Rapid maxillary expansion in children with obstructive sleep apnea syndrome: 12-month follow-up.
OBJECTIVE
To assess the outcome of rapid maxillary expansion in the treatment of obstructive sleep apnea syndrome (OSAS) in children, we studied 16 patients (mean age 6.6+/-2.0; 9 males) with dental malocclusion, a body mass index < or =85 percentile, and OSAS confirmed by polysomnography.


METHODS
At baseline and after the trial, all patients underwent physical examination, standard polysomnography and orthodontic assessment. The Brouillette questionnaire investigating symptoms of OSA was administered to parents before and during the trial to assess the clinical severity of their sleep-disordered breathing. Two treated patients were lost to follow-up and excluded from the final study.


RESULTS
In the 14 treated subjects who completed the study and follow-up, polysomnography showed a significant decrease in the apnea-hypopnea index (p=0.005), hypopnea obstructive index (p=0.002) and arousal index (p=0.001). Questionnaire responses before and after treatment showed a significant decrease in the severity of symptoms.


CONCLUSIONS
A rapid maxillary expander is an effective appliance for treating children with OSAS.
Villa
Maria Pia
MP
Pediatric Clinic, Sant' Andrea Hospital, II Faculty of Medicine, University La Sapienza, Rome, Italy. mariapia.villa@uniroma1.it
Malagola
Caterina
C
Pagani
Jacopo
J
Montesano
Marilisa
M
Rizzoli
Alessandra
A
Guilleminault
Christian
C
Ronchetti
Roberto
R
D000234:Adenoids / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy; D008297:Male; D008310:Malocclusion / Q000628:therapy; D010155:Palatal Expansion Technique; D014066:Palatine Tonsil / Q000473:pathology; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D012913:Snoring / Q000209:etiology