title: Rapid maxillary expansion (RME) for pediatric obstructive sleep apnea: a 12-year follow-up.
abstract: OBJECTIVE
  The objective of this study was to prospectively evaluate the long-term efficacy of rapid maxillary expansion (RME) in a group of children with obstructive sleep apnea (OSA).
  
  
  METHODS
  Thirty-one children diagnosed with OSA were involved in the study. These children had isolated maxillary narrowing and absence of enlarged adenotonsils at baseline. Twenty-three individuals (73% of the initial group) were followed up annually over a mean of 12 years after the completion of orthodontic treatment at a mean age of 8.68 years. Eight children dropped out over time due to either moving out of the area (n = 6) or refusal to submit to regular follow-up (n = 2). Subjects underwent clinical reevaluation over time and repeat polysomnography (PSG) in the late teenage years or in their early 20s. During the follow-up period, eight children dropped out and 23 individuals (including 10 girls) underwent a final clinical investigation with PSG (mean age of 20.9 years). The final evaluation also included computerized tomographic (CT) imaging that was compared with pre- and post-initial treatment findings.
  
  
  RESULTS
  Yearly clinical evaluations, including orthodontic and otolaryngological examinations and questionnaire scores, were consistently normal over time, and PSG findings remained normal at the 12-year follow-up period. The stability and maintenance of the expansion over time was demonstrated by the maxillary base width and the distance of the pterygoid processes measured using CT imaging.
  
  
  CONCLUSIONS
  A subgroup of OSA children with isolated maxillary narrowing initially and followed up into adulthood present stable, long-term results post RME treatment for pediatric OSA.
authors.affiliation: Department of Clinical Sciences and Translational Medicine, University of Tor Vergata, Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Pirelli
authors.affiliation: Department of Otolaryngology and Neurology, La Sapienza University, Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Saponara
authors.affiliation: Stanford University Sleep Disorders Clinic, Redwood City, CA, USA. Electronic address: cguil@stanford.edu.
authors.forename: Christian
authors.initials: C
authors.lastname: Guilleminault
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010155:Palatal Expansion Technique; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: Isolated maxillary deficiency; Pediatric obstructive sleep apnea; Rapid maxillary expansion; Very long-term follow-up