Surgically assisted rapid palatal expansion: a literature review.

Objective: To evaluate the effects of rapid maxillary expansion (RME) on conductive hearing loss and maxillary constriction. Materials and Methods: A total of 25 subjects (15 girls and 10 boys, aged between 6 years 8 months to 8 years 2 months) with conductive hearing loss and maxillary constriction were studied. Audiogram, tympanogram, and video-otoscopy were used to investigate the anatomical and physiological modifications of the bony and muscular structure of the maxilla and the auditory apparatus. The records were taken before maxillary expansion (T0), after expansion (7–14 days; T1), and after the retention period (8 months after expansion; T2). Results: After expansion, the audiometric records indicated an improvement in hearing levels for higher frequencies but not for lower ones. After the retention period, there was a functional improvement in all patients for all frequencies. The recovery of the tympanic membrane's elasticity occurred only after retention, as shown by the standard mode...

Correlations between rapid maxillary expansion (RME) and the auditory apparatus.

The aim of this prospective study was to describe the morphological and functional changes of the upper airways and the middle ears after rapid maxillary expansion (RME). Thirteen patients comprised the original study sample, of these three patients dropped out. Of the remaining 10 subjects, seven (two females, five males; average age, 8.7 years) underwent orthodontic RME with a Hyrax screw and three (one female, two males; average age, 8.3 years) served as the controls. Inclusion criteria for the study group were a uni- or bilateral crossbite with the evidence of a maxillary deficiency. Exclusion criteria were acute or chronic respiratory disease, allergies, cleft lip and palate, or absence of adenoids. An ear, nose, and throat (ENT) examination, lateral cephalometry, anterior rhinomanometry, tympanometry, and posterior rhinoscopy were carried out for each child at baseline (E1) and after 6 months (E2). Descriptive statistics were calculated for all diagnostic variables and correlations between the study and control group were evaluated.

Rhinomanometry showed a correlation ( r  = 0.57) between the size of the nasal pharyngeal area and nasal airflow, but only at 150 daPa. The size of the adenoids measured on the lateral cephalograms was correlated with the endoscopic findings. The size of the adenoids remained the same after RME. Patients with maxillary constriction had the largest adenoids and showed a negative pressure in the middle ear. However, this was reduced after RME.

The results suggest a possible impact of maxillary deficiency on otorhinological structures. RME may lead to otorhinological changes. Further interdisciplinary investigations are needed to corroborate these findings.

Effects of rapid maxillary expansion on the airways and ears--a pilot study.

AIM: This was to investigate in oral breathing children with an associated atypical pattern of swallowing and otitis media, the effects of rapid maxillary expansion on nasal airway resistance and conductive hearing loss. MATERIALS AND METHODS: This study examined 24 children (16 males and 8 females) in early mixed dentition period, with an age range of 6-8 years (mean age 7 years), diagnosed with otitis media from the otorhinolaryngology Department of "Tor Vergata" Hospital. The young patients were seen in the Department of Orthodontics, Faculty of Dentistry University of Rome "Tor Vergata". All the subjects had an open mouth breathing pattern with a secondary atypical swallowing mode and a conductive hearing loss resulting from otitis media. The therapeutic approach was to apply a RPE fixed appliance (Butterfly expander). RESULTS: Follow up showed that after rapid maxillary expansion there was nasal resistance reduction, increased nasal airflow and improvement in conductive hearing loss. CONCLUSION Rapid maxillary expansion has been used for both dental and rhinological purposes in the belief that clinically significant reductions in nasal resistance to airflow and an improvement in conductive hearing loss occur predictably.

Orthodontist-otorhinolaryngologist: an interdisciplinary approach to solve otitis media.

The aim of the study was to review in detail, the skeletal, dental and soft-tissue effects of Rapid Maxillary Expansion in young group of patients using Computed Tomographic Scan. The review is conducted through an electronic and manual searches which includes PubMed, Ovid, Cochrane, and Web of Science using the keywords. Searches includes the original studies which were conducted from the January 2000 to May 2020 amongst patients from 6 to 18 years using Hyrax, Haas-type and butterfly-type expanders. Based on the inclusion criteria, 23 relevant articles containing 298 patients were selected to evaluate changes related to skeletal, dental, soft-tissues and airway by assessing Computed Tomography scan. Significant effects have been observed at the mid-palatal suture due to the separation of two hemi-maxillae that led to an increase in the palatal volume, maxillary arch perimeter and correction of posterior crossbite. Changes were also recorded at the circum-maxillary sutures with maximum effects noted in internasal and nasomaxillary sutures. Other observations includes dental changes like buccal tipping of the maxillary posterior anchored teeth, increase in nasal and upper airway dimensions. Few side-effects of Rapid Maxillary Expansion includes recession of alveolar bone and dehiscence in cases of excessive dental tipping, dorsal hump on the nose with flattening of the nasal tip. Interpreting the outcomes with Computed Tomography scan strengthen the orthodontist’s precision in determining the 3-dimension effects with greater specificity. However, more number of Computed Tomography studies on soft-tissue changes and airway effects are required to understand comprehensive mechanics of the procedure.

https://www.oraljournal.com/pdf/2021/vol7issue1/PartA/6-4-34-886.pdf

Evaluation of treatment changes with rapid maxillary expansion using computed tomography scan: A comprehensive review

Effect of rapid maxillary expansion on hearing loss

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Effect of rapid maxillary expansion on hearing loss