title: Down syndrome: otolaryngological effects of rapid maxillary expansion.
abstract: OBJECTIVE
  Phenotypical Down syndrome includes pharyngeal and maxillary hypoplasia and, frequently, constricted maxillary arch with nasal obstruction.
  
  
  METHODS
  This clinical trial assessed the effects of rapid maxillary expansion on ENT disorders in 24 children with Down syndrome randomly allocated to receive either rapid maxillary expansion or not. Each group received ENT and speech therapy assessments before expansion and after the device had been removed.
  
  
  RESULTS
  In the rapid maxillary expansion group, the yearly ENT infection rate was reduced when assessed after device removal (p < 0.01). The parents of rapid maxillary expansion children reported a reduction in respiratory obstruction symptoms. Audiological assessment revealed improvements in the rapid maxillary expansion group (p < 0.01). Cephalometry showed increased maxillary width in the rapid maxillary expansion group.
  
  
  CONCLUSIONS
  Rapid maxillary expansion resulted in a reduction in hearing loss, yearly rate of ENT infections and parentally assessed symptoms of upper airway obstruction, compared with no treatment. These findings are probably related to expanded oronasal space, due to rapid maxillary expansion.
authors.affiliation: Department of Otolaryngology, Hospital São João, University of Porto Medical School, Portugal. cmoura@med.up.pt
authors.forename: C Pinto
authors.initials: CP
authors.lastname: de Moura
authors.forename: D
authors.initials: D
authors.lastname: Andrade
authors.forename: L M
authors.initials: LM
authors.lastname: Cunha
authors.forename: M J
authors.initials: MJ
authors.lastname: Tavares
authors.forename: M J
authors.initials: MJ
authors.lastname: Cunha
authors.forename: P
authors.initials: P
authors.lastname: Vaz
authors.forename: H
authors.initials: H
authors.lastname: Barros
authors.forename: S M
authors.initials: SM
authors.lastname: Pueschel
authors.forename: M Pais
authors.initials: MP
authors.lastname: Clemente
mesh_terms: D002508:Cephalometry / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome / Q000150:complications* / Q000628:therapy; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D009967:Orthodontic Appliances / Q000706:statistics & numerical data; D010038:Otorhinolaryngologic Diseases / Q000628:therapy*; D010155:Palatal Expansion Technique / Q000295:instrumentation; D010290:Parents; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D016896:Treatment Outcome