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01-06-2021 | Digital Volume Tomography | ENT • Original Article

Impact of rapid palatal expansion on the internal nasal valve and obstructive nasal symptoms in children

Authors: Audrey Yoon, Mohamed Abdelwahab, Stanley Liu, James Oh, Heeyeon Suh, Michael Trieu, Kevin Kang, Daniela Silva

Published in: Sleep and Breathing | Issue 2/2021

Abstract

Objective

The aim of this study is to evaluate the impact of rapid palatal expansion (RPE) on the nasal airway subjectively by utilizing patient-reported outcome measures (PROM) and objectively by evaluating validated internal nasal valve (INV) measurements obtained from cone beam computed tomography (CBCT) in pediatrics.

Materials and methods

In this retrospective cohort study, subjects who underwent RPE from March to December 2018 with cone beam CT and Nasal Obstruction Symptom Evaluation (NOSE) scores were included. Exclusion criteria included craniofacial deformity, allergies, asthma, recent nasal trauma, or surgery. INV measurements (angle and cross-sectional area), diastema, midpalatal suture opening, and NOSE scores were evaluated.

Results

Fifty-one subjects met the inclusion criteria with a mean age of 10.1 ± 2.6. Pre-expansion mean NOSE score was 32.55 (moderate) while post-expansion was 13.92 (mild). Mean NOSE score improved significantly by an average of 18.63 following post-expansion (P < 0.0001). The patients’ right and left INV angles increased significantly by a mean of 2.42° and 2.65° respectively (P < 0.0001). Right and left INV cross-sectional areas increased significantly by an average of 14.35 mm² (P < 0.0001) and 14.17 mm² (P < 0.0001) respectively. An average expansion of the diastema and the suture was 1.60 mm and 3.05 mm respectively (P < 0.0001), with an average of 6.29 mm of expansion. We found the amount of diastema expansion to correlate with change in NOSE score (R = − 0.32, P = 0.022). Age and diastema showed a negative correlation (R = − 0.44, P = 0.0019), while INV angle and diastema showed a statistically significant positive correlation (R = 0.28, P = 0.048).

Conclusions

RPE showed improvement in both NOSE scores and objective measures of the INV. This may show the possibility of considering RPE in managing resistant pediatric nasal airways. Future studies should include collaboration with pediatric otolaryngologists, with the inclusion of pediatric patients with persistent nasal obstruction.

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Title: Impact of rapid palatal expansion on the internal nasal valve and obstructive nasal symptoms in children
Authors: Audrey Yoon
Mohamed Abdelwahab
Stanley Liu
James Oh
Heeyeon Suh
Michael Trieu
Kevin Kang
Daniela Silva
Publication date: 01-06-2021
Publisher: Springer International Publishing
Keywords: Digital Volume Tomography
Digital Volume Tomography
Published in: Sleep and Breathing / Issue 2/2021
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-020-02140-y

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Impact of rapid palatal expansion on the internal nasal valve and obstructive nasal symptoms in children

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Objective

Materials and methods

Results

Conclusions

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