Rapid Maxillary Expansion (RME): An Otolaryngologic Perspective

Abstract

Background. To evaluate the possible effects of Rapid Maxillary Expansion (RME), such as nasal breathing problems, middle ear function, Obstructive Sleep Apnea (OSA) in the otolaryngology field. RME has already been introduced in orthodontics to expand the maxilla of young patients affected by transversal maxillary constriction. Methods. A literature search was performed using different databases (Medline/PubMed, EMBASE, and CINAHL), from May 2005 to November 2021, according to the PRISMA guidelines. Results. The application of RME in children has shown good results on nasal function, reducing nasal resistances, independently from a previous adenotonsillectomy. These results are not only related to the increasing of nasal transverse diameters and volume, but also to the stiffening of airway muscles, enabling the nasal filtrum function and avoiding mouth opening, thereby decreasing respiratory infections. Positive effects have also been reported for the treatment of conductive hearing loss and of OSA, with the reduction of Apnea Hypopnea Index (AHI), possibly due to (i) an increased pharyngeal dimensions, (ii) a new tongue posture, and (iii) reduced nasal respiratory problems. Conclusions. Otolaryngologists should be aware of the indications and benefits of the RME treatment, considering its possible multiple beneficial effects.

Eficacia de la expansión rápida maxilar en pacientes con apnea obstructiva del sueño. Revisión de literatura

“…Las etapas A y B se presentan generalmente hasta los 13 años y el C puede observarse desde los 11 a 17 años (15). Como ya lo mencionamos anteriormente la RME se basa en la separación palatina, para lo cual existen diferentes métodos de ejecución y la utilización del método adecuado para cada caso, esto se basa en características como la edad y los resultados que se desean alcanzar a corto y largo plazo (16,17), al lograr este efecto también se consigue dilatar el piso de la cavidad nasal mejorando la función respiratoria en casos vinculados con la obstrucción nasal crónica (18).…”

Unusual systemic and nondental effects of maxillary expansion therapy: A comprehensive and updated review of literature

“…The recent scientific literature pertaining to RME for the correction of maxillary/palatal deficiency has highlighted one of the significant nondental effects, that is, hearing improvement in middle-ear disorders/conductive hearing loss disorders in children and adolescent patients. [ 1 2 3 ] Findings such as constricted maxilla/palate and hearing problems associated with Eustachian tubes, the middle ear, and mouth breathing have been previously described in the existing literature. [ 1 2 3 ] A link between conductive hearing loss and maxillary deficiency in patients with high palatal form and posterior crossbite has been reported in scientific literature.…”

“…[ 1 2 3 ] Findings such as constricted maxilla/palate and hearing problems associated with Eustachian tubes, the middle ear, and mouth breathing have been previously described in the existing literature. [ 1 2 3 ] A link between conductive hearing loss and maxillary deficiency in patients with high palatal form and posterior crossbite has been reported in scientific literature. Resolution of the middle ear infection and hearing impairment/loss has been described in studies.…”

“…Resolution of the middle ear infection and hearing impairment/loss has been described in studies. [ 1 2 3 ] It has been reported that expansion of the constricted palate impacts the auditory anatomic area of the skull (Eustachian tube, i.e. tympanic cavity to the nasopharynx).…”

“…[ 4 ] In addition, a probable relation between palatal/maxillary expansion therapy and the attenuation of infectious processes was found. [ 1 2 3 5 6 7 ] Acoustic immittance measures also exhibit better integrity and functioning of the middle ear after maxillary expansion process. [ 1 2 3 5 6 7 ]…”