Rapid maxillary expansion in children with obstructive apnoea syndrome: 12-month follow-up

OBJECTIVES: The most common cause of childhood obstructive sleep apnea syndrome (OSAS) is adenotonsillar hypertrophy. To assess the outcome of rapid maxillary expansion in the treatment of obstructive sleep apnea syndrome (OSAS) in children, we studied 16 patients (mean age 6.6+/-2.0; 9 males) with dental malocclusion, a body mass index < or =85 percentile, and OSAS confirmed by polysomnography. METHODS: At baseline and after the trial, all patients underwent physical examination, standard polysomnography and orthodontic assessment. The Brouillette questionnaire investigating symptoms of OSA was administered to parents before and during the trial to assess the clinical severity of their sleep-disordered breathing. Two treated patients were lost to follow-up and excluded from the final study. RESULTS: In the 14 treated subjects who completed the study and follow-up, polysomnography showed a significant decrease in the apnea-hypopnea index (p=0.005), hypopnea obstructive index (p=0.002) and arousal index (p=0.001). Questionnaire responses before and after treatment showed a significant decrease in the severity of symptoms. CONCLUSION: This 12- month open clinical trial suggest that young children with OSA may benefit from early orthodontic treatment with rapid maxillary expander appliance . The orthodontist should systematically question parents on the presence of chronic snoring and other symptoms of OSA in young children.