Maxillary skeletal expansion has been developed to correct the transverse skeletal discrepancy from orthodontic point of view. Moreover, maxillary skeletal expansion has another great value of expanding nasal cavity to increase nasal airflow in OSA patients with nasal obstruction or serious nasal resistance. In particular, adult OSA patients who have fully matured midpalatal and circum-maxillary sutures require adjunctive surgical procedures for the successful basal bone expansion. Currently, distraction osteogenesis maxillary expansion (DOME), which has been updated from surgically assisted rapid palatal expansion (SARPE) with the development of orthodontic microimplants, is widely applied up to the elderly OSA patients suffering from severe nasal obstruction. In addition, multipiece segmental osteotomy (SO) can be applied to some cases who are scheduled for orthognathic surgery.
In this chapter, DOME procedure will be introduced in comparison with the traditional SARPE and SO procedures based on the differential clinical values in treating the OSA adults belong to the craniofacial phenotype with nasomaxillary constriction.
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