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. 2025 Mar 1;95(2):166-172.
doi: 10.2319/050124-344.1.

Nasal septum deviation after rapid maxillary expansion in the early mixed dentition

Rodrigo Teixeira, Daniela Garib, João Gabriel Rando Poiani, Camila Massaro, Guilherme Adam Fraga, Sergio Henrique Kiemle Trindade, Luiz Fernando Manzoni Lourençone, Djessyca Miranda E Paulo, Carlos Flores-Mir

Nasal septum deviation after rapid maxillary expansion in the early mixed dentition

Rodrigo Teixeira et al. Angle Orthod. .

Abstract

Objectives: To evaluate nasal septum changes after rapid maxillary expansion (RME) during the mixed dentition and to verify the association between quantitative and qualitative assessments of nasal septum deviation (NSD) by ear, nose, and throat (ENT) specialists.

Materials and methods: The sample comprised 24 patients (11 male, 13 female) with a mean age of 7.62 ± 0.92 years with maxillary transverse deficiencies. Cone-beam computed tomography (CBCT) images were obtained before and after RME. Three CBCT coronal sections passing through the maxillary first molars, 5 mm anterior and 5 mm posterior, were used for quantitative assessment. NSD was calculated using the ratio of nasal cavity height to nasal septum contour. Additionally, five ENT professionals evaluated NSD qualitatively using scores from 1 to 3 through CBCT sequential axial and coronal sections. Absent NSD was scored as zero. Interstage changes were assessed using Wilcoxon tests. Spearman correlation and linear regression were performed to evaluate the association between quantitative and qualitative analyses (P < .05).

Results: No significant change was observed in the NSD ratio. In pre-expansion CBCT images, absence of NSD and scores 1, 2, and 3 for NSD were found for 45.8%, 41.7%, 12.5%, and 0%, respectively. In the qualitative assessment, no significant change in NSD was observed after expansion. A strong association was found between NSD ratio and ENT score (r = 0.750).

Conclusions: In the mixed dentition, no significant change was observed in the NSD ratio. Qualitative analysis of NSD was associated with quantitative assessment of the ratio between nasal septum contour and nasal cavity height.

Keywords: Mixed dentition; Nasal cavity; Nasal septum; Palatal expansion technique; Respiratory airflow.

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Figures

Figure 1.
Figure 1.
Maxillary expander with differential opening (A) before and (B) after expansion.
Figure 2.
Figure 2.
Measurements performed in the cone-beam computed tomography (CBCT) coronal section. The dashed horizontal lines indicate the vertical limits of the nasal septum, the dashed vertical line represents the nasal septum height, and the dashed curve illustrates the nasal septum contour.
Figure 3.
Figure 3.
Qualitative assessment of the nasal septum deviation (NSD). (A) Pre-expansion and (B) postexpansion images with absence of NSD. (C) Pre-expansion and (D) postexpansion images with score 1 (the NSD did not reach the lower nasal turbinate). (E) Pre-expansion and (F) postexpansion images with score 2 (the NSD reached the lower nasal turbinate).
Figure 4.
Figure 4.
Linear regression plot (r2 = 0.563).
See this image and copyright information in PMC

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