Compadretti Giacomo Ceroni, Tasca Ignazio, Bonetti Giulio Alessandri
Department of Otorhinolaryngology, Imola Hospital, Imola, Italy.
Am J Rhinol. 2006 Jul-Aug;20(4):385-93. doi: 10.2500/ajr.2006.20.2881.
Rapid maxillary expansion is an orthodontic procedure that is commonly used to widen the maxilla. It is generally admitted that this technique is effective to correct palate narrowing, whereas there has not been agreement on the effect of this procedure in nasal parameters. The availability of a reliable and objective technique to assess the geometry of nasal cavities, such as acoustic rhinometry, stimulated the present investigation.
Twenty-seven children, undergoing rapid maxillary expansion, were evaluated by rhinomanometry and acoustic rhinometry. Postero-anterior radiographs were taken in 15 patients for cephalometric measurements. Examinations were performed before expansion treatment and after 12 month follow-up and compared to the measurements obtained from an untreated control group.
With regard to rhinomanometry, we recorded a significant reduction in nasal airway resistance (NAR) after the orthodontic procedure only in decongestion. Using acoustic rhinometry, we found a significant increase in total minimum cross-sectional areas (TMCA) and total nasal volume (TNV) after the expansion both in basal and decongested conditions. Also, nasal cavity width and interzygomatic distance had a significant mean increase after the treatment. Comparison of measures between the control group and the treated group showed that the increase in TMCA and TNV, as well as the decrease in NAR, were significantly greater in the treated group in both basal and decongested conditions.
We demonstrated that rapid maxillary expansion is an effective procedure in widening nasal cavities with respect to an untreated control group and that the reported improvement in nasal breathing after palatal expansion, is a consequence of an increase in nasal size.
上颌快速扩弓是一种常用于扩宽上颌骨的正畸治疗方法。一般认为该技术在纠正腭部狭窄方面有效,然而对于该治疗方法对鼻腔参数的影响尚未达成共识。一种可靠且客观的评估鼻腔几何形态的技术(如鼻声反射)的出现推动了本研究。
对27名接受上颌快速扩弓治疗的儿童进行鼻阻力测量和鼻声反射检查。对15名患者拍摄正位X线片进行头影测量。在扩弓治疗前和随访12个月后进行检查,并与未接受治疗的对照组所获得的测量结果进行比较。
关于鼻阻力测量,我们仅在解除充血状态下记录到正畸治疗后鼻气道阻力(NAR)显著降低。使用鼻声反射,我们发现扩弓后在基础状态和解除充血状态下,总最小横截面积(TMCA)和总鼻腔容积(TNV)均显著增加。此外,治疗后鼻腔宽度和颧间距离平均显著增加。对照组和治疗组之间的测量比较表明,在基础状态和解除充血状态下,治疗组的TMCA和TNV增加以及NAR降低均显著大于对照组。
我们证明,与未接受治疗的对照组相比,上颌快速扩弓是一种有效扩宽鼻腔的方法,并且报道的腭部扩弓后鼻呼吸改善是鼻腔大小增加的结果。