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Down syndrome: otolaryngological effects of rapid maxillary expansion

  • C Pinto de Moura (a1) (a2), D Andrade (a3), L M Cunha (a4), M J Tavares (a3), M J Cunha (a5), P Vaz (a3), H Barros (a6), S M Pueschel (a7) and M Pais Clemente (a1)...

Abstract

Objective:

Phenotypical Down syndrome includes pharyngeal and maxillary hypoplasia and, frequently, constricted maxillary arch with nasal obstruction.

Study design:

This clinical trial assessed the effects of rapid maxillary expansion on ENT disorders in 24 children with Down syndrome randomly allocated to receive either rapid maxillary expansion or not. Each group received ENT and speech therapy assessments before expansion and after the device had been removed.

Results:

In the rapid maxillary expansion group, the yearly ENT infection rate was reduced when assessed after device removal (p < 0.01). The parents of rapid maxillary expansion children reported a reduction in respiratory obstruction symptoms. Audiological assessment revealed improvements in the rapid maxillary expansion group (p < 0.01). Cephalometry showed increased maxillary width in the rapid maxillary expansion group.

Conclusions:

Rapid maxillary expansion resulted in a reduction in hearing loss, yearly rate of ENT infections and parentally assessed symptoms of upper airway obstruction, compared with no treatment. These findings are probably related to expanded oronasal space, due to rapid maxillary expansion.

Copyright

Corresponding author

Address for correspondence: Dr Carla Pinto de Moura, Department of Otolaryngology, Hospital São João, Porto Medical School, Alameda Hernani Monteiro, 4200-251 Porto, Portugal. E-mail: cmoura@med.up.pt

Footnotes

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Presented as a poster at the American Academy of Otolaryngology-Head and Neck Surgery; Annual Meeting, 17–20 September 2006, Toronto, Canada.

Footnotes

References

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1Fryns, JP. Down syndrome. In: Buyse, ML, ed. Birth Defect Encyclopedia. Cambridge, Massachusetts, USA: Blackwell Scientific Publication, 1990;391–3
2Shott, SR, Amin, R, Chini, B, Heubi, C, Hotze, S, Akers, R. Obstructive sleep apnea: should all children with Down syndrome be tested? Arch Otolaryngol Head Neck Surg 2006;132:432–6
3Roizen, NJ, Patterson, D. Down's syndrome. Lancet 2003;361:1281–6
4Moura, CP, Silveira, H, Andrade, D, Palha, M, Pais Clemente, M. Trisomy 21 syndrome – otolaryngological perspective [in Portuguese]. Arquivos de Medicina 2004;18:61–5
5Shibahara, Y, Sando, I. Congenital anomalies of the eustachian tube in Down syndrome Histopathologic care report. Ann Otol Rhinol Laryngol 1989 Jul;98(7 Pt 1):543–7
6Cameron, CG, Franchi, L, Baccetti, T, McNamara, JA Jr.Long term effect of rapid maxillary expansion: a posteroanterior cephalometric evaluation. Am J Orthod Dentofacial Orthop 2002;121:129–35
7White, BC, Woodside, DG, Cole, P. The effect of rapid maxillary expansion on nasal airway resistance. J Otolaryngol 1989;18:137–43
8Marchesan, IQ. Clinical aspects of oral movement [in Portugese]. In: Marchesan IQ. Fundamentos em Fonoaudiologia. Rio de Janeiro: Ed Guanabara Koogan SA, 1998;1336
9Moura, CP, Vales, F, Andrade, D, Cunha, LM, Barros, H, Pueschel, SM et al. Rapid maxillary expansion and nasal patency in children with Down syndrome. Rhinology 2005;43:138–42
10Pinto, R.Articulation Test of Alcoitão. Centro de Medicina de Reabilitação de Alcoitão [in Portugese]. Alcoitão: Escola de Reabilitação, 1984
11González, NZ, Lopez, LD. Speech Therapy and Maxillary Orthopaedics on Oro-facial Rehabilitation, 2nd edn [in Spanish]. Barcelona: Masson SA, 1999;5562
12Ricketts, RM, Roth, RH, Chaconas, SJ, Schulhof, RJ, Engel, GA. Orthodontic diagnosis and planning. Denver: Rocky Mountain Data Systems, 1982
13Gray, LP. Results of 310 cases of rapid maxillary expansion selected for medical reasons. J Laryngol Otol 1975;89:601–14
14Timms, DJ. A study in basal movement with rapid maxillary expansion. Am J Orthod 1980;77:500–7
15Chung, C-H, Font, B. Skeletal and dental changes in the sagittal, vertical and transverse dimensions after rapid palatal expansion. Am J Orthod Dentofacial Orthop 2004;126:569–75
16Warren, DW, Hershey, HG, Turvey, TA, Hinton, VA, Hairfield, WM. The nasal airway following maxillary expansion. Am J Orthod Dentofacial Orthop 1987;91:111–16
17Basciftci, FA, Mutlu, N, Karaman, AI, Malkoc, S, Kuçukkolbasi, H. Does the timing and method of rapid maxillary expansion have an effect on the changes in nasal dimensions? Angle Orthod 2002;72:118–23

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