Maxillary Expansion Effects in Children With Upper Airway Obstruction

Universidade Federal de Goias

Status: Unknown

Conditions: Airway Obstruction

Treatments: Procedure: Adenotonsillectomy; Procedure: Rapid maxillary expansion

Study type: Interventional

Funder types: Other

Identifiers

NCT03004300

044029

Details and patient eligibility

About

The most frequent causes of mouth breathers are the adenotonsillar hypertrophy. Adenotonsillectomy is the main choice for the elimination of the obstruction. However, this surgical treatment does not have its effect well elucidated and apnea has been cited in the literature as a residual outcome. Other types of supporting treatment may also been involved such as the use of corticosteroids, physiotherapy and orthodontic-orthopedic treatment, among them rapid maxillary expansion (RME).

RME corrects the morphological constriction of the upper arch caused by buccal breathing and also reduce the airway resistance. Despite reports of RME influencing volume enhancement in pharyngeal airway, there are still few three-dimensional studies following the post-expansion effects. In addition, these changes are doubtful due postural changes of the tongue during the tomography exam. Conflicts of results are also present for changes in the nasal septum of children. The main alteration mentioned is the increase in the length of the lower third of the septum.

The investigators propose a randomized, prospective, controlled clinical trial in patients with atresic maxilla with or without adenotonsillar hypertrophy. The patients will be treated with RME and adenotonsillectomy when the obstruction is present. The purpose of this study is elucidate if there is different outcomes considering the moment of RME treatment before or after the adenotonsillectomy.

Enrollment: 60 estimated patients

Sex: All

Ages: 5 to 9 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Children (boys and girls) between 5 and 9 years of age.
• Atresic maxilla.
• Skeletal Class I
• With or without Adenotonsillar hypertrophy
• Parents or tutors sign Informed Consent.

Exclusion criteria

• Craniofacial syndromes or neurologic disease diagnosis.
• History of adenotonsillectomy and orthodontic treatment
• History of facial trauma
• Morbid obesity
• Premature loss of posterior teeth

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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60 participants in 3 patient groups

group 1

Active Comparator group

Description:

Patients with atresic maxilla without upper airway obstruction submitted to rapid maxillary expansion

Treatment:

Procedure: Rapid maxillary expansion

group 2

Experimental group

Description:

Patients with atresic maxilla and adenotonsillar hypertrophy submitted to rapid maxillary expansion before adenotonsillectomy

Treatment:

Procedure: Adenotonsillectomy

Procedure: Rapid maxillary expansion

group 3

Experimental group

Description:

Patients with atresic maxilla and adenotonsillar hypertrophy submitted to rapid maxillary expansion after adenotonsillectomy

Treatment:

Procedure: Adenotonsillectomy

Procedure: Rapid maxillary expansion