Rapid Maxillary Expansion in Children with Obstructive Sleep Apnea Syndrome

THE ASSOCIATION BETWEEN OBSTRUCTIVE SLEEP APNEA SYNDROME (OSAS), MAXILLOFACIAL MALFORMATIONS, AND MALOCCLUSIONS HAS ATTRACTED ATTENTION. Many patients with OSAS show craniofacial abnormalities involving both the jaws as well as skeletal structures of the respiratory dynamic space. These aberrations may be apparent very early in life. Nasal septal deviation is known to reduce airflow and increase resistance to nasal breathing. Abnormal nasal resistance can be experimentally induced at birth in monkeys. When these conditions appear in the first year of life, they can cause a deformation of the upper jaw, affecting its cross-sectional development with a resulting reduced jaw size in experimental animals and in humans. Nasal septal deviation results in the asymmetric distribution of intranasal space and affects the turbinates. The latter effect in turn causes a reduction of total airflow. The developmental impact of abnormal nasal resistance related to septal deviation early in life, with or without nasal turbinate hypertrophy, is abnormal maxillary development. Rapid maxillary expansion (RME) treats upper-jaw constriction. We questioned whether RME treatment for children could improve (1) nasal airflow by decreasing the abnormal nasal resistance and (2) OSAS. MATERIALS AND METHODS