Objectives: Theobjectivesofthisstudyweretoconfirmtheefficacyofrapidmaxillaryexpansioninchildren withmoderateadenotonsillarhypertrophyinalargersampleandtoevaluateretrospectivelyitslong-term benefits in a group of children who underwent orthodontic treatment 10 years ago. Methods: After general clinical examination and overnight polysomnography, all eligible children underwent cephalometric evaluation and started 12 months of therapy with rapid maxillary expansion. Anewpolysomnographywasperformedattheendoftreatment(T1).Fourteenchildrenunderwentclinical evaluation and Brouilette questionnaire, 10 years after the end of treatment (T2). Results: Forty patients were eligible for recruitment. At T1, 34/40 (85%) patients showed a decrease of apnea–hypopneaindex(AHI)greaterthan20%(ΔAHI67.45%±25.73%)andweredefinedresponders.Only 6/40 (15%) showed a decrease <20% of AHI at T1 and were defined as non-responders (ΔAHI −53.47%±61.57%).Moreover,57.5%ofpatientspresentedresidualOSA(AHI>1ev/h)aftertreatment.Disease duration was significantly lower (2.5±1.4 years vs 4.8±1.9 years, p<0.005) and age at disease onset was higher in responder patients compared to non-responders (3.8±1.5 years vs 2.3±1.9 years, p<0.05). Cephalometric variables showed an increase of cranial base angle in non-responder patients (p<0.05). Fourteen children (mean age 17.0±1.9 years) who ended orthodontic treatment 10 years previously showed improvement of Brouilette score. Conclusion: Starting an orthodontic treatment as early as symptoms appear is important in order to increase the efficacy of treatment. An integrated therapy is needed.

Rapid maxillary expansion outcomes in treatment of obstructive sleep apnea in children / Villa, MARIA PIA; Rizzoli, Alessandra; Rabasco, Jole; Vitelli, Ottavio; Pietropaoli, Nicoletta; Cecili, Manuela; Marino, Alessandra; Malagola, Caterina. - In: SLEEP MEDICINE. - ISSN 1389-9457. - STAMPA. - 16:6(2015), pp. 709-716. [10.1016/j.sleep.2014.11.019]

Rapid maxillary expansion outcomes in treatment of obstructive sleep apnea in children

VILLA, MARIA PIA
;
RIZZOLI, ALESSANDRA;RABASCO, JOLE;VITELLI, OTTAVIO;PIETROPAOLI, NICOLETTA;MARINO, Alessandra;MALAGOLA, Caterina
2015

Abstract

Objectives: Theobjectivesofthisstudyweretoconfirmtheefficacyofrapidmaxillaryexpansioninchildren withmoderateadenotonsillarhypertrophyinalargersampleandtoevaluateretrospectivelyitslong-term benefits in a group of children who underwent orthodontic treatment 10 years ago. Methods: After general clinical examination and overnight polysomnography, all eligible children underwent cephalometric evaluation and started 12 months of therapy with rapid maxillary expansion. Anewpolysomnographywasperformedattheendoftreatment(T1).Fourteenchildrenunderwentclinical evaluation and Brouilette questionnaire, 10 years after the end of treatment (T2). Results: Forty patients were eligible for recruitment. At T1, 34/40 (85%) patients showed a decrease of apnea–hypopneaindex(AHI)greaterthan20%(ΔAHI67.45%±25.73%)andweredefinedresponders.Only 6/40 (15%) showed a decrease <20% of AHI at T1 and were defined as non-responders (ΔAHI −53.47%±61.57%).Moreover,57.5%ofpatientspresentedresidualOSA(AHI>1ev/h)aftertreatment.Disease duration was significantly lower (2.5±1.4 years vs 4.8±1.9 years, p<0.005) and age at disease onset was higher in responder patients compared to non-responders (3.8±1.5 years vs 2.3±1.9 years, p<0.05). Cephalometric variables showed an increase of cranial base angle in non-responder patients (p<0.05). Fourteen children (mean age 17.0±1.9 years) who ended orthodontic treatment 10 years previously showed improvement of Brouilette score. Conclusion: Starting an orthodontic treatment as early as symptoms appear is important in order to increase the efficacy of treatment. An integrated therapy is needed.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/793662
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