Department of Microbiology, Sao Leopoldo Mandic Institute and Research Center, SP, Brazil.
Department of Post-graduation in Orthodontics, Sao Leopoldo Mandic Institute and Research Center, Campinas, SP, Brazil.
Phys Ther Sport. 2019 Mar;36:70-77. doi: 10.1016/j.ptsp.2019.01.005. Epub 2019 Jan 14.
The aim of this case report was to demonstrate the effects of the Maxillary Skeletal Expander (MSE) used to orthopedically correct a maxillary constriction, on the respiratory functions and swimming performance of a Para-athlete. Cone-beam computed tomography (CBCT) images taken before and after MSE activation were used to demonstrate the disarticulation of midpalatal suture, and the changes involved in dental and nasomaxillary structures, nasal cavity and pharyngeal airway. Respiratory tests included: maximum inspiratory and expiratory pressure, oral peak expiratory flow and inspiratory nasal flow. The 6-min-walk and heart rate recovery tests were also performed. Patient's swimming performances during national swimming competitions were compared. CBCT images showed that palatal expansion was 5.91 mm at the suture, and that nasal and pharyngeal airways increased in volume by 31%. All respiratory indices improved after MSE activation. The 6-min walk test and heart rate recovery test performance also improved after the maxillary expansion. Patient's swimming performance in all category were anemic prior to the treatment, but performance improved considerably after the expansion, particularly the 100 m-Backstroke modality. MSE treatment had a significant positive impact in respiratory functions and sport performance.
本病例报告旨在展示上颌骨扩张器（MSE）在矫治安氏Ⅱ类 1 分类错颌中的作用，及其对上颌后缩患者呼吸功能和游泳表现的影响。通过对 MSE 激活前后的锥形束 CT（CBCT）图像进行分析，展示了中隔骨缝的分离，以及牙和鼻上颌结构、鼻腔和咽气道的变化。呼吸测试包括：最大吸气和呼气压力、口腔呼气峰流速和鼻吸气流量。还进行了 6 分钟步行和心率恢复测试。比较了患者在全国游泳比赛中的游泳表现。CBCT 图像显示，骨缝处腭扩张 5.91 mm，鼻和咽气道体积增加 31%。MSE 激活后，所有呼吸指标均得到改善。上颌骨扩张后，6 分钟步行测试和心率恢复测试的表现也得到了改善。患者在接受治疗前所有泳姿的成绩都较差，但在扩张后成绩有了显著提高，特别是 100 米仰泳。MSE 治疗对上颌后缩患者的呼吸功能和运动表现有显著的积极影响。
