Rapid maxillary expansion versus middle ear tube placement: Comparison of hearing improvements in children with resistance otitis media with effusion

Abstract

Objective: To test the null hypothesis that there are significant differences in hearing improvements of children with resistance otitis media with effusion (OME) who undergo a rapid maxillary expansion (RME) procedure or ventilation tube placement. Methods: Forty-two children between 4.5 and 15 years old were divided into three groups: RME, ventilation tube, and control groups. The RME group consisted of 15 children with maxillary constriction and resistance OME that indicated ventilation tube placement. The ventilation tube group consisted of 16 children for whom ventilation tube placement was indicated but no maxillary constriction. The control group consisted of 11 children with no orthodontic and/or rhinologic problems. Hearing thresholds were evaluated with three audiometric records: (1) before RME/ventilation tube placement (T0); (2) after RME/ventilation tube placement (T1), and (3) after an observation period of 10 months (T2). The control group was matched to these periods, except T1. Results: Hearing thresholds decreased significantly in both the RME and ventilation tube groups (P < .001). Hearing thresholds decreased approximately 15 and 17 decibels in the RME and ventilation tube groups, respectively, but differences in improvements were insignificant between the two study groups (P > .05). Slight changes were observed in the control groups. Conclusion: The null hypothesis was rejected. RME showed similar effects as ventilation tube placement for release of otitis media and improvement of hearing thresholds levels. RME should be preferred as a first treatment option for children with maxillary constriction and resistance OME.

Effect of rapid maxillary expansion on glenoid fossa and condyle-fossa relationship in growing patients (MEGP): Study protocol for a controlled clinical trial

“…Should the prespecified endpoints be met, clinical implications of RME are manifold: (1) enhancing nasal breathing[ 18 19 20 ] and thus avoiding vital problems such as obstructive sleep apnea;[ 21 22 23 24 25 ] (2) preventing temporomandibular disorders; (3) avoiding the occurrence of skeletal and dental malocclusions that may require, at adulthood, an invasive orthognathic surgery;[ 26 ] and (4) facilitating hearing by relieving constriction at the level of the Eustachian tube. [ 27 ] Hence, there is a justification to conduct clinical studies to document the enhancement of nasal breathing and hearing by opening the Eustachian tube after RME.…”

Rapid Maxillary Expansion (RME): An Otolaryngologic Perspective

“…Kilic et al [ 9 ] compared the effects of RME and of a trans-tympanic tube placement on pure-tone threshold in children with recurrent otitis media with effusion (OME). They divided children into three groups: a control group, a ventilation tube placement group (children with resistant OME lasting at least 3 months and conductive hearing loss—CHL) and an RME group.…”

“…Most of these studies (Cozza [ 12 ], Pirelli [ 13 ]) included children without evidence of an adenoidal blockage at the nasopharyngoscopic evaluation, eventually because of previous adenoidectomy or adenotonsillectomy (i.e., 73.8% of children included by Pirelli). Kilic [ 9 ] excluded children previously treated by adenotonsillectomy, but did not include information on adenoid dimension, such as Villano [ 8 ]. Conversely, De Stefano described, according to Cassano’s classification, the reduction in adenoidal tissue due to RME application.…”

Effects of rapid maxillary expansion on hearing loss and otitis media in cleft palate children

“…A systematic review of 2017 on RME effects on auditory improvement also confirmed the thesis in seven studies over nine analyzed [21]: improvement in CHL was observed at the end of the retention period and was shown to be stable during a significant follow-up. Evaluation of the stability of CHL improvement was described during follow-up ranging from 10 to 12 months [19][20][21][22][23][24][25]. It has to be noted, though, that studies with 2-year follow-up employed a transpalatal arch for retention after removal of the maxillary appliance [23][24][25].…”