Abstract
Rapid Maxillary Expander (RME) may be an alternative treatment for OSAS. It has been used for patients who have OSAS and craniofacial anomalies because it changes the mandible posture forwards, enlarges upper airway and increases upper airspace, improving the respiratory function.
Aim: To compare the efficacy of adenotonsillectomy (AT) and orthodontic treatment in children with OSAS.
Methods: Children with referred SDB underwent polysomnography at baseline and after 12 months of surgical or orthodontic treatment.
Results: We included 32 children (mean age 4.9±1.5 yrs, 75% male). Eighteen children underwent AT (group A) and 14 children RME (group B). There were no differences for age, sex and BMI between the two groups.
Children treated with AT showed an AHI at baseline higher than children treated with RME (14.3±8.2 vs 5.5±1.4 ev/h, p<0.001); this difference were no significant after 12 months (1.3±1.4 vs 1.6±1.9 ev/h,NS).
After one year, 40.6% had a residual disease, without any differences between the 2 groups. Children with residual OSAS (RO) had an higher duration of disease than children with complete resolution of SDB (47.3±18.4 vs 31.9±18.7 months). In the group A 7 children (38.8%) had RO and of them 5 children (71.4%) had a malocclusion. In the group B 6 children (42%) had RO, and between them 3 children (50%) had severe tonsillar hypertrophy.
Conclusions: Both treatment showed efficacy in the management of paediatric OSAS but both had a residual disease, not related to the treatment or the severity of the disease but to its duration. Data underline the importance of an early treatment using integrated approach.
- © 2011 ERS
