Rapid maxillary expansion outcomes in treatment of obstructive sleep apnea in children

Villa, Maria Pia; Rizzoli, Alessandra; Rabasco, Jole; Vitelli, Ottavio; Pietropaoli, Nicoletta; Cecili, Manuela; Marino, Angela; Malagola, C

doi:10.1016/j.sleep.2014.11.019

Cited by 78 publications

(68 citation statements)

References 40 publications

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“…The obvious theoretical advantages of such intervention are to reduce or compete eradicate residual OSA in children. However, the cumulative evidence to date on RME experience in the setting of residual OSA consists of small uncontrolled studies with a relatively short follow-up period [119][120][121][122][123][124]. Overall, it would appear that RME may have a role in carefully selected patients, more specifically in those presenting obvious malocclusion (i.e., high, narrow palate associated with deep bite, retrusive bite or crossbite) and OSA [125,126].…”

Section: Rapid Maxillary Expansionmentioning

confidence: 99%

Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision

Gozal

Tan

Kheirandish‐Gozal

2020

JCM

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Treatment approaches to pediatric obstructive sleep apnea (OSA) have remarkably evolved over the last two decades. From an a priori assumption that surgical removal of enlarged upper airway lymphadenoid tissues (T&A) was curative in the vast majority of patients as the recommended first-line treatment for pediatric OSA, residual respiratory abnormalities are frequent. Children likely to manifest persistent OSA after T&A include those with severe OSA, obese or older children, those with concurrent asthma or allergic rhinitis, children with predisposing oropharyngeal or maxillomandibular factors, and patients with underlying medical conditions. Furthermore, selection anti-inflammatory therapy or orthodontic interventions may be preferable in milder cases. The treatment options for residual OSA after T&A encompass a large spectrum of approaches, which may be complementary, and clearly require multidisciplinary cooperation. Among these, continuous positive airway pressure (CPAP), combined anti-inflammatory agents, rapid maxillary expansion, and myofunctional therapy are all part of the armamentarium, albeit with currently low-grade evidence supporting their efficacy. In this context, there is urgent need for prospective evidence that will readily identify the correct candidate for a specific intervention, and thus enable some degree of scientifically based precision in the current one approach fits all model of pediatric OSA medical care.

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Section: Rapid Maxillary Expansionmentioning

confidence: 99%

Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision

Gozal

Tan

Kheirandish‐Gozal

2020

JCM

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“…Thus, persisting mild OSAS in several of our subjects with ACH, even after adenotonsillectomy, indicates that further treatment may be warranted. Orthodontic treatment (i.e., rapid maxillary expansion) could be another approach that increases treatment efficacy [29].…”

Section: Syndromesmentioning

confidence: 99%

Sleep-Disordered Breathing in Children with Rare Skeletal Disorders: A Survey of Clinical Records

Zaffanello¹,

Piacentini²,

Sacchetto³

et al. 2018

Med Princ Pract

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Objective: Craniofacial disharmony in skeletal diseases is strongly associated with sleep-disordered breathing. This study was aimed at studying the sleep respiratory patterns in young children with rare skeletal disorders. Design: This retrospective study included children with achondroplasia (ACH), osteogenesis imperfecta (OI) and Ellis van Creveld Syndrome. Our subjects underwent an in-laboratory overnight respiratory polygraph between January 2012 and April 2016. All medical records were reviewed and brain Magnetic Resonance Imaging was conducted on patients with ACH, nasopharynx, oropharynx and laryngopharynx spaces. Patients: Twenty-four children were enrolled, 13 with ACH, 2 with spondyloepiphyseal dysplasia, 1 with odontochondrodysplasia, 6 with OI and 2 with Ellis van Creveld Syndrome. Results: Children with ACH, who had adenotonsillectomy, showed fewer sleep respiratory involvement than untreated children. Among 13 patients with ACH, brain magnetic resonance imaging was available in 10 subjects and significant negative correlation was found between sleep respiratory patterns, nasopharynx and oropharynx space (p < 0.05). In 2 patients with spondyloepiphyseal dysplasia, mild-to-moderate sleep respiratory involvement was found. Both subjects had a history of adenotonsillectomy. Mild sleep respiratory involvement was also observed in 4 out of 6 patients with OI. One patient with Ellis van Creveld syndrome had mild sleep respiratory disturbance. Conclusions: Sleep respiratory disturbances were detected in children with ACH, and with less severity also in OI and Ellis van Creveld syndrome. Adenotonsillectomy was successful in ACH in reducing symptoms. In light of our findings, multicenter studies are needed to obtain further information on these rare skeletal diseases.

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“…Estudos que apontam associação da AOS com distúrbios neuromusculares na orofaringe e morfologia craniofacial dão suporte à indicação de TMO, em especial variáveis orofaríngeas, como volume de língua, anatomia e dimensão das VAS que possuem correlação com a gravidade da AOS (Shu et al, 2013). Além disso, reforçam o papel da TMO, a fim de constatar que esta propiciou redução do índice de apneia e hipopneia (IAH) em adultos com a síndrome da apneia obstrutiva do sono (SAOS) moderada (Guimarães et al, 2009) e em crianças com apneia residual (Lee et al, 2015;Villa et al, 2015a).…”

Section: Lista De Figurasunclassified

“…Possivelmente, a presença de má-oclusão foi outro fator interferindo na atividade coordenada dos músculos elevadores como verificado na análise clínica, no grupo RP nenhuma das crianças tinha mordida cruzada, enquanto essa má oclusão estava presente em oito do grupo AOS, o que é condizente com o estreitamento da maxila comum nesses casos (Villa et al, 2015a). A associação de mudança na postura da mandíbula e a condição oclusal podem ter interferido na coordenação muscular, principalmente quanto aos parâmetros de assimetria (AS absoluto) e atividade muscular (ATIV).…”

Section: Eletromiografia De Superfície Dos Músculos Supra-hioideosunclassified

“…Assim a presença da má oclusão mordida cruzada entre os sujeitos com AOS confirma a necessidade do tratamento ortodôntico após adenoamigdalectomia (Villa et al, 2015a). Tanto a avaliação do item 1 como o item 2 são comuns na rotina fonoaudiológica e não há outra forma de realizá-la além desta descrita aqui.…”

Section: Eletromiografia De Superfície Dos Músculos Supra-hioideosunclassified

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Características funcionais da musculatura orofacial em crianças com e sem apneia obstrutiva do sono

Dias¹

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A Deus, por tudo de bom que faz por mim, por me guiar e me iluminar em cada decisão a ser tomada, por minha família e amigos. Por me dar sabedoria e força para sempre seguir a diante. À Profa. Dra. Fabiana Cardoso Pereira Valera, pela contribuição e colaboração na realização desta dissertação. Pela enorme dedicação e paciência, por me ensinar com tanto envolvimento e competência. Obrigada por tudo! À Profa. Dra. Luciana Vitaliano Voi Trawitzki e Profa. Dra. Wilma Terezinha Anselmo-Lima, pelo apoio, incentivo, confiança e disposição em transmitir seus valiosos conhecimentos prático-científicos, fundamentais para meu crescimento pessoal e profissional. Às amigas de mestrado, Francine, Jaqueline, Manoela e Nayra, por compartilharmos a mesma jornada, aprendemos a crer na superação dos erros e a acreditar nos valores humanos. Às amigas e amigos do LISE, por todas as dúvidas discutidas, trocas de conhecimentos e companheirismo. Por dias incríveis de aprendizado, estresse e risadas. Obrigada pelo apoio e amizade! Às fonoaudiólogas, Gislaine Folha, Lucia Giglio, Melissa Picinato-Pirola e Taís Grechi, exemplos de competência e profissionalismo, contribuíram direta e indiretamente na construção deste trabalho e no meu crescimento pessoal e profissional. À equipe multiprofissional do Centro Especializado do Respirador Bucal (CERB-Casa 20) pelo apoio, convívio e viabilização para que este trabalho fosse concluído. Em especial, á Dra. Leila Azevedo, pela troca de conhecimento e grande contribuição para a realização deste trabalho.

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Rapid maxillary expansion outcomes in treatment of obstructive sleep apnea in children

Cited by 78 publications

References 40 publications

Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision

Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision

Sleep-Disordered Breathing in Children with Rare Skeletal Disorders: A Survey of Clinical Records

Características funcionais da musculatura orofacial em crianças com e sem apneia obstrutiva do sono

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