From the Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain (MTA, JL, MO, PSV, MD-F, PDD); and Operative Dentistry and Endodontics Unit, University of Santiago de Compostela, Santiago de Compostela, Spain (MR-P).
Am J Phys Med Rehabil. 2019 Apr;98(4):e32-e34. doi: 10.1097/PHM.0000000000001022.
This case report involves a 10-yr-old boy diagnosed with spinal muscular atrophy type 2 who underwent nighttime mechanical ventilation with bilevel positive airway pressure. The oral examination revealed restricted mouth opening, lip interposition, dental crowding, and maxillary compression. After maxillary expansion, the upper airway volume increased 18.6%; 13 episodes of airway infections (20 days of hospitalization) were recorded in the 2 yrs before the maxillary expansion and only 4 episodes (no hospital admissions) in the 2 subsequent years. In conclusion, maxillary expansion in children with systemic disease that involves respiratory impairment may, in some cases, provide functional and clinical improvements, increase upper airway airflows, and possibly decrease the number of respiratory infections.
本病例报告涉及一名 10 岁男孩,被诊断为脊髓性肌萎缩症 2 型,夜间接受双水平气道正压通气治疗。口腔检查显示张口受限、唇间插入、牙齿拥挤和上颌骨受压。上颌骨扩弓后,上气道容积增加了 18.6%;在扩弓前的 2 年中,共记录到 13 次气道感染(住院 20 天),而在随后的 2 年中仅记录到 4 次(无住院)。总之,患有呼吸系统受损的系统性疾病的儿童进行上颌骨扩弓,在某些情况下可能会提供功能和临床改善,增加上气道气流,并可能减少呼吸道感染的次数。