Rapid Maxillary Expansion (RME): An Otolaryngologic Perspective

Abstract

Background. To evaluate the possible effects of Rapid Maxillary Expansion (RME), such as nasal breathing problems, middle ear function, Obstructive Sleep Apnea (OSA) in the otolaryngology field. RME has already been introduced in orthodontics to expand the maxilla of young patients affected by transversal maxillary constriction. Methods. A literature search was performed using different databases (Medline/PubMed, EMBASE, and CINAHL), from May 2005 to November 2021, according to the PRISMA guidelines. Results. The application of RME in children has shown good results on nasal function, reducing nasal resistances, independently from a previous adenotonsillectomy. These results are not only related to the increasing of nasal transverse diameters and volume, but also to the stiffening of airway muscles, enabling the nasal filtrum function and avoiding mouth opening, thereby decreasing respiratory infections. Positive effects have also been reported for the treatment of conductive hearing loss and of OSA, with the reduction of Apnea Hypopnea Index (AHI), possibly due to (i) an increased pharyngeal dimensions, (ii) a new tongue posture, and (iii) reduced nasal respiratory problems. Conclusions. Otolaryngologists should be aware of the indications and benefits of the RME treatment, considering its possible multiple beneficial effects.

Keywords: adenotonsillectomy; children; obstructive sleep apnea; oral breathing; rapid maxillary expansion.

Figure 1

Literature evaluation and selection, according to PRISMA criteria (http://www.prisma-statement.org/ (accessed on 16 July 2022).

Figure 2

Reported effects on the Apnea Hypopnea Index (AHI) index after Rapid Maxillary Expansion (RME) application. A: Guilleminault C. et al., 2013 [3]. B: Villa M.P. et al., 2015 [64]. C: Fastuca R. et al. [56]. D: Pirelli P. et al., 2015 [65]. E: Pirelli P. et al., 2005 [13]. F, G: Guilleminault C. et al., 2011 [5]. H: Villa M.P. et al., 2013 [4]. I: Hoxa S et al. [28].