Nasal Septal Deviation After Surgically Assisted Rapid Maxillary Expansion

Abstract

Background and Aim Surgically assisted rapid maxillary expansion (SARME) is a surgical technique widely used to correct deficiency of the transverse maxillary dimension. Although some studies investigated the effect of SARME on nasal and facial alterations, there is no evidence that correlates nasal septal deviation (NSD) to SARME as a possible postoperative sequel. The aim of this study is to address and quantify possible variations in the position of the nasal bony septum after SARME and identify any NSD as a postoperative outcome of this surgical technique. Patients and Methods This is a retrospective study, conducted at the Department of Oral and Maxillofacial Surgery of the University Hospital of Araraquara (Unesp, faculty of dentistry), SP, Brazil. Twenty-nine patients who underwent SARME were studied; every patient was evaluated by cone-beam computerized tomography (CBCT) before (T0) and six months after surgery (T1), and we collected the variation of nasal septal position by measuring the distance between the bony septum and the nasal lateral wall. Our measurements were carried out at the level of the head, midpoint and tail of the inferior turbinate. Results A mean NSD ranging from 0.4 to 1.2 mm was measured, and it is more pronounced at the anterior part of the bony septum. Twenty-seven patients (93.1%) presented minor changes in bony septum position; in 2 cases (6.8%), a significant NSD was found (p < 0.05). Conclusion A variation of bony nasal septum position can be expected in any direction after SARME, and it is more pronounced at anterior portion.

The influence of orthopedic rapid maxillary expansion on the deviation of the nasal septum

“…Given these factors, studies exploring the effects of RME on the maxillofacial complex have been reviewed. Although there have been many previous studies on the nasal airway changes and RME [13,20,26,27], there was a limited number of studies on NSD and RME [17][18][19] and no study on how the nasal septum and maxillary segments move in the different genders of pediatric patients.…”

“…Seidita et al [17] investigated the impact of surgically assisted rapid maxillary expansion (SARME) on the nasal septal region and found minor changes in most patients (93.1%). Gokce et al [24] stated that the severity of NSD is modified by the RME procedure.…”

“…The study cohort comprised 40 patients divided into an experimental group and a control group. The experimental group consisted of 26 patients (13 females and 13 males) aged between 8.3 and 13.1 years (mean age, 10.7 ± 2.1 years) with maxillary skeletal transversal constriction and a septal deviation of more than 1 mm [1,7,17,18,24]. The control group consisted of 14 patients (6 females and 8 males) (mean age, 11.2 ± 1.10) who required maxillary expansion but without NSD.…”

“…Asymmetric growth of the nasal septum can result in facial skeletal asymmetries, suggesting that the human nasal septum may serve as a growth center for the face [15,16]. Although many studies have investigated nasal septal deviation and expansion [17][18][19], there is no available data on how the maxillary segments move in the different genders. Nasal breathing is essential for the proper growth and development of the craniofacial complex.…”