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快速上颌扩弓(RME):耳鼻喉科视角

Rapid Maxillary Expansion (RME): An Otolaryngologic Perspective.

作者信息

Cerritelli Luca, Hatzopoulos Stavros, Catalano Andrea, Bianchini Chiara, Cammaroto Giovanni, Meccariello Giuseppe, Iannella Giannicola, Vicini Claudio, Pelucchi Stefano, Skarzynski Piotr Henryk, Ciorba Andrea

机构信息

ENT and Audiology Unit, Department of Neurosciences and Rehabilitation, University Hospital of Ferrara, 44124 Ferrara, Italy.

Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 47121 Forlì, Italy.

出版信息

J Clin Med. 2022 Sep 5;11(17):5243. doi: 10.3390/jcm11175243.

Abstract

To evaluate the possible effects of Rapid Maxillary Expansion (RME), such as nasal breathing problems, middle ear function, Obstructive Sleep Apnea (OSA) in the otolaryngology field. RME has already been introduced in orthodontics to expand the maxilla of young patients affected by transversal maxillary constriction. A literature search was performed using different databases (Medline/PubMed, EMBASE, and CINAHL), from May 2005 to November 2021, according to the PRISMA guidelines. The application of RME in children has shown good results on nasal function, reducing nasal resistances, independently from a previous adenotonsillectomy. These results are not only related to the increasing of nasal transverse diameters and volume, but also to the stiffening of airway muscles, enabling the nasal filtrum function and avoiding mouth opening, thereby decreasing respiratory infections. Positive effects have also been reported for the treatment of conductive hearing loss and of OSA, with the reduction of Apnea Hypopnea Index (AHI), possibly due to (i) an increased pharyngeal dimensions, (ii) a new tongue posture, and (iii) reduced nasal respiratory problems. Otolaryngologists should be aware of the indications and benefits of the RME treatment, considering its possible multiple beneficial effects.

摘要

为评估快速上颌扩弓(RME)在耳鼻喉科领域可能产生的影响,如鼻呼吸问题、中耳功能、阻塞性睡眠呼吸暂停(OSA)。RME已被引入正畸学,用于扩大受横向上颌缩窄影响的年轻患者的上颌骨。根据PRISMA指南,于2005年5月至2021年11月期间使用不同数据库(Medline/PubMed、EMBASE和CINAHL)进行了文献检索。RME在儿童中的应用已显示出对鼻功能有良好效果,可降低鼻阻力,且与先前是否进行腺样体扁桃体切除术无关。这些结果不仅与鼻横径和容积的增加有关,还与气道肌肉的强化有关,从而实现鼻过滤功能并避免张口,进而减少呼吸道感染。对于传导性听力损失和OSA的治疗也有积极效果,呼吸暂停低通气指数(AHI)降低,这可能是由于(i)咽部尺寸增加,(ii)新的舌位,以及(iii)鼻呼吸问题减少。考虑到RME治疗可能具有的多种有益效果,耳鼻喉科医生应了解其适应证和益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81dd/9457357/f2b2439e0e79/jcm-11-05243-g001.jpg

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