title: Effect of Surgically Assisted Rapid Maxillary Expansion on Upper Airway Volume: A Systematic Review.
abstract: OBJECTIVE
  Surgically assisted rapid maxillary expansion (SARME) is required in non-growing patients when maturity or resistance precludes desired sutural separation by noninvasive techniques. The aim of this review was to determine what volumetric changes occur in the upper airway spaces after SARME in adults.
  
  
  METHODS
  A systematic review was performed with data assessed for suitability of meta-analysis. The primary outcome measurement of volumetric changes in an upper airway space was sought in non-growing patients undergoing SARME. Electronic database searches were performed for published literature in Medline (by Ovid), Pre-Medline, Old Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) spanning all available years to August 1, 2015. Unpublished literature was searched electronically through ClinicalTrials.gov and the National Research Register. Additional hand searching of reference lists of relevant articles, grey searching, and expert correspondence was conducted for any additional studies. Two authors independently screened search results, extracted data, and assessed the risk of bias of included studies.
  
  
  RESULTS
  Twenty-one studies were located by initial screening; 10 were excluded after full-text review, leaving 11 studies eligible that met all inclusion criteria for this systematic review. In total, 204 treated patients (mean age, 18 to 31 yr) were included in the qualitative synthesis. Ten studies evaluated nasal cavity volume, 2 evaluated palatal volume, and 1 evaluated oropharyngeal volume. Appliances used included tooth-borne hyrax and transpalatal distractor devices.
  
  
  CONCLUSIONS
  SARME was found to produce substantial short-term volume increases in the nasal cavity in non-growing patients that were maintained for at least 63 months. Evidence weakly suggested no effect on oropharyngeal volume. However, most studies were evaluated as having a high risk of bias. The effect of such volume changes on respiratory function still needs to be determined; thus, SARME cannot be recommended for respiratory purposes.
authors.affiliation: Postgraduate Student, Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney Dental Hospital, Sydney South West Area Health Service, Sydney, Australia.
authors.forename: Lloyd M
authors.initials: LM
authors.lastname: Buck
authors.affiliation: Senior Lecturer, Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney Dental Hospital, Sydney South West Area Health Service, Sydney, Australia.
authors.forename: Oyku
authors.initials: O
authors.lastname: Dalci
authors.affiliation: Professor and Chair, Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney Dental Hospital, Sydney South West Area Health Service, Sydney, Australia.
authors.forename: M Ali
authors.initials: MA
authors.lastname: Darendeliler
authors.affiliation: Senior Lecturer, Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney Dental Hospital, Sydney South West Area Health Service, Sydney, Australia; Research Associate, Department of Oral Surgery and Implantology, Aristotle University of Thessaloniki, Thessaloniki, Greece. Electronic address: alexandra.papadopoulou@sydney.edu.au.
authors.forename: Alexandra K
authors.initials: AK
authors.lastname: Papadopoulou
mesh_terms: D000328:Adult; D006801:Humans; D009305:Nasopharynx / Q000473:pathology / Q000503:physiopathology*; D010155:Palatal Expansion Technique / Q000009:adverse effects; D012143:Respiratory Physiological Phenomena