Christian Calvo-Henriquez1, Robson Capasso2, Carlos Chiesa-Estomba3, Stanley Yung Liu2, Silvia Martins-Neves4, Elena Castedo5, Carlos O'Connor-Reina6, Alberto Ruano-Ravina7, Sandra Kahn8. 1. Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS) Study Group, Paris, France; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Spain. Electronic address: christian.ezequiel.calvo.henriquez@sergas.es. 2. Department of Otolaryngology - Head and Neck Surgery, Sleep Surgery Division, Stanford University Medical Center, Stanford, CA, USA. 3. Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS) Study Group, Paris, France; Service of Otolaryngology, Donostia University Hospital, San Sebastian, Spain. 4. Department of Orthodontics, My Face Clinics and Academy, Lisbon, Portugal. 5. Orthodontic Private Practice, Santiago de Compostela, Spain. 6. Service of Otolaryngology, Hospital QuironSalud Marbella, Marbella, Spain. 7. Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP, Spain. 8. Private Practice, San Francisco, CA, USA.
Abstract
OBJECTIVE: A reduced transversal dimension of the maxilla leads to narrower nasal cavities, which may reduce airflow to the lungs. Maxillary expansion widens nasal floor. However, there is huge controversy regarding whether this increase does actually lead to increased airflow. In this systematic review and meta-analysis we aim to resolve this question by evaluating studies that have undertaken rhinomanometric measurements. REVIEW METHODS: Pubmed (Medline), the Cochrane Library, EMBASE and Trip Database were checked by two authors. Two authors extracted the data. Main outcome was expressed as the difference between resistance before and after treatment and the 95% confidence interval. RESULTS: 30 studies were selected for full text reading. A total of 12 studies (301 patients) met the inclusion criteria. All selected articles found reduced resistance after palatal expansion. The data pooled in the meta-analysis reveals a statistically significant difference of 0.12 Pa s/cm3 mean reduction after palatal expansion (CI 95% 0.06, 0.18) for nine uncontrolled studies. Regarding nasal airflow, the pooled data show a statistically significant difference of 29.9 cm3/s increase after palatal expansion (CI 95% 9.17, 50.64). CONCLUSION: According to the available evidence, palatal expansion in pediatric patients decreases nasal resistance and increases nasal flow.
OBJECTIVE: A reduced transversal dimension of the maxilla leads to narrower nasal cavities, which may reduce airflow to the lungs. Maxillary expansion widens nasal floor. However, there is huge controversy regarding whether this increase does actually lead to increased airflow. In this systematic review and meta-analysis we aim to resolve this question by evaluating studies that have undertaken rhinomanometric measurements. REVIEW METHODS: Pubmed (Medline), the Cochrane Library, EMBASE and Trip Database were checked by two authors. Two authors extracted the data. Main outcome was expressed as the difference between resistance before and after treatment and the 95% confidence interval. RESULTS: 30 studies were selected for full text reading. A total of 12 studies (301 patients) met the inclusion criteria. All selected articles found reduced resistance after palatal expansion. The data pooled in the meta-analysis reveals a statistically significant difference of 0.12 Pa s/cm3 mean reduction after palatal expansion (CI 95% 0.06, 0.18) for nine uncontrolled studies. Regarding nasal airflow, the pooled data show a statistically significant difference of 29.9 cm3/s increase after palatal expansion (CI 95% 9.17, 50.64). CONCLUSION: According to the available evidence, palatal expansion in pediatric patients decreases nasal resistance and increases nasal flow.
Authors: Emanuela Sitzia; Sara Santarsiero; Filippo Maria Tucci; Giovanni De Vincentiis; Angela Galeotti; Paola Festa Journal: Ital J Pediatr Date: 2021-09-16 Impact factor: 2.638