Abstract
Introduction
OSAS is a multifactorial disease with a coexistence of different risk factors. Despite primary treatment in children is adenotonsillectomy (AT), there is evidence suggesting that rapid maxillary expansion (RME) is a potential additional treatment in children presenting OSA. The aim of this study is to confirm, with a larger sample, our previous findings in order to underline the efficacy of RME in children with sleep disordered breathing (SDB) who did not undergo AT .
Methods
Children between 4 and 8 years old who referred to our Pediatric Sleep Centre because of SDB, were enrolled. After the orthodontic evaluation all children presented with a high, narrow palate, that in some patients was associated with signs of malocclusion underwentan endo-oral RME treatment for 12 months. Standard overnight polisomnography recordings were obtained before starting orthodontic treatment (T0) and after 12 months of treatment (T1).
Results
40 patients were eligible for recruitment .The AHI decreased significantly from T0 ( 4,7 ± 4.4 ev/h) to T1 (1.6 ± 1.4 ev/h)(p= 0,000) as well as the arousal Index, whereas total sleep time and mean overnight oxygen saturation increased significantly. We obtained resolution of the disease (AHI < 1 ev/h) in 47.5 % of patients and an efficacy of treatment was achieved in 85 % of children
The analysis of different influencing predictive factors on treatment efficacy revealed a significant influence of the disease duration (p 0.03 ).
Conclusions
Our data confirm the usefulness and efficacy of early orthodontic treatment in children with mild and moderate OSA and stressed the importance of an early treatment in order to achieve a best outcome.
- © 2014 ERS
