Skip to main content
Top
Published in: Sleep and Breathing 2/2011

01-05-2011 | Original Article

Efficacy of rapid maxillary expansion in children with obstructive sleep apnea syndrome: 36 months of follow-up

Authors: Maria Pia Villa, Alessandra Rizzoli, Silvia Miano, Caterina Malagola

Published in: Sleep and Breathing | Issue 2/2011

Login to get access

Abstract

Purpose

In view of the positive outcome of orthodontic treatment using rapid maxillary expansion (RME) on sleep-disordered breathing, we generated data on RME in children with obstructive sleep apnea (OSA) by evaluating objective and subjective data over a 36-month follow-up period, to determine whether RME is effective in the long-term treatment of OSA. We selected all patients with dental malocclusions and OSA syndrome (OSAS) confirmed by polysomnography.

Methods

Ten of the 14 children who completed the 12-month therapeutic trial using RME were enrolled in our follow-up study. The study was performed 24 months after the end of the RME orthodontic treatment. We enrolled all children presented with deep, retrusive or crossbite at the orthodontic evaluation. All subjects underwent an overnight polysomnography at the baseline, after 1 year of treatment and 24 months after the end of the orthodontic treatment. The children's mean age was 6.6 ± 2.1 years at entry and 9.7 ± 1.6 years at the end of follow-up.

Results

After treatment, the apnea hypopnoea index (AHI) decreased and the clinical symptoms had resolved by the end of the treatment period. Twenty-four months after the end of the treatment, no significant changes in the AHI or in other variables were observed.

Conclusions

RME may be a useful approach in children with malocclusion and OSAS, as the effects of such treatment were found to persist 24 months after the end of treatment.
Literature
1.
go back to reference Guilleminault C, Partinen M, Praud JP, Quera-Salva MA, Powell N, Riley R (1989) Morphometric facial changes and obstructive sleep apnea in adolescents. J Pediatr 114:997–999PubMedCrossRef Guilleminault C, Partinen M, Praud JP, Quera-Salva MA, Powell N, Riley R (1989) Morphometric facial changes and obstructive sleep apnea in adolescents. J Pediatr 114:997–999PubMedCrossRef
2.
go back to reference Guilleminault C, Li KK, Khramtsov A, Pelayo R, Martinez S (2004) Sleep disordered breathing: surgical outcomes in prepubertal children. Laryngoscope 114:132–137PubMedCrossRef Guilleminault C, Li KK, Khramtsov A, Pelayo R, Martinez S (2004) Sleep disordered breathing: surgical outcomes in prepubertal children. Laryngoscope 114:132–137PubMedCrossRef
3.
go back to reference Tasker C, Crosby JH, Stradling JR (2002) Evidence for persistence of upper airway narrowing during sleep, 12 years after adenotonsillectomy. Arch Dis Child 86:34–37PubMedCrossRef Tasker C, Crosby JH, Stradling JR (2002) Evidence for persistence of upper airway narrowing during sleep, 12 years after adenotonsillectomy. Arch Dis Child 86:34–37PubMedCrossRef
4.
go back to reference Mitchell RB, Kelly J (2004) Outcome of adenotonsillectomy for severe obstructive sleep apnea in children. Int J Pediatr Otorhinolaryngol 68:1375–1379PubMedCrossRef Mitchell RB, Kelly J (2004) Outcome of adenotonsillectomy for severe obstructive sleep apnea in children. Int J Pediatr Otorhinolaryngol 68:1375–1379PubMedCrossRef
5.
go back to reference Souki BQ, Pimenta GB, Souki MQ, Franco LP, Becker HM, Pinto JA (2009) Prevalence of malocclusion among mouth breathing children: do expectations meet reality? Int J Pediatr Otorhinolaryngol 73:767–773PubMedCrossRef Souki BQ, Pimenta GB, Souki MQ, Franco LP, Becker HM, Pinto JA (2009) Prevalence of malocclusion among mouth breathing children: do expectations meet reality? Int J Pediatr Otorhinolaryngol 73:767–773PubMedCrossRef
6.
go back to reference Pirelli P, Saponara M, Guilleminault C (2004) Rapid maxillary expansion in children with obstructive sleep apnea syndrome. Sleep 27:761–766PubMed Pirelli P, Saponara M, Guilleminault C (2004) Rapid maxillary expansion in children with obstructive sleep apnea syndrome. Sleep 27:761–766PubMed
7.
go back to reference Villa MP, Malagola C, Pagani J, Montesano M, Rizzoli A, Guilleminault C, Ronchetti R (2007) Rapid maxillary expansion in children with obstructive sleep apnea syndrome: 12 months follow-up. Sleep Med 8:128–134PubMedCrossRef Villa MP, Malagola C, Pagani J, Montesano M, Rizzoli A, Guilleminault C, Ronchetti R (2007) Rapid maxillary expansion in children with obstructive sleep apnea syndrome: 12 months follow-up. Sleep Med 8:128–134PubMedCrossRef
8.
go back to reference Cistulli PA, Palmisano RG, Poole MD (1998) Treatment of obstructive sleep apnea syndrome by rapid maxillary expansion. Sleep 21:831–835PubMed Cistulli PA, Palmisano RG, Poole MD (1998) Treatment of obstructive sleep apnea syndrome by rapid maxillary expansion. Sleep 21:831–835PubMed
9.
go back to reference Kiliç N, Oktay H (2008) Effects of rapid maxillary expansion on nasal breathing and some naso-respiratory and breathing problems in growing children: a literature review. Int J Pediatr Otorhinolaryngol 72:1595–1601PubMedCrossRef Kiliç N, Oktay H (2008) Effects of rapid maxillary expansion on nasal breathing and some naso-respiratory and breathing problems in growing children: a literature review. Int J Pediatr Otorhinolaryngol 72:1595–1601PubMedCrossRef
10.
go back to reference De Felippe NL, Bhushan N, Da Silveira AC, Viana G, Smith B (2009) Long-term effects of orthodontic therapy on the maxillary dental arch and nasal cavity. Am J Orthod Dentofacial Orthoped 136:490.e1–490.e8CrossRef De Felippe NL, Bhushan N, Da Silveira AC, Viana G, Smith B (2009) Long-term effects of orthodontic therapy on the maxillary dental arch and nasal cavity. Am J Orthod Dentofacial Orthoped 136:490.e1–490.e8CrossRef
11.
go back to reference Monini S, Malagola C, Villa MP, Tripodi C, Tarentini S, Malagnino I, Marrone V, Lazzarino AI, Barbara M (2009) Rapid maxillary expansion for the treatment of nasal obstruction in children younger than 12 years. Arch Otolaryngol Head Neck Surg 135:22–27PubMedCrossRef Monini S, Malagola C, Villa MP, Tripodi C, Tarentini S, Malagnino I, Marrone V, Lazzarino AI, Barbara M (2009) Rapid maxillary expansion for the treatment of nasal obstruction in children younger than 12 years. Arch Otolaryngol Head Neck Surg 135:22–27PubMedCrossRef
12.
go back to reference Zucconi M, Caprioglio A, Calori G, Ferini-Strambi L, Oldani A, Castronovo C, Smirne S (1999) Craniofacial modifications in children with habitual snoring and obstructive sleep apnoea: a case–control study. Eur Respir J 13:411–417PubMedCrossRef Zucconi M, Caprioglio A, Calori G, Ferini-Strambi L, Oldani A, Castronovo C, Smirne S (1999) Craniofacial modifications in children with habitual snoring and obstructive sleep apnoea: a case–control study. Eur Respir J 13:411–417PubMedCrossRef
13.
go back to reference Guilleminault C, Huang YS, Glamann C, Li K, Chan A (2007) Adenotonsillectomy and obstructive sleep apnea in children: a prospective survey. Otolaryngol Head Neck Surg 136:169–175PubMedCrossRef Guilleminault C, Huang YS, Glamann C, Li K, Chan A (2007) Adenotonsillectomy and obstructive sleep apnea in children: a prospective survey. Otolaryngol Head Neck Surg 136:169–175PubMedCrossRef
14.
go back to reference Ancoli-Israel S, Chesson A, Quan SF, for the American Academy of Sleep Medicine (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. American Academy of Sleep Medicine, Westchester Ancoli-Israel S, Chesson A, Quan SF, for the American Academy of Sleep Medicine (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. American Academy of Sleep Medicine, Westchester
15.
go back to reference Greenfeld M, Tauman R, DeRowe A, Sivan Y (2003) Obstructive sleep apnea syndrome due to adenotonsillar hypertrophy in infants. Int J Pediatr Otorhinolaryngol 67:1055–1060PubMedCrossRef Greenfeld M, Tauman R, DeRowe A, Sivan Y (2003) Obstructive sleep apnea syndrome due to adenotonsillar hypertrophy in infants. Int J Pediatr Otorhinolaryngol 67:1055–1060PubMedCrossRef
16.
go back to reference Friedman M, Ibrahim H, Joseph NJ (2004) Staging of obstructive sleep apnea/hypopnea syndrome: a guide to appropriate treatment. Laryngoscope 114:454–459PubMedCrossRef Friedman M, Ibrahim H, Joseph NJ (2004) Staging of obstructive sleep apnea/hypopnea syndrome: a guide to appropriate treatment. Laryngoscope 114:454–459PubMedCrossRef
17.
go back to reference Ilizarov GA (1988) The principles of the Ilizarov method. Bull Hosp Joint Dis Orthop Inst 48:1–11 Ilizarov GA (1988) The principles of the Ilizarov method. Bull Hosp Joint Dis Orthop Inst 48:1–11
18.
go back to reference Brouillette R, Hanson D, David R, Klemka L, Szatkowski A, Fernbach S, Hunt C (1984) A diagnostic approach to suspected obstructive sleep apnea in children. J Pediatr 105:10–14CrossRef Brouillette R, Hanson D, David R, Klemka L, Szatkowski A, Fernbach S, Hunt C (1984) A diagnostic approach to suspected obstructive sleep apnea in children. J Pediatr 105:10–14CrossRef
19.
go back to reference Rechtschaffen A, Kales A. Springer A manual of standardized terminology, techniques and scoring system for sleep stage of human subjects. Los Angeles: Brain Information Service/Brain Research Institute, University of California; 1968 Rechtschaffen A, Kales A. Springer A manual of standardized terminology, techniques and scoring system for sleep stage of human subjects. Los Angeles: Brain Information Service/Brain Research Institute, University of California; 1968
20.
go back to reference Villa MP, Bernkopf E, Pagani J, Broia V, Montesano M, Ronchetti R (2002) Randomized controlled study of an oral jaw-positioning appliance for the treatment of obstructive sleep apnea in children with malocclusion. Am J Respir Crit Care Med 165:123–127PubMed Villa MP, Bernkopf E, Pagani J, Broia V, Montesano M, Ronchetti R (2002) Randomized controlled study of an oral jaw-positioning appliance for the treatment of obstructive sleep apnea in children with malocclusion. Am J Respir Crit Care Med 165:123–127PubMed
21.
go back to reference Zhao Y, Nguyen M, Gohl E, Mah JK, Sameshima G, Enciso R (2010) Oropharyngeal airway changes after rapid palatal expansion evaluated with cone-beam computed tomography. Am J Orthod Dentofacial Orthoped 137:S71–S78CrossRef Zhao Y, Nguyen M, Gohl E, Mah JK, Sameshima G, Enciso R (2010) Oropharyngeal airway changes after rapid palatal expansion evaluated with cone-beam computed tomography. Am J Orthod Dentofacial Orthoped 137:S71–S78CrossRef
22.
go back to reference Miano S, Rizzoli A, Evangelisti M, Bruni O, Ferri R, Pagani J, Villa MP (2009) NREM sleep instability changes following rapid maxillary expansion in children with obstructive apnea sleep syndrome. Sleep Med 10:471–478PubMedCrossRef Miano S, Rizzoli A, Evangelisti M, Bruni O, Ferri R, Pagani J, Villa MP (2009) NREM sleep instability changes following rapid maxillary expansion in children with obstructive apnea sleep syndrome. Sleep Med 10:471–478PubMedCrossRef
23.
go back to reference Chrcanovic BR, Custódio AL (2009) Orthodontic or surgically assisted rapid maxillary expansion. Oral Maxillofac Surg 13:123–137PubMedCrossRef Chrcanovic BR, Custódio AL (2009) Orthodontic or surgically assisted rapid maxillary expansion. Oral Maxillofac Surg 13:123–137PubMedCrossRef
Metadata
Title
Efficacy of rapid maxillary expansion in children with obstructive sleep apnea syndrome: 36 months of follow-up
Authors
Maria Pia Villa
Alessandra Rizzoli
Silvia Miano
Caterina Malagola
Publication date
01-05-2011
Publisher
Springer-Verlag
Published in
Sleep and Breathing / Issue 2/2011
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-011-0505-1

Other articles of this Issue 2/2011

Sleep and Breathing 2/2011 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine