (SARME), with osteotomies separating the maxilla into two segments (SARME-2S) and three segments (SARME-3S), on obstruction symptoms and nasal cavity dimensions in patients with maxillary transverse skeletal deficiency (MTSD).
Materials And Methods:
Sixteen patients with MTSD of 7 mm or above were evaluated in each group, for a total of 32 patients. All patients were evaluated pre- and postoperatively up to 10 months after the expander activations. The minimum cross-sectional area (MCA) and the volume of the nasal cavities were identified by acoustic rhinometry. The Nasal Obstruction Symptom Evaluation (NOSE) scale questionnaire was applied. The palate surface area (PSA) was measured, via digitized maxillary models, as a criterion for comparison with the other variables studied.
Results:
There was no difference between the groups (p = 0.370) and was verified a significant increase in PSA postoperatively. MCA showed a small increase without statistical significance, and together with the volume of the nasal cavities remained constant during the study. NOSE scale scores decreased significantly in the postoperative periods, implying a decrease in nasal obstruction symptoms in both groups.
Conclusions:
SARME with two and three segments show similar results, and both may improve nasal obstruction symptoms when present in patients with MTSD.
Clinical Relevance:
SARME, regardless of the chosen surgical technique, should follow the recommendation to correct just the MTSD. While an improvement in nasal breathing is expected, this must be understood as likely, but not certain.
