A clinical trial on 3D CT scan and polysomnographyc changes after rapid maxillary expansion in children with snoring

Abstract Objective: The present prospective clinical study aimed to investigate the effects of rapid maxillary expansion on the airway, correlating airway volumes obtained on multi-slice computed tomography and polysomnography assessment of oxygen saturation and apnea/hypopnea index. Methods: Twenty-four patients (11 with obstructive sleep apnea and 13 with residual snoring, mean age 10.0 (1.8), were enrolled in the study. Each patient underwent multislice computed tomography and nocturnal polysomnography before rapid maxillary expansion and after removal of maxillary expansion after six months. Airway regions were segmented, and volumes were computed. Results: The increase in oropharyngeal volume was significant in both groups. Oxygen saturation and apnea/hypopnea index were not statistically significant. No correlation was found between total airway volume, oxygen saturation, and apnea/hypopnea index changes between the time points examined. Conclusions: This study showed that when rapid maxillary expansion is performed in individuals with sleep-disordered breathing, there were statistically significant differences in oropharyngeal volume between pre- and post-rapid maxillary expansion, but there was no correlation between oxygen saturation values and oropharyngeal volume increase. Level of evidence: The article is classified as Evidence Level 3 (Three).

摘要
研究目的：本前瞻性临床研究旨在探讨上颌快速扩弓（rapid maxillary expansion）对气道的影响，并将多层计算机断层扫描（multi-slice computed tomography）测得的气道容积与多导睡眠监测（polysomnography）评估的血氧饱和度及呼吸暂停低通气指数（apnea/hypopnea index）进行相关性分析。
研究方法：共纳入24例患者，其中11例为阻塞性睡眠呼吸暂停患者，13例为残留打鼾患者，平均年龄10.0（标准差1.8）岁。所有患者均在上颌快速扩弓治疗前，以及术后6个月拆除上颌扩弓装置后，接受多层计算机断层扫描与夜间多导睡眠监测。研究人员对气道区域进行分割并计算其容积。
研究结果：两组患者的口咽部容积均显著增加；血氧饱和度与呼吸暂停低通气指数的变化无统计学显著性差异；在两个检测时间点间，总气道容积、血氧饱和度及呼吸暂停低通气指数的变化均未发现相关性。
研究结论：本研究表明，针对伴睡眠呼吸紊乱的患者实施上颌快速扩弓治疗时，其术前与术后的口咽部容积差异具有统计学意义，但血氧饱和度数值与口咽部容积增加之间无相关性。
证据等级：本研究被归类为3级（三级）证据。