Complications associated with surgically assisted rapid palatal expansion without pterygomaxillary separation

Çakarer, Sırmahan; Keskin, Başak; İşler, Sabri Cemil; Cansız, Erol; Uzun, Ayşenur; Keskin, Cengizhan

doi:10.1016/j.jormas.2017.06.008

Cited by 13 publications

(28 citation statements)

References 19 publications

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“…The pterygoid plates are also sites of considerable resistance, but because osteotomy carries an increased risk of injuring the pterygoid plexus, some surgeons choose not to address this resistance, without losing much mobility [27]. When the pterygoid junction is not released, the opening of the maxillary halves is more V-shaped, with the apex of the V pointing dorsally [27,44,[50][51][52][53].…”

Section: Sarpe/sarme Is a Surgical Technique Developed To Correct Tramentioning

confidence: 99%

“…Wound infections [1,2,11,26,27,33,[53][54][55][56] were reported to occur 5 days to 4 months after surgery [11]. Infections were related to poor oral hygiene practice in some patients [2].…”

Section: Reversible Complicationsmentioning

confidence: 99%

“…Maxillary sinusitis appeared after SARME up to six weeks postoperatively [1,11,26,27,53,[55][56][57]. The most common cause was unrecognized preoperative chronic sinusitis [58].…”

Section: Reversible Complicationsmentioning

confidence: 99%

“…The most common cause was unrecognized preoperative chronic sinusitis [58]. Fungal infection of the maxillary sinus after SARME is unusual [53].…”

Section: Reversible Complicationsmentioning

confidence: 99%

“…The trauma associated with lateral nasal wall osteotomies may trigger fistula formation from the inferior meatus to the maxillary sinus, thus modifying the flora of the maxillary sinus by introducing a fungus [53].…”

Section: Reversible Complicationsmentioning

confidence: 99%

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Complications in surgically assisted rapid maxillary expansion: a systematic review of the medical literature

Olszewski¹,

Wiśniewski

2019

Nemesis

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Our aim was to perform a systematic open-access review of various complications reported for surgically assisted rapid maxillary expansion (SARME) procedures. There were 37 articles found in Pubmed using the search equation. Twelve articles were initially excluded according to the exclusion criteria. The 25 remaining articles were read in full for their descriptions of complications related to the SARME procedure in mature patients. The main reversible complications of SARME were infection, postoperative pain, and bleeding. There were also complications related to distractors, to secondary surgeries, and pterygomaxillary junction. The main non-reversible complications of SARME were associated with teeth, periodontal bone loss, and skull base fractures. Large field-of-view cone beam computed tomography (maxilla and skull base) should be implemented as initial planning tool to prevent many potential complications. The current trend for “minimally invasive” surgery in SARME might be, from an ethical point of view, transformed onto “minimally complicated” surgery as complication is still more harmful for any given patient than any potential perioperative surgical invasiveness.

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Section: Sarpe/sarme Is a Surgical Technique Developed To Correct Tramentioning

confidence: 99%

Section: Reversible Complicationsmentioning

confidence: 99%

“…Maxillary sinusitis appeared after SARME up to six weeks postoperatively [1,11,26,27,53,[55][56][57]. The most common cause was unrecognized preoperative chronic sinusitis [58].…”

Section: Reversible Complicationsmentioning

confidence: 99%

“…The most common cause was unrecognized preoperative chronic sinusitis [58]. Fungal infection of the maxillary sinus after SARME is unusual [53].…”

Section: Reversible Complicationsmentioning

confidence: 99%

Section: Reversible Complicationsmentioning

confidence: 99%

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Complications in surgically assisted rapid maxillary expansion: a systematic review of the medical literature

Olszewski¹,

Wiśniewski

2019

Nemesis

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Posterior Palatal Expansion via Subnasal Endoscopy (2PENN) for Maxillary Deficiency: A Pilot Study

Jara,

Thuler,

Hutz

et al. 2023

The Laryngoscope

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ObjectiveSurgically assisted rapid palatal expansion (SARPE) addresses transverse maxillary deficiency, a known contributor to nasal obstruction. The purpose of this study was to assess the feasibility, preliminary outcomes, and safety of posterior palatal expansion via subnasal endoscopy (2PENN), a modified SARPE procedure, aimed at achieving anterior and posterior maxillary expansion.MethodsThis prospective case series included consecutive adult patients with findings of transverse maxillary deficiency that underwent the 2PENN procedure from 4/2021 to 4/2022. Patients completed pre‐ and post‐operative clinical evaluations, Nasal Obstruction and Septoplasty Effectiveness (NOSE) questionnaires, and computed tomography (CT), with measures including expansion at the level of the posterior nasal spine (PNS), first maxillary inter‐molar distance (IMD), and anterior nasal spine (ANS).ResultsThe cohort (N = 20) was middle‐aged (39 ± 11 years), predominantly male (80%), and overweight (BMI 28 ± 4 kg/m2). The majority (85%) of patients had sleep breathing issues, of which 10 (59%) had polysomnography‐confirmed obstructive sleep apnea (OSA). Full anterior–posterior separation of the mid‐palatal suture line was evident on all post‐operative CT scans, with mean expansion at the PNS of 3.6 ± 1.3 mm, IMD of 6.1 ± 1.6 mm and ANS of 7.0 ± 1.6 mm (p < 0.001). Following surgery, mean NOSE scores improved from 57 ± 23 to 14 ± 13 (p < 0.001). One patient required maxillary antrostomy for post‐operative sinusitis.Conclusion2PENN is an effective and safe technique for achieving both anterior and posterior maxillary expansion in patients with transverse maxillary deficiency. Further study is warranted to better understand the effect of 2PENN in patients with OSA, particularly as it relates to improving pharyngeal patency.Level of Evidence4 Laryngoscope, 2023

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A comparison of tooth-borne and bone-anchored expansion devices in SARME

Barone

Cahali

Vasconcelos

et al. 2020

Oral Maxillofac Surg

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Complications associated with surgically assisted rapid palatal expansion without pterygomaxillary separation

Cited by 13 publications

References 19 publications

Complications in surgically assisted rapid maxillary expansion: a systematic review of the medical literature

Complications in surgically assisted rapid maxillary expansion: a systematic review of the medical literature

Posterior Palatal Expansion via Subnasal Endoscopy (2PENN) for Maxillary Deficiency: A Pilot Study

A comparison of tooth-borne and bone-anchored expansion devices in SARME

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