PMID- 26827275 OWN - NLM STAT- MEDLINE DCOM- 20180905 LR - 20180905 IS - 1479-666X (Print) IS - 1479-666X (Linking) VI - 16 IP - 1 DP - 2018 Feb TI - Does rapid maxillary expansion affect nasopharyngeal airway? A prospective Cone Beam Computerised Tomography (CBCT) based study. PG - 1-11 LID - S1479-666X(15)00125-0 [pii] LID - 10.1016/j.surge.2015.12.006 [doi] AB - BACKGROUND AND PURPOSE: There is limited literature discussing the three dimnesional (3D) impact of rapid maxillary expansion (RME) on upper airway. The purpose of this prospective Cone Beam Computerised Tomography (CBCT) based study is to assess the immediate 3D effects and to correlate the volumteric changes in the upper naspharyngeal airway spaces secondary to RME. MATERIALS AND METHODS: Seventeen participants (8 male, 9 female, with a mean age of 12.6 +/- 1.8 years), who required RME for the management of narrow maxillary arch, were recruited for this study. The prescribed expansion regimen was quarter turn (0.25 mm), twice a day until over-expansion was achieved. The mean period for the active phase was 14 days with a range of 12-21 days. Pretreatment (T1) and immediate post-expansion (T2) CBCT images were obtained and then processed using ITK snap and OnDemand3D softwar packages. Paired t-test and Interclass Correlation Coefficient (ICC) were used to assess the reproducibility of the measurements, student t-test (P < 0.05) and Pearson Correlation Coefficient (PCC) were applied to evaluate the volumetric changes in the nasopharyngeal airway spaces, linear dentolaveolar changes and correlate these changes. MAIN FINDINGS: Though, the data of one patient was excluded from the study, owing to major differences (>5 degrees) in the head and neck posture between T1 and T2 CBCT scans, the study' findings shows that bonded RME is an effective dentoalveolar expander in growing patients (P= 0.01) with an average expansion of 3.7 mm and 2.8 mm in males and females respectively. Likewise, the upper nasopharynx (UNP) expanded significantly (15.2% in males and 12% in females). In comparison, the upper retropalatal space (URP) was significantly reduced, by almost one sixth of its original volume, more in males than females, 11.2% and 2.8% respectively. A strong direct correlation between the maxillary sinus volumetric changes, and between appliance expansion and dentoalveolar expansion were evident (PCC = 0.86, 0.75, respectively). There was also a moderate correlation between changes in the UNP and URP spaces. CONCLUSIONS: RME was found to be an effective dentoalveolar expander and significantly augment the UNP and minimize the URP space. A similar comparative clinical study with long-term follow-up would be beneficial in accurately deteremining the clinical impact of RME on the airway and breathing as well as the stability of these effects. CI - Copyright (c) 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved. FAU - Almuzian, Mohammed AU - Almuzian M AD - Orthodontic Department, Sydney Dental Hospital, University of Sydney, Sydney, NSW, Australia; Medical Devices Unit, NHS Greater Glasgow and Clyde, Glasgow, UK. Electronic address: dr_muzian@hotmail.com. FAU - Ju, Xiangyang AU - Ju X AD - Medical Devices Unit, NHS Greater Glasgow and Clyde, Glasgow, UK. FAU - Almukhtar, Anas AU - Almukhtar A AD - Orthodontic Department, Glasgow Dental Hospital and School, MVLS College, University of Glasgow, Glasgow, UK. FAU - Ayoub, Ashraf AU - Ayoub A AD - Oral & Maxillofacial Surgery, Glasgow Dental Hospital & School, MVLS College, University of Glasgow, Glasgow, UK. FAU - Al-Muzian, Lubna AU - Al-Muzian L AD - Deportment of Dental Public Health, School of Dentistry, Faculty of Medical and Human Science, University of Manchester, Manchester, UK. FAU - McDonald, Jim P AU - McDonald JP AD - Orthodontic Department, Glasgow Dental Hospital and School, MVLS College, University of Glasgow, Glasgow, UK. LA - eng PT - Journal Article DEP - 20160128 PL - Scotland TA - Surgeon JT - The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland JID - 101168329 SB - IM MH - Adolescent MH - Child MH - *Cone-Beam Computed Tomography MH - Female MH - Humans MH - Male MH - Maxilla/*diagnostic imaging/surgery MH - Maxillary Sinus/*diagnostic imaging/surgery MH - Nasopharynx/*diagnostic imaging/surgery MH - *Palatal Expansion Technique MH - Palate/*diagnostic imaging/surgery MH - Prospective Studies OTO - NOTNLM OT - Airway space OT - CBCT OT - ITK snap software OT - OnDemand3D software OT - Rapid maxillary expansion EDAT- 2016/02/02 06:00 MHDA- 2018/09/06 06:00 CRDT- 2016/02/01 06:00 PHST- 2015/02/10 00:00 [received] PHST- 2015/11/19 00:00 [revised] PHST- 2015/12/22 00:00 [accepted] PHST- 2016/02/02 06:00 [pubmed] PHST- 2018/09/06 06:00 [medline] PHST- 2016/02/01 06:00 [entrez] AID - S1479-666X(15)00125-0 [pii] AID - 10.1016/j.surge.2015.12.006 [doi] PST - ppublish SO - Surgeon. 2018 Feb;16(1):1-11. doi: 10.1016/j.surge.2015.12.006. Epub 2016 Jan 28.