Inchingolo Alessio Danilo, Marinelli Grazia, Cavino Mirka, Zaminga Lucia Pia, Savastano Sara, Inchingolo Francesco, Tartaglia Gianluca Martino, Del Fabbro Massimo, Palermo Andrea, Inchingolo Angelo Michele, Dipalma Gianna
Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy.
Department of Biomedical, Surgical and Dental Science, Milan University, 20122 Milan, Italy.
J Clin Med. 2025 Sep 18;14(18):6565. doi: 10.3390/jcm14186565.
: Obstructive sleep apnea syndrome (OSAS) and impaired nasal breathing are common in children and are frequently linked to maxillary constriction. Rapid maxillary expansion (RME) is an orthopedic treatment used to increase upper airway dimensions and improve respiratory function. It has been hypothesized that RME could contribute to improvements in behavior and cognition, possibly through enhanced sleep and respiratory function. It also promotes the shift from oral to nasal breathing, supporting craniofacial development and neuromuscular stability, and it is increasingly recognized as a multidisciplinary intervention that can improve pediatric health outcomes. With increasing evidence supporting its efficacy, RME should be considered not only for its orthodontic benefits but also as a multidisciplinary treatment option within pediatric care protocols. This underscores the importance of integrated care among orthodontists, ENT specialists, and pediatricians. To systematically assess the impact of RME on nasal respiratory parameters and sleep-disordered breathing, particularly OSAS, in pediatric patients. Following PRISMA guidelines, a systematic review was conducted using 12 clinical studies evaluating anatomical and functional respiratory changes after RME in children with mouth breathing or OSAS. Parameters included airway volume (CBCT, cephalometry), nasal resistance (rhinomanometry), and polysomnography (PSG) data. RME consistently resulted in significant increases in nasal cavity volume and upper airway dimensions. Multiple studies reported reductions in the apnea-hypopnea index (AHI), improved oxygen saturation, and better subjective sleep quality. Longitudinal studies confirmed the stability of these benefits. However, variability in study protocols limited meta-analytical comparison. RME is effective in enhancing nasal breathing and mitigating OSAS symptoms in children. While results are promising, further high-quality randomized controlled trials are needed to validate these findings and guide standardized treatment protocols.
阻塞性睡眠呼吸暂停综合征（OSAS）和鼻呼吸功能受损在儿童中很常见，且常与上颌骨狭窄有关。快速上颌扩弓（RME）是一种正畸治疗方法，用于增加上呼吸道尺寸并改善呼吸功能。据推测，RME可能有助于改善行为和认知，可能是通过改善睡眠和呼吸功能实现的。它还促进从口呼吸向鼻呼吸的转变，支持颅面发育和神经肌肉稳定性，并且越来越被认为是一种可以改善儿科健康结果的多学科干预措施。随着越来越多的证据支持其有效性，RME不仅应因其正畸益处而被考虑，还应作为儿科护理方案中的一种多学科治疗选择。这凸显了正畸医生、耳鼻喉科专家和儿科医生之间综合护理的重要性。为了系统评估RME对儿科患者鼻呼吸参数和睡眠呼吸障碍，特别是OSAS的影响。遵循PRISMA指南，进行了一项系统综述，使用12项临床研究评估了口呼吸或OSAS儿童在RME后解剖学和功能性呼吸变化。参数包括气道容积（CBCT、头影测量）、鼻阻力（鼻阻力测量）和多导睡眠图（PSG）数据。RME始终导致鼻腔容积和上呼吸道尺寸显著增加。多项研究报告了呼吸暂停低通气指数（AHI）降低、氧饱和度改善和主观睡眠质量提高。纵向研究证实了这些益处的稳定性。然而，研究方案的差异限制了荟萃分析比较。RME在增强儿童鼻呼吸和减轻OSAS症状方面是有效的。虽然结果很有希望，但需要进一步的高质量随机对照试验来验证这些发现并指导标准化治疗方案。
