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Randomized clinical trial of surgically assisted rapid maxillary expansion with two and three segments for nasal breathing

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Abstract

Objectives

To evaluate surgically assisted rapid maxillary expansion (SARME), with osteotomies separating the maxilla into two segments (SARME-2S) and three segments (SARME-3S), on obstruction symptoms and nasal cavity dimensions in patients with maxillary transverse skeletal deficiency (MTSD).

Materials and methods

Sixteen patients with MTSD of 7 mm or above were evaluated in each group, for a total of 32 patients. All patients were evaluated pre- and postoperatively up to 10 months after the expander activations. The minimum cross-sectional area (MCA) and the volume of the nasal cavities were identified by acoustic rhinometry. The Nasal Obstruction Symptom Evaluation (NOSE) scale questionnaire was applied. The palate surface area (PSA) was measured, via digitized maxillary models, as a criterion for comparison with the other variables studied.

Results

There was no difference between the groups (p = 0.370) and was verified a significant increase in PSA postoperatively. MCA showed a small increase without statistical significance, and together with the volume of the nasal cavities remained constant during the study. NOSE scale scores decreased significantly in the postoperative periods, implying a decrease in nasal obstruction symptoms in both groups.

Conclusions

SARME with two and three segments show similar results, and both may improve nasal obstruction symptoms when present in patients with MTSD.

Clinical relevance

SARME, regardless of the chosen surgical technique, should follow the recommendation to correct just the MTSD. While an improvement in nasal breathing is expected, this must be understood as likely, but not certain.

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Data availability

The data analyzed in this study are available upon request to the corresponding author.

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Acknowledgements

The authors would like to thank Dr. Mitti Koyama for her support in the statistical analysis and also to all the patients who participated in this research.

Funding

This study was supported by the governmental agency Fundação de Amparo a Pesquisa do Estado de São Paulo (grant number10/52179–6).

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Authors and Affiliations

  1. Postgraduate Program in Translational Surgery, Federal University of São Paulo, Rua Botucatu, 740, 2º Andar, Vila Clementino, São Paulo, SP, 04023-062, Brazil

    Alexandre Augusto Ferreira da Silva & Gabriela Pereira Ribeiro Prado

  2. Postgraduate Program in Translational Surgery, Craniomaxillofacial Surgery Department, Plastic Surgery Division, Federal University of São Paulo, Rua Botucatu, 740, 2º Andar, Vila Clementino, São Paulo, SP, 04023-062, Brazil

    Max Domingues Pereira

Authors
  1. Alexandre Augusto Ferreira da Silva
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  2. Gabriela Pereira Ribeiro Prado
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Contributions

A.A.F.S.: contributed to design, data acquisition, analysis and interpretation, draft, and critical revision of the manuscript; G.P.R.P.: contributed to data acquisition, analysis and interpretation, and critical revision of the manuscript; M.D.P.: contributed to conception, design, data acquisition and interpretation, and critical revision of the manuscript. All authors gave final approval and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Max Domingues Pereira.

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Ethical approval

All procedures involving human participants followed the ethical standards of the 1964 Helsinki declaration. This study was approval by the Research Ethics Committee of the Federal University of São Paulo, Brazil, under number 517.722. It was registered in the Brazilian Registry of Clinical Trials (ensaiosclinicos.gov.br) under code RBR-8rhkm25.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Competing interests

The authors declare no competing interests.

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da Silva, A.A.F., Prado, G.P.R. & Pereira, M.D. Randomized clinical trial of surgically assisted rapid maxillary expansion with two and three segments for nasal breathing. Clin Oral Invest 27, 6209–6219 (2023). https://doi.org/10.1007/s00784-023-05237-2

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