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Analysis of nasal airway symmetry and pharyngeal airway following rapid maxillary expansion

OBJECTIVES: This retrospective cohort study tested the effect of Rapid Maxillary
Expansion (RME) on symmetrical volumetric changes in the nasal cavity. Volumetric
changes in overall nasal cavity, nasopharynx, and oropharynx were also assessed as well
as minimum cross-sectional width changes and molar angulation in association with
RME.
METHODS: CBCT scans of before and after RME treatment for 28 subjects (17 females,
11 males, average age 9.85 ± 2.42 years) were collected from a previously de-identified
database. All subjects were treated for maxillary constriction using banded hyrax
expanders. Mimics software was utilized to segment the nasal and pharyngeal airways
and create various compartments (left and right nasal cavity, nasopharynx, and
oropharynx) for volumetric analysis. Minimum cross-sectional width measurements and
maxillary first molar angulation were also assessed. Paired T-test was used to quantify
the changes brought about by expansion. Statistical significance was set at the 0.05 level.
RESULTS: Posterior expansion as measured between right and left greater palatine foramen
(GPF) averaged 2.41 mm (SD = 1.03 mm). There were statistically significant differences
in overall nasal cavity (2249.6 ± 2102.5 mm3), right nasal cavity (968.8 ± 1082.7), left
nasal cavity (1197.3 ± 1587.0), nasopharyngeal (1000.6 ± 917.7), and oropharyngeal
(2349.2 ± 2520.8) volumes. In comparing the right to left nasal cavity, no significant
changes were noted for initial volume, post-expansion volume, or pre to post-expansion
changes (T2-T1). For cross-sectional analysis, the right nasal cavity (0.13 ± 0.07 mm)
and left nasal cavity (0.11 ± 0.06 mm) showed significant increases in minimum crosssectional
width measurements. Initial maxillary molar angulation had no significant
correlation to initial nasal cavity volume on either side.
CONCLUSIONS: RME has significant benefits to increasing nasal and pharyngeal airway
cavity volumes in all segments of the airway. Nasal cavity expands symmetrically.
Minimum cross-sectional width of the left and right nasal cavities showed highly
symmetrical improvements. Initial maxillary molar angulation has no relationship to
initial nasal cavity volume.

Identiferoai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/30019
Date19 June 2018
CreatorsDiCosimo, Charles
ContributorsParsi, Goli
Source SetsBoston University
Languageen_US
Detected LanguageEnglish
TypeThesis/Dissertation
RightsAttribution-NonCommercial-NoDerivatives 4.0 International, http://creativecommons.org/licenses/by-nc-nd/4.0/

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