The effects of rapid maxillary expansion on persistent pediatric snoring post-tonsillectomy.

Abstract

To investigate the short-term effects of rapid maxillary expansion (RME) on the quality of life of children who had persistent snoring post-adenotonsillectomy (AT). The study included childrenwith maxillary constriction aged 5 to 12years, two or more years after AT whose parents/guardians reported that they still snored ≥ 5 nights per week. We enrolled children with sleep-disordered breathing, including children with primary snoring and children with obstructive sleep apnea(OSA). All patients underwent laryngeal nasofibroscopy and complete polysomnography. Quality of Life (QOL) Questionnaire (OSA-18), the Pediatric Sleep Questionnaire (PSQ), Conners Abbreviated Scale (CAS), and the Epworth Sleepiness Scale (ESS) were administered before and after RME. Of 24 children enrolled, 13 had primary snoring and 11 had OSA.Overall OSA-18 scores were reduced in both groups (intragroup difference, p < 0.001). The PSQ total score, CAS, and ESS were significantly reduced in both groups (p < 0.001) In the evaluation of snoring, there was a reduction due to the treatment effect in both groups (p < 0.001). Daytime sleepinessand attention deficit hyperactivity disorders were also positively affected in both groups. Our study demonstrated the potential benefit of RME in treating children with persistent snoring and transverse maxillary deficiency (TMD). RME can improve snoring and the QOL of children with refractory SDB after AT. ClinicalTrials.gov Identifier: RBR-463byn.