A disjunção pterigomaxilar em expansão rápida de maxila assistida cirurgicamente influencia no volume das vias aéreas superiores? um estudo prospectivo usando Dolphin Imaging 3D

Abstract

The transverse maxillary atresia is a common finding in patients with dentofacial deformities and, in such cases, the surgically assisted rapid maxillary expansion (SARME) has been used as a treatment option. The present study aimed to evaluate the effect of the SARME (with or without pterigomaxilar disjunction [PD]) on the upper airway volume. A prospective study with adult individuals affected by transverse maxillary skeletal deficiency undergoing SARME was performed. The patients were randomly divided into two groups: without PD (−PD); with PD (+PD). Eleven patients per group were estimated to obtain a representative sample (90% of power and a 95% of confidence level). Volumetric images of cone beam computed tomographies were obtained preoperatively (T1), immediately after expander device stabilization (T2) and 6 months after expander device stabilization (T3). Volumetric measurements of the nasal cavity (NCV), maxillary sinuses (MSV), nasopharynx (NFV), oropharynx (OV) and the oropharynx cross-sectional area (OCSA) were obtained using the Dolphin 3D Imaging Software. All statistical analyzes considered a significant value of p <0.05. A total of 322 subjects were evaluated, 25 individuals aged 17 to 49 comprised the sample (DP group, n = 12; group ± SD, n = 13). In the group +PD there was a statistically significant increase during the T2 period for the NFV (p=0.003), OV (p=0.007) and OCSA (p=0.001). There was no statistically significant difference between groups (p <0.05), however, the realization of PD resulted in a significant increase of volumetric measurements of the nasopharynx and MASTO after 6 months of the expander device locking.