Calvo-Henriquez Christian, Capasso Robson, Chiesa-Estomba Carlos, Liu Stanley Yung, Martins-Neves Silvia, Castedo Elena, O'Connor-Reina Carlos, Ruano-Ravina Alberto, Kahn Sandra
Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS) Study Group, Paris, France; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Spain.
Department of Otolaryngology - Head and Neck Surgery, Sleep Surgery Division, Stanford University Medical Center, Stanford, CA, USA.
Int J Pediatr Otorhinolaryngol. 2020 Aug;135:110139. doi: 10.1016/j.ijporl.2020.110139. Epub 2020 May 25.
A reduced transversal dimension of the maxilla leads to narrower nasal cavities, which may reduce airflow to the lungs. Maxillary expansion widens nasal floor. However, there is huge controversy regarding whether this increase does actually lead to increased airflow. In this systematic review and meta-analysis we aim to resolve this question by evaluating studies that have undertaken rhinomanometric measurements.
Pubmed (Medline), the Cochrane Library, EMBASE and Trip Database were checked by two authors. Two authors extracted the data. Main outcome was expressed as the difference between resistance before and after treatment and the 95% confidence interval.
30 studies were selected for full text reading. A total of 12 studies (301 patients) met the inclusion criteria. All selected articles found reduced resistance after palatal expansion. The data pooled in the meta-analysis reveals a statistically significant difference of 0.12 Pa s/cm mean reduction after palatal expansion (CI 95% 0.06, 0.18) for nine uncontrolled studies. Regarding nasal airflow, the pooled data show a statistically significant difference of 29.9 cm/s increase after palatal expansion (CI 95% 9.17, 50.64).
According to the available evidence, palatal expansion in pediatric patients decreases nasal resistance and increases nasal flow.
上颌骨横向尺寸减小会导致鼻腔变窄，这可能会减少肺部的气流。上颌骨扩弓可使鼻底变宽。然而，这种变宽是否真的会导致气流增加存在巨大争议。在这项系统评价和荟萃分析中，我们旨在通过评估进行鼻阻力测量的研究来解决这个问题。
两名作者检索了PubMed（Medline）、Cochrane图书馆、EMBASE和Trip数据库。两名作者提取数据。主要结果表示为治疗前后阻力的差异以及95%置信区间。
30项研究被选作全文阅读。共有12项研究（301例患者）符合纳入标准。所有入选文章均发现腭扩展后阻力降低。荟萃分析汇总的数据显示，9项非对照研究在腭扩展后平均阻力降低0.12 Pa·s/cm，差异有统计学意义（95%CI 0.06，0.18）。关于鼻气流，汇总数据显示，腭扩展后气流增加29.9 cm/s，差异有统计学意义（95%CI 9.17，50.64）。
根据现有证据，儿科患者的腭扩展可降低鼻阻力并增加鼻气流。
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