Growth in Width of the Dental Arches After Partial Extirpation of the Mid-Palatal Suture in Man

Abstract

During the last 27 years 35 children with choanal atresia were operated by a method which entails a resection of the posterior 2/3 of the mid-palatal suture. In order to evaluate the consequences of this resection the width of the dental arches was measured in 320 individuals including 55 operated and unoperated patients with choanal atresia. Extirpation of the mid-palatal suture during growth resulted in a frequency of cross-bite of 52% and a significant reduction of the width of the upper dental arch and the maxilla. The findings may indicate that the growth in this specific suture is highly autonomous. Growth appeared to proceed far beyond childhood.

Management of bilateral choanal atresia in the neonate: an institutional review

“…Increasingly, the transpalatal approach has been reserved for revision cases in older patients. There is a reported 52% incidence of dental malocclusion (crossbite) resulting from narrowed maxillary dental arches in patients younger than 5 years managed with the transpalatal approach [12]. Other possible complications include bleeding, palate flap necrosis, palatal fistula, persistent submucosal tunnels, and restenosis [5].…”

Sphenoid sinus development in choanal atresia

“…The width of the nasal airway [12] is known to be reduced by the malformation. The transpalatal surgical procedures have also been reported to reduce the transverse size of the hard palate [13]. …”

Balloon dilation for management of choanal atresia and stenosis

“…Transnasal puncture alone led to high rates of restenosis, however with prolonged stenting, there was a more lasting outcome [2,7]. The trans-palatal approach offered improved exposure, and better success rates, but was associated with long term complications such as cross-bite deformity and palatal growth abnormalities [1,8]. The widespread adoption of endoscopes for use in sinus surgery led to a resurgence of interest in the transnasal approach [9][10][11].…”