Rapid maxillary expansion in the treatment of nocturnal enuresis

Abstract

There is growing consensus that upper airway obstruction is a causative factor in nocturnal enuresis. This phenomenon has an unhappy history, although some surgeons in the past have touched on its treatment through the relief of upper airway obstruction. Only recently have sleep laboratory investigations presented a clearer, though still incomplete, picture of the etiology of nocturnal enuresis through disturbed sleep patterns. The obstruction is usually an adenoidal hypertrophy or, less commonly, an anterior nasal stenosis. While the otolaryngologist can readily cope with the former, surgical difficulties make treating the latter problematic. In many cases, the constriction can be reduced by rapid maxillary expansion. In the ten cases examined in this study, nocturnal enuresis ceased within a few months of maxillary expansion.