Oral and maxillofacial surgery · 2026
Nasal septum morphology after surgically assisted rapid maxillary expansion with different expanders: A retrospective tomographic analysis.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Folhes Júlia Ferreira, Fernandez Christian Ruben Cusi, de Jesus Oliveira Gonçalves Carlos Augusto, Júnior Mario Cappelette, de Souza Daniel Falbo Martins, Homsi Nicolas, Carneiro José Thiers
Аннотация
OBJECTIVES: to evaluate, through tomographic analysis, whether surgically assisted rapid maxillary expansion (SARME) promotes changes in the degree of nasal septal deviation in adult patients, and to investigate whether these changes are influenced by the type of expander used.
MATERIALS AND METHODS: this retrospective, observational, and quantitative study included 33 adult patients submitted to SARME and treated with either a Hyrax expander (n = 21) or a transpalatal distractor (n = 12). Computed tomography scans were analyzed at the preoperative period (T0) and six months postoperatively (T1). Nasal cavity height and nasal septum contour were measured, and their ratio was used to determine the degree of septal deviation. Measurement reliability was assessed using the intraclass correlation coefficient.
RESULTS: Inter-examiner reliability was excellent (ICC 0.938-0.974). No statistically significant differences were demonstrated in intragroup or intergroup analyses. From T0 to T1, nasal cavity height changed by +0.14 mm (Hyrax) and -0.01 mm (transpalatal distractor), septal contour by -0.34 mm and +0.14 mm, and NSD by -0.011 and +0.003. Intragroup p-values ranged from 0.070 to 0.982, and intergroup p-values at T1 were 0.932, 0.936 and 0.901.
CONCLUSION: SARME does not promote significant changes in nasal septal deviation in adult patients, regardless of the type of expander used. Biomechanical differences between tooth-borne and bone-borne expanders do not appear to influence this outcome, indicating that SARME can be performed without concern for inducing or worsening septal deviation in adults with transverse maxillary deficiency, and that the choice of expander may be guided by other clinical criteria CLINICAL RELEVANCE: these findings suggest that SARME can be safely performed without concern for inducing or worsening nasal septal deviation, supporting its use in adult patients with maxillary atresia, regardless of the expander type selected.
MATERIALS AND METHODS: this retrospective, observational, and quantitative study included 33 adult patients submitted to SARME and treated with either a Hyrax expander (n = 21) or a transpalatal distractor (n = 12). Computed tomography scans were analyzed at the preoperative period (T0) and six months postoperatively (T1). Nasal cavity height and nasal septum contour were measured, and their ratio was used to determine the degree of septal deviation. Measurement reliability was assessed using the intraclass correlation coefficient.
RESULTS: Inter-examiner reliability was excellent (ICC 0.938-0.974). No statistically significant differences were demonstrated in intragroup or intergroup analyses. From T0 to T1, nasal cavity height changed by +0.14 mm (Hyrax) and -0.01 mm (transpalatal distractor), septal contour by -0.34 mm and +0.14 mm, and NSD by -0.011 and +0.003. Intragroup p-values ranged from 0.070 to 0.982, and intergroup p-values at T1 were 0.932, 0.936 and 0.901.
CONCLUSION: SARME does not promote significant changes in nasal septal deviation in adult patients, regardless of the type of expander used. Biomechanical differences between tooth-borne and bone-borne expanders do not appear to influence this outcome, indicating that SARME can be performed without concern for inducing or worsening septal deviation in adults with transverse maxillary deficiency, and that the choice of expander may be guided by other clinical criteria CLINICAL RELEVANCE: these findings suggest that SARME can be safely performed without concern for inducing or worsening nasal septal deviation, supporting its use in adult patients with maxillary atresia, regardless of the expander type selected.