Rapid maxillary expansion (RME) for pediatric obstructive sleep apnea: a 12-year follow-up
Abstract
Objective The objective of this study was to prospectively evaluate the long-term efficacy of rapid maxillary expansion (RME) in a group of children with obstructive sleep apnea (OSA).Material and method Thirty-one children diagnosed with OSA were involved in the study. These children had isolated maxillary narrowing and absence of enlarged adenotonsils at baseline. Twenty-three individuals (73% of the initial group) were followed up annually over a mean of 12 years after the completion of orthodontic treatment at a mean age of 8.68 years. Eight children dropped out over time due to either moving out of the area (n = 6) or refusal to submit to regular follow-up (n = 2). Subjects underwent clinical reevaluation over time and repeat polysomnography (PSG) in the late teenage years or in their early 20s. During the follow-up period, eight children dropped out and 23 individuals (including 10 girls) underwent a final clinical investigation with PSG (mean age of 20.9 years). The final evaluation also included computerized tomographic (CT) imaging that was compared with pre- and post-initial treatment findings.Results Yearly clinical evaluations, including orthodontic and otolaryngological examinations and questionnaire scores, were consistently normal over time, and PSG findings remained normal at the 12-year follow-up period. The stability and maintenance of the expansion over time was demonstrated by the maxillary base width and the distance of the pterygoid processes measured using CT imaging.Conclusion A subgroup of OSA children with isolated maxillary narrowing initially and followed up into adulthood present stable, long-term results post RME treatment for pediatric OSA.
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Studies incorporating polysomnography alongside structural assessment to evaluate functional outcomes of mandibular advancement in children are more limited in number.
“In contrast, studies incorporating polysomnography alongside structural assessment to evaluate functional outcomes of mandibular advancement in children are more limited in number [20–22, 42–45]”
From Long-Term Changes Following Orthopedic Mandibular Advancement Therapy in Pediatric Obstructive Sleep Apnea: a 7-Year Follow-up Study (2026) · cites this paper as [45]
Pirelli et al. demonstrated sustained polysomnographic improvements over a 12-year follow-up, but that study focused on children with isolated maxillary constriction rather than mandibular retrognathia.
“For example, while Pirelli et al. [45] demonstrated sustained polysomnographic improvements over a 12-year follow-up, that study focused on children with isolated maxillary constriction rather than mandibular retrognathia.”
From Long-Term Changes Following Orthopedic Mandibular Advancement Therapy in Pediatric Obstructive Sleep Apnea: a 7-Year Follow-up Study (2026) · cites this paper as [45]
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- Authors
- Pirelli, P., Saponara, M., & Guilleminault, C.
- Affiliations
- University of Rome Tor Vergata (IT)
- Sapienza University of Rome (IT)
- Stanford Medicine (US)
- Corresponding author
- Guilleminault, Christian
- Venue
- Sleep Medicine
- Publisher
- Elsevier BV
- Published
- 2015-08
- Volume
- 16
- Issue
- 8
- Pages
- 933-935
- ISSN
- 1389-9457 (ISSN-L)
- OpenAlex
- W1934293453
- Cited by
- 143
- References
- 21
- Citations by year
- 2026: 12 · 2025: 5 · 2024: 13 · 2023: 2 · 2022: 20 · 2021: 17 · 2020: 14 · 2019: 11 · 2018: 13 · 2017: 12 · 2016: 20 · 2015: 3 · 2014: 1
- FWCI
- 11.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Dentistry › Orthodontics › Orthodontics and Dentofacial Orthopedics
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Keywords
- rapid maxillary expansion, pediatric obstructive sleep apnea, long-term follow-up, orthodontic treatment, polysomnography, pterygoid process, treatment stability
- MeSH terms
- Adolescent, Child, Female, Follow-Up Studies, Humans, Male, Palatal Expansion Technique, Surveys and Questionnaires, Treatment Outcome, Polysomnography, Sleep Apnea, Obstructive, Young Adult
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