Long term effects of surgically assisted rapid maxillary expansion without performing osteotomy of the pterygoid plates

Purpose: Surgically assisted rapid maxillary expansions (SARME) are commonly used to widen the maxilla. This study evaluates long term stability of surgically assisted rapid palatal expansion without performing osteotomy of the pterygoid plates and its effects on nasal airway volume. Materials and methods: 13 patients (mean age 31,23 +/- 6, 11) with a maxillary transverse deficit of at least 5 mm were examined 1 month before and on average 63 months after a mean palatal distraction of 8.29 +/- 1.68 mm by acoustic rhinometry. Profiles of the nasal airway volumes were collected. A cast model analysis was performed. The data were evaluated using Wilcoxon signed rank test. Results: A V-shaped movement of the segments was observed. The gain for total nasal volume was 23.25%. Findings indicate a significant enhancement of nasal volume in all patients (P < 0.01) as result of the maxillary expansion. No relapse occurred in the study group. Conclusion: SARME provides a long term stable orthodontic bite correction and permanently enhances the nasal airways. A transverse shift of the segments can be achieved over the whole bony palate even when no osteotomy of the pterygo-maxillary suture is performed. (C) 2009 European Association for Cranio-Maxillo-Facial Surgery