1 Division of Sleep Surgery, Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA.
2 Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Mansoura University Mansoura, Egypt.
Otolaryngol Head Neck Surg. 2019 Aug;161(2):362-367. doi: 10.1177/0194599819842808. Epub 2019 May 14.
To assess the effect of distraction osteogenesis maxillary expansion (DOME) on objective parameters of the internal nasal valve and correlate findings with subjective outcomes.
Retrospective cohort study.
Tertiary referral center.
After Institutional Review Board approval, included subjects were those with obstructive sleep apnea, had undergone DOME from September 2014 to April 2018, and had cone beam computed tomography scans available before and after expansion. Measurement of the internal nasal valve parameters was performed with Invivo6 Software (version 6.0.3). Interrater reliability of all pre- and postexpansion parameters was measured. Patient-reported outcome measures included the Nasal Obstruction and Septoplasty Effectiveness Scale (NOSE) and Epworth Sleepiness Scale scores, and correlation between objective and subjective outcomes were evaluated by Spearman correlation analysis.
Thirty-two subjects met inclusion criteria. All showed significant improvement in their subjective outcomes as well as an increase in their internal valve parameters. Significant correlation was observed between increased angles and improvement in postexpansion NOSE score (right angle, = .024; left angle, = .029).
DOME widens the internal nasal valve objectively (dimensions), which correlates significantly with subjective improvement (NOSE scores).
评估分散式上颌骨扩张术（DOME）对鼻内阀固有参数的影响，并将发现与主观结果相关联。
回顾性队列研究。
三级转诊中心。
在获得机构审查委员会批准后，纳入的受试者为患有阻塞性睡眠呼吸暂停的患者，他们在 2014 年 9 月至 2018 年 4 月期间接受了 DOME 治疗，并且在扩张前后有锥形束计算机断层扫描（CBCT）扫描。使用 Invivo6 软件（版本 6.0.3）测量鼻内阀参数。测量了所有术前和术后参数的组内可靠性。患者报告的结果测量包括鼻腔阻塞和鼻中隔成形术效果量表（NOSE）和嗜睡量表评分，通过 Spearman 相关分析评估客观和主观结果之间的相关性。
32 名受试者符合纳入标准。所有患者的主观结果均有明显改善，内阀参数也有所增加。在扩张后，增加的角度与 NOSE 评分的改善之间存在显著相关性（右侧角，r =.024；左侧角，r =.029）。
DOME 客观上增加了鼻内阀的宽度（维度），这与主观改善（NOSE 评分）显著相关。
