Evaluation of Changes in Nasal Airway in Patients Having Undergone Surgically Assisted Maxillary Expansion

Catunda, Ivson Souza; Vasconcelos, Belmiro Cavalcanti do Egito; Caubi, Antônio Figueiredo; Amaral, Marcelo Fernando do; Moreno, Eduardo; Melo, Auremir Rocha

doi:10.1097/scs.0b013e31826917ae

Cited by 3 publications

(6 citation statements)

References 21 publications

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“…After reviewing abstracts, 20 articles initially satisfied the inclusion criteria. After retrieval and review of these articles in full text, 7 were found to not measure or report volume values for the airways, [26][27][28][29][30][31][32] and 2 appeared to use duplicate samples. 33,34 Studies excluded at fulltext review are listed in Table 2.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Effect of Surgically Assisted Rapid Maxillary Expansion on Upper Airway Volume: A Systematic Review

Buck

Dalci

Darendeliler

et al. 2016

Journal of Oral and Maxillofacial Surgery

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SARME was found to produce substantial short-term volume increases in the nasal cavity in non-growing patients that were maintained for at least 63 months. Evidence weakly suggested no effect on oropharyngeal volume. However, most studies were evaluated as having a high risk of bias. The effect of such volume changes on respiratory function still needs to be determined; thus, SARME cannot be recommended for respiratory purposes.

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Section: Study Selection and Characteristicsmentioning

confidence: 99%

Effect of Surgically Assisted Rapid Maxillary Expansion on Upper Airway Volume: A Systematic Review

Buck

Dalci

Darendeliler

et al. 2016

Journal of Oral and Maxillofacial Surgery

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“…A total of 10 studies (257 patients) met the inclusion criteria. [15][16][17][18][19][20][21][22][23][24] A total of three authors were contacted twice to provide additional data. 17,21,22 However none of them replied.…”

Section: Search Resultsmentioning

confidence: 99%

“…The remaining eight studies used different variations of surgically assisted maxillary expansion (SAME) 15,16,[18][19][20][21][22][23] including: endoscopic assisted surgical expansion (EASE), 18 distraction osteogenesis maxillary expansion (DOME), 15,16 and traditional procedures using a rapid expansion protocol (SARPE) or other protocols for SAME. [19][20][21][22][23] In these surgically assisted protocols, three studies performed disjunction of the pterygomaxillary suture. 18,19,23 Nasal airway resistance.…”

Section: Results Of the Included Studiesmentioning

confidence: 99%

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The Impact of Maxillary Expansion on Adults’ Nasal Breathing: A Systematic Review and Meta-Analysis

Calvo‐Henríquez¹,

Megias-Barrera²,

Chiesa‐Estomba³

et al. 2021

Am J Rhinol�Allergy

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Objective Nasal surgery fails to restore nasal breathing in some cases. Maxillary constriction is suggested as a major cause of failure. It is thought that maxillary constriction leads to the closure of the internal and external nasal valves. Moreover, it is well established in the literature that maxillary expansion, both in adults and children, increases upper airway volume. However, it is yet unclear whether maxillary expansion may improve nasal function. Review Methods: Pubmed (Medline), the Cochrane Library, EMBASE and Trip Database were checked by two authors from the Rhinology Study Group of the Young Otolaryngologists section of the International Federation of Otorhinolaryngological Societies. Two authors extracted the data. The main outcome was expressed as the value (in variable units) prior to treatment (T0), after expansion procedures (T1), after the retention period (T2), and after a follow-up period (T3). Results A total of 10 studies (257 patients) met the inclusion criteria. The data pooled in the meta-analysis reveals a statistically significant reduction of 0.27 Pa/cm3/s (CI 95% 0.15, 0.39) in nasal resistance after palatal expansion As far as subjective changes are concerned, the pooled data for the change in the NOSE score shows a statistically significant mean reduction after maxillary expansion of 40.08 points (CI 95% 36.28, 43.89). Conclusion The initial available evidence is too limited to suggest maxillary expansion as a primary treatment option to target nasal breathing. However the data is encouraging with regards to the effect of maxillary expansion on nasal function. Further higher quality studies are needed in order to define clearer patient selection criteria, distinguish optimal techniques, and demonstrate long-term efficacy in long term follow up studies.

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“…6 Rapid maxillary expansion (RME) that is primarily used to treat transverse maxillary discrepancy is well documented in the dental literature for improvement in nasal airway patency and nasal obstruction. [7][8][9][10] In the pediatric population, RME has been used to improve nasal breathing in patients with obstructive sleep apnea. 11 Given these findings, the primary objective of our study was to characterize maxillary bone skeletal parameters in adult patients with persistent nasal obstruction after initial soft tissue treatment.…”

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confidence: 99%

The Upper Airway Nasal Complex: Structural Contribution to Persistent Nasal Obstruction

Williams

Patel

Chen

et al. 2019

Otolaryngol.--head neck surg.

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Objective To determine the contribution of the nasal floor and hard palate morphology to nasal obstruction for nonresponders to prior intranasal surgery. Study Design Retrospective case-control study. Setting Tertiary academic center. Methods Institutional review board–approved, retrospective institutional database analysis was obtained of a cohort of 575 patients who presented with nasal obstruction over a 21-year period. Of the patients, 89 met inclusion criteria: 52 were placed into the experimental group, defined as having persistent nasal obstruction following endoscopic sinus surgery (ESS), septoplasty, nasal valve repair, and/or turbinoplasty using validated subjective questionnaires, and 37 were placed into the control group, defined as having resolution of subjective nasal obstruction. Computed tomography imaging was presented to 3 blinded experts, who measured numerous nasal airway and hard palate morphology parameters, including anterior nasal floor width, anterior maxillary angle, maxilla width, anterior nasal floor width, and palatal vault height. Standard demographic information, comorbidities, perioperative 22-item Sinonasal Outcome Test (SNOT-22), and follow-up time were also assessed. Wilcox rank sum analysis or t test was performed where appropriate. Results Follow-up ranged from 2 to 36 months following surgical intervention. Several skeletal characteristics within the upper airway were significantly associated with persistent nasal obstruction, including acute maxillary angle ( P = .035), narrow maxillary width ( P = .006), and high arched palate ( P = .004). Conclusion Persistent nasal obstruction may be seen in patients with narrow, high arched hard palate despite prior nasal surgical intervention and may benefit from additional skeletal remodeling procedures such as maxillary expansion.

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Evaluation of Changes in Nasal Airway in Patients Having Undergone Surgically Assisted Maxillary Expansion

Abstract: The nasal airway underwent a positive change following surgically assisted maxillary expansion. Moreover, the nasal valve angle is suggested as a new parameter for the analysis of this improvement.

Cited by 3 publications

References 21 publications

Effect of Surgically Assisted Rapid Maxillary Expansion on Upper Airway Volume: A Systematic Review

Effect of Surgically Assisted Rapid Maxillary Expansion on Upper Airway Volume: A Systematic Review

The Impact of Maxillary Expansion on Adults’ Nasal Breathing: A Systematic Review and Meta-Analysis

The Upper Airway Nasal Complex: Structural Contribution to Persistent Nasal Obstruction

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