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Down syndrome: otolaryngological effects of rapid maxillary expansion

Published online by Cambridge University Press:  25 June 2008

C Pinto de Moura ,
D Andrade ,
L M Cunha ,
M J Tavares ,
M J Cunha ,
P Vaz ,
H Barros ,
S M Pueschel  and
M Pais Clemente
C Pinto de Moura*
Affiliation:
Department of Otolaryngology, Hospital São João, University of Porto Medical School, Portugal Department of Medical Genetics, Hospital São João, University of Porto Medical School, Portugal
D Andrade
Affiliation:
Paediatric Dentistry Department, University of Porto Dental Medical School, Portugal
L M Cunha
Affiliation:
REQUIMTE, Faculty of Sciences, University of Porto, Portugal
M J Tavares
Affiliation:
Paediatric Dentistry Department, University of Porto Dental Medical School, Portugal
M J Cunha
Affiliation:
Department of Speech Therapy, University of Porto Superior Health Technology School, Portugal
P Vaz
Affiliation:
Paediatric Dentistry Department, University of Porto Dental Medical School, Portugal
H Barros
Affiliation:
Department of Epidemiology, Hospital São João, University of Porto Medical School, Portugal
S M Pueschel
Affiliation:
Department of Paediatrics, Brown University, School of Medicine, Providence, Rhode Island, USA
M Pais Clemente
Affiliation:
Department of Otolaryngology, Hospital São João, University of Porto Medical School, Portugal
*
Address for correspondence: Dr Carla Pinto de Moura, Department of Otolaryngology, Hospital São João, Porto Medical School, Alameda Hernani Monteiro, 4200-251 Porto, Portugal. E-mail: cmoura@med.up.pt
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Abstract

Objective:

Phenotypical Down syndrome includes pharyngeal and maxillary hypoplasia and, frequently, constricted maxillary arch with nasal obstruction.

Study design:

This clinical trial assessed the effects of rapid maxillary expansion on ENT disorders in 24 children with Down syndrome randomly allocated to receive either rapid maxillary expansion or not. Each group received ENT and speech therapy assessments before expansion and after the device had been removed.

Results:

In the rapid maxillary expansion group, the yearly ENT infection rate was reduced when assessed after device removal (p < 0.01). The parents of rapid maxillary expansion children reported a reduction in respiratory obstruction symptoms. Audiological assessment revealed improvements in the rapid maxillary expansion group (p < 0.01). Cephalometry showed increased maxillary width in the rapid maxillary expansion group.

Conclusions:

Rapid maxillary expansion resulted in a reduction in hearing loss, yearly rate of ENT infections and parentally assessed symptoms of upper airway obstruction, compared with no treatment. These findings are probably related to expanded oronasal space, due to rapid maxillary expansion.

Keywords

Down SyndromeMaxillaOtorhinolaryngologic Surgical ProceduresOtitis MediaAirway Obstruction
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 12 , December 2008 , pp. 1318 - 1324
Copyright
Copyright © JLO (1984) Limited 2008

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Footnotes

Presented as a poster at the American Academy of Otolaryngology-Head and Neck Surgery; Annual Meeting, 17–20 September 2006, Toronto, Canada.

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