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Sleep Med. 2015 Aug;16(8):933-5. doi: 10.1016/j.sleep.2015.04.012. Epub 2015 May 19.

Rapid maxillary expansion (RME) for pediatric obstructive sleep apnea: a 12-year follow-up.

Author information

1
Department of Clinical Sciences and Translational Medicine, University of Tor Vergata, Rome, Italy.
2
Department of Otolaryngology and Neurology, La Sapienza University, Rome, Italy.
3
Stanford University Sleep Disorders Clinic, Redwood City, CA, USA. Electronic address: cguil@stanford.edu.

Abstract

OBJECTIVE:

The objective of this study was to prospectively evaluate the long-term efficacy of rapid maxillary expansion (RME) in a group of children with obstructive sleep apnea (OSA).

MATERIAL AND METHOD:

Thirty-one children diagnosed with OSA were involved in the study. These children had isolated maxillary narrowing and absence of enlarged adenotonsils at baseline. Twenty-three individuals (73% of the initial group) were followed up annually over a mean of 12 years after the completion of orthodontic treatment at a mean age of 8.68 years. Eight children dropped out over time due to either moving out of the area (n = 6) or refusal to submit to regular follow-up (n = 2). Subjects underwent clinical reevaluation over time and repeat polysomnography (PSG) in the late teenage years or in their early 20s. During the follow-up period, eight children dropped out and 23 individuals (including 10 girls) underwent a final clinical investigation with PSG (mean age of 20.9 years). The final evaluation also included computerized tomographic (CT) imaging that was compared with pre- and post-initial treatment findings.

RESULTS:

Yearly clinical evaluations, including orthodontic and otolaryngological examinations and questionnaire scores, were consistently normal over time, and PSG findings remained normal at the 12-year follow-up period. The stability and maintenance of the expansion over time was demonstrated by the maxillary base width and the distance of the pterygoid processes measured using CT imaging.

CONCLUSION:

A subgroup of OSA children with isolated maxillary narrowing initially and followed up into adulthood present stable, long-term results post RME treatment for pediatric OSA.

KEYWORDS:

Isolated maxillary deficiency; Pediatric obstructive sleep apnea; Rapid maxillary expansion; Very long-term follow-up

PMID:
26141004
DOI:
10.1016/j.sleep.2015.04.012
[Indexed for MEDLINE]

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