Advertisement

Orthodontic measurements and nasal respiratory function after surgically assisted rapid maxillary expansion: an acoustic rhinometry and rhinomanometry study

Published:April 20, 2012DOI:https://doi.org/10.1016/j.ijom.2011.12.037

      Abstract

      The present study sought to assess nasal respiratory function in adult patients with maxillary constriction who underwent surgically assisted rapid maxillary expansion (SARME) and to determine correlations between orthodontic measurements and changes in nasal area, volume, resistance, and airflow. Twenty-seven patients were assessed by acoustic rhinometry, rhinomanometry, orthodontic measurements, and use of a visual analogue scale at three time points: before surgery; after activation of a preoperatively applied palatal expander; and 4 months post-SARME. Results showed a statistically significant increase (p < 0.001) in all orthodontic measurements. The overall area of the nasal cavity increased after surgery (p < 0.036). The mean volume increased between assessments, but not significantly. Expiratory and inspiratory flow increased over time (p < 0.001). Airway resistance decreased between assessments (p < 0.004). Subjective analysis of the feeling of breathing exclusively through the nose increased significantly from one point in time to the next (p < 0.05). There was a statistical correlation between increased arch perimeter and decreased airway resistance. Respiratory flow was the only variable to behave differently between sides. The authors conclude that the SARME procedure produces major changes in the oral and nasal cavity; when combined, these changes improve patients’ quality of breathing.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to International Journal of Oral and Maxillofacial Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Arnett G.W.
        • Jelic J.S.
        • Kim J.
        • Cummings D.R.
        • Beress A.
        • Worley M.D.
        • et al.
        Soft tissue cephalometric analysis: diagnosis and treatment planning of dentofacial deformity.
        Am J Orthod Dentofacial Orthop. 1999; 116: 239-253https://doi.org/10.1016/S0889-5406(99)70234-9
        • Betts N.J.
        • Vanarsdall R.L.
        • Barber H.D.
        • Higgins-Barber K.
        • Fonseca R.J.
        Diagnosis and treatment of transverse maxillary deficiency.
        Int J Adult Orthod Orthog Surg. 1995; 10: 75-96
        • Alpern M.C.
        • Yurosko J.J.
        Rapid palatal expansion in adults with and without surgery.
        Angle Orthod. 1987; 57: 245-263
        • Bell W.H.
        • Jacobs J.D.
        Surgical-orthodontic correction of horizontal maxillary deficiency.
        J Oral Surg. 1979; 37: 897-902
        • Bicakci A.A.
        • Agar U.
        • Sökücü O.
        • Babacan H.
        • Doruk C.
        Nasal airway changes due to rapid maxillary expansion timing.
        Angle Orthod. 2005; 75: 1-6
        • Doruk C.
        • Sökücü O.
        • Sezer H.
        • Canbay E.I.
        Evaluation of nasal airway resistance during rapid maxillary expansion using acoustic rhinometry.
        Eur J Orthod. 2004; 26: 397-401https://doi.org/10.1093/ejo/26.4.397
        • Silverstein K.
        • Quinn P.D.
        Surgically assisted rapid palatal expansion for management of transverse maxillary deficiency.
        J Oral Maxillofac Surg. 1997; 55: 725-731https://doi.org/10.1016/S0278-2391(97)90587-5
        • Wriedt S.
        • Kunkel M.
        • Zentner A.
        • Wahlmann U.W.
        Surgically assisted rapid palatal expansion an acoustic rhinometric, morphometric and sonographic investigation.
        J Orofac Orthop. 2001; 62: 107-115https://doi.org/10.1007/PL00001921
        • Berger J.L.
        • Pangrazio-Kulbersh V.
        • Thomas B.W.
        • Kaczynski R.
        Photographic analysis of facial changes associated with maxillary expansion.
        Am J Orthod Dentofacial Orthop. 1999; 116: 563-571https://doi.org/10.1016/S0889-5406(99)70190-3
        • Bertelè G.
        • Mercanti M.
        • Stella F.
        Strutural dentofacial variations in maxilla expansion.
        Minerva Stomatol. 1999; 48: 101-103
        • Chamberland S.
        • William R.P.
        Closer Look at the stability of surgically assisted rapid palatal expansion.
        J Oral Maxillofac Surg. 2008; 66: 1895-1900https://doi.org/10.1016/j.joms.2008.04.020
        • Koudstaal M.J.
        • Poort L.J.
        • van der Wal K.G.H.
        • Wolvius E.B.
        • Prahl-andersen B.
        • Schulten A.J.M.
        Surgically assisted rapid maxillary expansion (SARME): a review of the literature.
        Int J Oral Maxillofac Surg. 2005; 34: 709-714https://doi.org/10.1016/j.ijom.2005.04.025
        • Mommaerts M.Y.
        Transpalatal distraction as a method of maxillary expansion.
        Br J Oral Maxillofac Surg. 1999; 37: 268-272https://doi.org/10.1016/j.tripleo.2009.09.011
        • Özturk M.
        • Doruk C.
        • Ozeç I.
        • Polat S.
        • Babacan H.
        • Biçakci A.A.
        Pulpal blood flow: effects of corticotomy and midline osteotomy in surgically assisted rapid palatal expansion.
        J Craniomaxillofac Surg. 2003; 31: 97-100https://doi.org/10.1016/S1010-5182(02)00188-9
        • Phillips C.
        • Medland W.H.
        • Fields H.W.
        • Proffit W.R.
        • White R.P.
        Stability of surgical maxillary expansion.
        Int J Adult Orthod Orthog Surg. 1992; 7: 139-146
        • Bell R.A.
        A review of maxillary expansion in relation to rate of expansion and patient's age.
        Am J Orthod. 1982; 81: 32-36https://doi.org/10.1016/0002-9416(82)90285-8
        • Pogrel M.A.
        • Kaban L.B.
        • Vargervik K.
        • Baumrind S.
        Surgically assisted maxillary rapid expansion in adults.
        Int J Adult Orthodon Orthognath Surg. 1992; 7: 37-41
        • Lehman Jr., J.A.
        • Haas A.J.
        Surgical-orthodontic correction of transverse maxillary deficiency.
        Dent Clin North Am. 1990; 34: 385-395
        • Anttila A.
        • Finne K.
        • Keski-Nisula K.
        • Somppi M.
        • Panula K.
        • Peltomaki T.
        Feasibility and long-term stability of surgically assisted rapid maxillary expansion with lateral osteotomy.
        Eur J Orthod. 2004; 26: 391-395https://doi.org/10.1093/ejo/26.4.391
        • Chung C.H.
        • Woo A.
        • Zagarinsky J.
        • Vanarsdall R.L.
        • Fonseca R.J.
        Maxillary sagittal and vertical displacement induced by surgically assisted rapid palatal expansion.
        Am J Orthod Dentofacial Orthop. 2001; 120: 144-148https://doi.org/10.1067/mod.2001.113791
        • Lagravere M.
        • Major P.W.
        • Flores-Mir C.
        Dental and skeletal changes following surgically assisted rapid maxillary expansion.
        Int J Oral Maxillofac Surg. 2006; 35: 481-487https://doi.org/10.1016/j.ijom.2006.01.025
        • Utumi E.R.
        • Zambon C.E.
        • Castro Neto N.P.
        • Pedron I.G.
        • Ceccheti M.M.
        Correção cirúrgica da deficiência transversal da maxila: relato de caso.
        Rev Inst Ciênc Saúde. 2008; 26: 362-365
        • Woods M.
        • Wiesenfeld D.
        • Probert T.
        Surgically assisted maxillary expansion.
        Aust Dent J. 1997; 42: 38-42https://doi.org/10.1111/j.1834-7819.1997.tb00094.x
        • Hilberg O.
        • Pedersen O.F.
        Acoustic rhinometry: recommendations for technical specifications and standard operating procedures.
        Rhinology. 2000; S16: 3-17
        • Nigro J.F.A.
        • Nigro C.E.N.
        • Mion O.
        • Mello Jr., J.F.
        • Voegels R.L.
        Avaliação objetiva da permeabilidade nasal por meio da rinometria acústica.
        Arq Otorrinolaringol. 2003; 7: 310-315
        • Roithman R.
        • Cole P.
        • Chapnik J.
        • Barreto S.M.
        • Szalai J.P.
        • Zamel N.
        Acoustic rhinometry, rhinomanometry and the sensation of nasal patency: a correlative study.
        J Otolaryngol. 1994; 23: 453-458
        • Doruk C.
        • Sökücü O.
        • Biçakçi A.A.
        • Yilmaz U.
        • Tas F.
        Comparison of nasal volume changes during rapid maxillary expansion using acoustic rhinometry and computed tomography.
        Eur J Orthod. 2007; 29: 251-255https://doi.org/10.1093/ejo/cjl069
        • Moura C.P.
        • Vales F.
        • Andrade D.
        • Cunha L.M.
        • Barros H.
        • Pueschel S.M.
        • et al.
        Rapid maxillary expansion and nasal patency in children with Down Syndrome.
        Rhinology. 2005; 43: 139-142
        • Clement P.A.R.
        • Gordts F.
        Consensus report on acoustic rhinometry and rhinomanometry.
        Rhinology. 2005; 43: 169-179
        • Haarmann S.
        • Budihardja A.S.
        • Wolff K.D.
        • Wargerin K.
        Changes in acoustic airway profiles and nasal airway resistance after Le Fort I osteotomy and functional rhinosurgery: a prospective study.
        Int J Oral Maxillofac Surg. 2009; 38: 321-325https://doi.org/10.1016/j.ijom.2009.01.006
        • Marchetti C.
        • Pironi M.
        • Bianchi A.
        • Musci A.
        Surgically assisted rapid palatal expansion vs. segmental Le Fort I osteotomy: transverse stability over a 2-year period.
        J Cranio-Maxillofac Surg. 2009; 37: 74-78https://doi.org/10.1016/j.jcms.2008.08.006
        • Mitsuda S.T.
        • Pereira M.D.
        • Passos A.P.
        • Hino C.T.
        • Ferreira L.M.
        Effects of surgically assisted rapid maxillary expansion on nasal dimensions using acoustic rhinometry.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109: 191-196
        • Basciftci F.A.
        • Mutlu N.
        • Karaman A.I.
        • Malhoc S.
        • Küçükkolbasi H.
        Does the timing and method of rapid maxillary expansion have an effect on the changes in nasal dimensions?.
        Angle Orthod. 2002; 72: 118-123
        • Glassman A.S.
        • Nahigian S.J.
        • Medway J.M.
        • Aronowitz H.I.
        Conservative surgical orthodontic adult rapid palatal expansion: sixteen cases.
        Am J Orthod. 1984; 86: 207-213https://doi.org/10.1016/0002-9416(84)90372-5
        • Lanigan D.T.
        • Mintz S.M.
        Complications of surgically assisted rapid palatal expansion: review of the literature and report of a case.
        J Oral Maxillofac Surg. 2002; 60: 104-110https://doi.org/10.1053/joms.2002.29087
        • Ilizarov G.A.
        Clinical applications of tension-stress effects for limb lengthening.
        Clin Orthop. 1990; 250: 8-26https://doi.org/10.1097/00003086-199001000-00003
        • Roithman R.
        • Cole P.
        • Chapnik J.
        • Shpirer I.
        • Hoffstein V.
        • Zamel N.
        Acoustic rhinometry in the evaluation of nasal obstruction.
        Laryngoscope. 1995; 105: 275-281https://doi.org/10.1288/00005537-199503000-00010