Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea.
Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea.
J Clin Sleep Med. 2022 Jul 1;18(7):1885-1888. doi: 10.5664/jcsm.9968.
Children with Down syndrome (DS) have distinct orofacial structures that predispose them to sleep-disordered breathing. The management options for obstructive sleep apnea include continuous positive airway pressure, adenotonsillectomy, mandibular advancement, and maxillary expansion. However, most of these treatment options are less effective or less viable for children with DS. Rapid maxillary expansion with a fixed orthodontic appliance is a viable alternative for DS patients because it separates the midpalatal suture and dilates the airway, regardless of the patient's compliance. We present a case of a 15-year-old boy with DS and severe obstructive sleep apnea, which dramatically improved with rapid maxillary expansion and subsequent orthodontic treatment. Although only the short-term changes have been presented in this report, this case emphasizes the need for further discussions on the viability of rapid maxillary expansion for treating obstructive sleep apnea in children with DS.
Kim A, Cho HJ, Choi EK, Choi YJ. Improvement in obstructive sleep apnea in a child with Down syndrome with rapid palatal expansion. . 2022;18(7):1885-1888.
唐氏综合征(Down syndrome,DS)患儿存在特有的口面结构,易导致睡眠呼吸紊乱。阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)的治疗方法包括持续气道正压通气、腺样体扁桃体切除术、下颌前伸术和上颌扩弓术。但对于 DS 患儿来说,这些治疗方法大多效果不佳或不可行。正畸固定矫治器快速上颌扩弓术是 DS 患儿的一种可行选择,因为它可以分隔中缝并扩张气道,而无需考虑患者的配合度。
我们报告了一例 15 岁 DS 合并重度阻塞性睡眠呼吸暂停患儿的病例,该患儿经快速上颌扩弓和随后的正畸治疗后病情明显改善。尽管本报告仅介绍了短期变化,但该病例强调了需要进一步讨论快速上颌扩弓治疗 DS 患儿 OSA 的可行性。
Kim A, Cho HJ, Choi EK, Choi YJ. Improvement in obstructive sleep apnea in a child with Down syndrome with rapid palatal expansion.. 2022;18(7):1885-1888.