Cone beam CT evaluation of skeletal and nasomaxillary complex volume changes after rapid maxillary expansion in OSA children
| Autor: | Valeria Fiaschetti, Gianluca Mampieri, Paola Pirelli, Ezio Fanucci, Sabina Saccomanno, Aldo Giancotti, R Condò |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Nasal cavity
Cone beam computed tomography Palatal Expansion Technique Sleep Apnea Pediatric obstructive sleep apnea Polysomnography stomatognathic system Suture (anatomy) Volume of the upper airways Settore MED/36 medicine Maxilla Humans Rapid maxillary expansion Respiratory system Child Orthodontics Sleep Apnea Obstructive Cone Beam CT medicine.diagnostic_test business.industry Palate Obstructive Nasal airways General Medicine respiratory system Cone-Beam Computed Tomography medicine.disease medicine.anatomical_structure Breathing Malocclusion business |
| Popis: | Objective The first objective of this study was to evaluate skeletal changes and changes in dimensions and volume of the upper airways before and after rapid maxillary expansion (RME) therapy in children with obstructive sleep apnoea (OSA), by Cone Beam computed tomography (CBCT). The second objective was to evaluate if RME therapy could improve both the patency of the nasal airways and the Obstructive Sleep Apnoea Syndrome (OSAS). Methods 19 children with OSA and malocclusion took CBCT scans with a Dentascan and 3D reconstruction program before (T0) and 4 months after (T1) RME. Patients underwent an ENT visit with auditory and respiratory tests, including a daytime sleepiness questionnaire, a 19-channel polysomnography, and an orthognatodontic examination before orthodontic therapy (T0), after 2 months (T1) with the device still on, and 4 months after the end of the orthodontic treatment (T2). Results In all cases opening of the mid-palatal suture was demonstrated. Nasal osseous width, volume of the total upper airways, nasal cavity and nasopharynx and oropharynx increased significantly (P, .001). The increased W-ANS, W-mid and WPNS were closed linked to the enlarged midpalatal suture (P, .001). The increased WPNS were closed linked to the enlarged pterygoid processes (P, .001). The increased V-NC and V-NPA was closely linked to the enlarged W-PNS (P, .001) as well as VOPA and consequently to the enlarged midpalatal suture and pterygoid processes. Conclusion RME treatment had a positive effect on children affected by chronic snoring and OSA, causing an increase in volume of the nasal cavity and nasopharynx, with expansion of the nasal osseous width and maxillary width. Enlarged nasal width at the PNS plane contributed to the increase in nasopharynx volume. Enlarged maxillary width showed a direct correlation to increased airways volume, bringing a functional improvement. The results show that the RME therapy can restore and improve a normal nasal airflow with disappearance of obstructive sleep breathing disorder. |
| Databáze: | OpenAIRE |
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