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Adenotonsillectomy (AT) is considered the most effective and the standard treatment for Obstructive Sleep Apnea (OSA) in children. Since maxillary hypoplasia is a risk factor for OSA, Rapid Maxillary Expansion (RME) has been be considered as a complementary treatment in selected cases,improving the OSA. To compare changes in polysomnography (PSG) and in anterior active rhinomanometry (AAR) in children diagnosed with OSA, treated with RME or AT.
Methods: A sample of 51 children aged 5 to 10 years, diagnosed with OSA through PSG and referred for AT, was selected in a hospital based mouth-breathing specialized center. Children were divided in 2 groups: the AT group with 25 individuals, without maxillary hypoplasia, and the RME group composed of 26 children with maxillary constriction and posterior crossbite, with indication for RME before the AT surgery. Children underwent an initial evaluation at the time of selection (T0) and six months after the intervention: AT or RME (T1).
PSG was performed to measure the apnea/hypopnea index (AHI), mean and minimum oxygen saturation (SpO2), desaturation index and desaturation time below 90%. AAR was used to measure nasal inspiratory flow (NIF), % NIF and nasal resistance. To compare the differences between the groups at T0, T1 and T1-T0, t-tests and Mann-Whitney tests were used. To compare the changes resulting from ERM and AT, paired t-tests and the Wilcoxon test were used, for a statistical significance level of 5%.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Adenotonsillectomy group | Experimental | adenotonsillectomy surgical group |
|
| Rapid maxillary expansion group | Experimental | rapid maxillary expansion group |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Adenotonsillectomy | Procedure | the adenotonsillectomy group children, indicated for immediate adenotonsillectomy |
|
| Measure | Description | Time Frame |
|---|---|---|
| polysomnography measures | PSG was performed to measure the apnea/hypopnea index (AHI) | Children underwent at enrollment (T0) and six months after the intervention: AT or RME (T1). |
| polysomnography measures | PSG was performed to measure the mean and minimum oxygen saturation (SpO2) | Children underwent at enrollment (T0) and six months after the intervention: AT or RME (T1). |
| polysomnography measures | PSG was performed to measure the desaturation index | Children underwent at enrollment (T0) and six months after the intervention: AT or RME (T1). |
| polysomnography measures | PSG was performed to measure the desaturation time below 90%. | Children underwent at enrollment (T0) and six months after the intervention: AT or RME (T1). |
| Measure | Description | Time Frame |
|---|---|---|
| anterior active rhinomanometry measures | AAR was used to measure the nasal inspiratory flow (NIF) | Children underwent at enrollment (T0) and six months after the intervention: AT or RME (T1). |
| anterior active rhinomanometry measures |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Federal University of Minas Gerais | Belo Horizonte | Minas Gerais | 30.130-100 | Brazil |
only IPD used in the results publication
Beginning 3 months and ending 3 years after the publication of results
Statistical analyses of the study results will be shared through Excel spreadsheets
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A sample of 51 children aged 5 to 10 years, diagnosed with OSA through PSG and referred for AT, was selected in a hospital based mouth-breathing specialized center. Children were divided in 2 groups: the AT group with 25 individuals, without maxillary hypoplasia, and the RME group composed of 26 children with maxillary constriction and posterior crossbite, with indication for RME before the AT surgery. Children underwent an initial evaluation at the time of selection (T0) and six months after the intervention: AT or RME (T1).
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| Rapid maxillary expansion | Procedure | expansion group children with a narrow palate and posterior crossbite, with indication for rapid maxillary expansion |
|
AAR was used to measure the nasal inspiratory flow percent (NIF)
| Children underwent at enrollment (T0) and six months after the intervention: AT or RME (T1). |
| anterior active rhinomanometry measures | AAR was used to measure the nasal resistance. | Children underwent at enrollment (T0) and six months after the intervention: AT or RME (T1). |
| ID | Term |
|---|---|
| D020181 | Sleep Apnea, Obstructive |
| ID | Term |
|---|---|
| D012891 | Sleep Apnea Syndromes |
| D001049 | Apnea |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D020919 | Sleep Disorders, Intrinsic |
| D020920 | Dyssomnias |
| D012893 | Sleep Wake Disorders |
| D009422 | Nervous System Diseases |
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