Randomized clinical trial of surgically assisted rapid maxillary expansion with two and three segments for nasal breathing.

OBJECTIVES

To evaluate surgically assisted rapid maxillary expansion (SARME), with osteotomies separating the maxilla into two segments (SARME-2S) and three segments (SARME-3S), on obstruction symptoms and nasal cavity dimensions in patients with maxillary transverse skeletal deficiency (MTSD).

MATERIALS AND METHODS

Sixteen patients with MTSD of 7 mm or above were evaluated in each group, for a total of 32 patients. All patients were evaluated pre- and postoperatively up to 10 months after the expander activations. The minimum cross-sectional area (MCA) and the volume of the nasal cavities were identified by acoustic rhinometry. The Nasal Obstruction Symptom Evaluation (NOSE) scale questionnaire was applied. The palate surface area (PSA) was measured, via digitized maxillary models, as a criterion for comparison with the other variables studied.

RESULTS

There was no difference between the groups (p = 0.370) and was verified a significant increase in PSA postoperatively. MCA showed a small increase without statistical significance, and together with the volume of the nasal cavities remained constant during the study. NOSE scale scores decreased significantly in the postoperative periods, implying a decrease in nasal obstruction symptoms in both groups.

CONCLUSIONS

SARME with two and three segments show similar results, and both may improve nasal obstruction symptoms when present in patients with MTSD.

CLINICAL RELEVANCE

SARME, regardless of the chosen surgical technique, should follow the recommendation to correct just the MTSD. While an improvement in nasal breathing is expected, this must be understood as likely, but not certain.