Rapid maxillary expansion effects of nasal airway in children with cleft lip and palate using computational fluid dynamics.

Abstract

Rapid maxillary expansion (RME) improves nasal airway ventilation in non-cleft palate children. Children with unilateral cleft lip and palate (UCLP) may have nasal obstruction and experience an increased risk of obstructive sleep apnoea. The effect of RME in UCLP children is unclear. This retrospective study evaluated RME-induced changes in ventilation parameters in children with UCLP using computational fluid dynamics. Nineteen patients (10 boys, mean age 10.7years) who required RME had cone-beam computed tomography images taken before and after RME. Twenty control participants (11 boys, mean age 11.1years) received regular orthodontic treatment. Nasal airway ventilation parameters (air pressure, air velocity and airflow rate) were analysed via computational fluid dynamics, and nasal cross-sectional area (CSA) was measured. Maximum pressure, velocity and nasal resistance were significantly reduced by RME in the UCLP group. Air flow rate and CSA on the cleft side significantly were increased by RME in the UCLP group. In children with UCLP, increasing the quantity of airflow and CSA on the cleft side by RME substantially improved nasal ventilation.