scholarly journals Balloon Dilatation and Rapid Maxillary Expansion: A Novel, Combined Treatment for Congenital Nasal Pyriform Aperture Stenosis in an Infant

2021 ◽  
Author(s):  
Sara Santarsiero
Keyword(s):  
Sleep Apnea ◽  
Minimally Invasive ◽  
Combined Treatment ◽  
Nasal Bone ◽  
Specific Treatment ◽  
Maxillary Expansion ◽  
Treatment Protocols ◽  
Feeding Difficulties ◽  
Obstructive Sleep ◽  
Pyriform Aperture

Abstract BackgroundCongenital nasal pyriform aperture stenosis (CNPAS) is a rare condition isolated or inserted in a multi-formative syndrome, which still encounters management difficulties. There are no specific treatment protocols and the use of traditional surgery represents an anachronism since cognitive assumptions and non-invasive or minimally invasive therapeutic innovations would currently be available. However, the rarity of the disease and the infantile context makes RCTs difficult to process. Case presentationWe expose the case of a one-month-old caucasian male infant suffering from CNPAS. The patient presented to the Emergency Department of the Bambino Gesù Pediatric Hospital with a clinical picture characterized by nasal obstruction, noisy breathing, feeding difficulties and suspected sleep apnea. During hospitalization he underwent overnight pulse oximetry, airway endoscopy and maxillofacial CT with a final diagnosis of CNPAS with moderate obstructive sleep apnea. We treated him successfully through an innovative therapeutic strategy that required the collaboration of a team of ENT surgeons and orthodontists.ConclusionsThe combination of minimally invasive balloon surgery and the application of a palatal device may represent a successful strategy for patients with CNPAS, probably also applicable to other types of nasal bone stenosis. Future studies may allow the definition of treatment strategies of these pathologies, we hope in the context of novel practical guidelines.

scholarly journals Balloon dilation and rapid maxillary expansion: a novel combination treatment for congenital nasal pyriform aperture stenosis in an infant

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Emanuela Sitzia ◽  
Sara Santarsiero ◽  
Filippo Maria Tucci ◽  
Giovanni De Vincentiis ◽  
Angela Galeotti ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Balloon Dilation ◽  
Nasal Bone ◽  
Treatment Protocol ◽  
Specific Treatment ◽  
Sleep Apnoea ◽  
Maxillary Expansion ◽  
Feeding Difficulties ◽  
Obstructive Sleep ◽  
Pyriform Aperture

Abstract Background Congenital nasal pyriform aperture stenosis (CNPAS) is a rare condition that may occur alone or as part of a multi-formative syndrome. Management remains difficult. There is no specific treatment protocol. Traditional surgery would be anachronistic; a non-invasive or minimally invasive therapeutic option is required. However, the rarity of the disease and the infantile context render randomised clinical trials difficult. Case presentation We present the case of a one-month-old Caucasian boy with CNPAS. He presented to the Emergency Department of the Bambino Gesù Pediatric Hospital with nasal obstruction, noisy breathing, feeding difficulties, and suspected sleep apnoea. During hospitalisation, he underwent overnight pulse oximetry, airway endoscopy, and maxillofacial computed tomography (CT); the final diagnosis was CNPAS with moderate obstructive sleep apnoea syndrome. We successfully treated the patient using an innovative strategy that involved collaboration between ear-nose-and-throat surgeons and orthodontists. Conclusions A combination of minimally invasive balloon surgery and placement of a palatal device may successfully treat CNPAS; it may also treat other types of nasal bone stenosis. Future studies may allow the development of practice consensus treatment strategies.

Rapid maxillary expansion in children with obstructive sleep apnea syndrome: 12-month follow-up

2007 ◽  
Vol 8 (2) ◽  
pp. 128-134 ◽  
Author(s):  
Maria Pia Villa ◽  
Caterina Malagola ◽  
Jacopo Pagani ◽  
Marilisa Montesano ◽  
Alessandra Rizzoli ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Rapid Maxillary Expansion in Obstructive Sleep Apnea in Young Patients: Cardio-Respiratory Monitoring

2017 ◽  
Vol 41 (4) ◽  
pp. 312-316 ◽  
Author(s):  
Alfio Buccheri ◽  
Fabio Chinè ◽  
Giovanni Fratto ◽  
Licia Manzon
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Young Patients ◽  
Rapid Maxillary Expansion ◽  
Respiratory Monitoring ◽  
Respiratory Disorder ◽  
Maxillary Expansion ◽  
Mean Values ◽  
Obstructive Sleep ◽  
The Mean

Objective(s): Obstructive sleep apnea syndrome (OSAS) is a respiratory disorder which affects from 1 to 3 % of people during development. OSAS treatment may be pharmacological, surgical or based on application of intraoral devices to increase nasal respiratory spaces. The purpose of this study was to determine the efficacy of the Rapid Maxillary Expander in OSAS young patients by measuring cardio-respiratory monitoring parameters (AHI, the average value of complete and incomplete obstructed respiration per hour of sleep, and SAO2, the percentage of oxygen saturation). Study design: The study was conducted on 11 OSAS young subjects (mean age 6.9±1.04 years), all treated with rapid maxillary expansion (RME). Cardio-respiratory monitoring (8-channel Polymesam) was performed at the beginning (diagnostic, T0) and after 12 months of treatment. Results: The mean values of cardio-respiratory parameters at TO were: AHI=6.09±3.47; SAO2=93.09%±1.60. After 12 months of treatment, the mean values of the same polysomnographic parameters were: AHI=2.36 ± 2.24;SAO2=96.81% ±1.60. These changes were associated with an improvement in clinical symptoms, such as reduction of snoring and sleep apnea. Conclusion(s): This study confirms the therapeutic efficacy of RME in OSAS young patients. This orthopedic-orthodontic treatment may represent a good option in young patients affected by this syndrome.

Evaluation of submucosal minimally invasive lingual excision technique for treatment of obstructive sleep apnea/hypopnea syndrome

2009 ◽  
Vol 140 (2) ◽  
pp. 281-281 ◽  
Author(s):  
Baran Acar ◽  
Hayriye Karabulut ◽  
Mehmet Ali Babademez ◽  
Bulent Ciftci ◽  
Rıza Murat Karasen
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Minimally Invasive ◽  
Obstructive Sleep ◽  
Hypopnea Syndrome

scholarly journals Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision

2020 ◽  
Vol 9 (3) ◽  
pp. 888 ◽  
Author(s):  
David Gozal ◽  
Hui-Leng Tan ◽  
Leila Kheirandish-Gozal
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Treatment Options ◽  
A Priori ◽  
Upper Airway ◽  
Surgical Removal ◽  
Low Grade ◽  
Maxillary Expansion ◽  
Obstructive Sleep ◽  
Anti Inflammatory

Treatment approaches to pediatric obstructive sleep apnea (OSA) have remarkably evolved over the last two decades. From an a priori assumption that surgical removal of enlarged upper airway lymphadenoid tissues (T&A) was curative in the vast majority of patients as the recommended first-line treatment for pediatric OSA, residual respiratory abnormalities are frequent. Children likely to manifest persistent OSA after T&A include those with severe OSA, obese or older children, those with concurrent asthma or allergic rhinitis, children with predisposing oropharyngeal or maxillomandibular factors, and patients with underlying medical conditions. Furthermore, selection anti-inflammatory therapy or orthodontic interventions may be preferable in milder cases. The treatment options for residual OSA after T&A encompass a large spectrum of approaches, which may be complementary, and clearly require multidisciplinary cooperation. Among these, continuous positive airway pressure (CPAP), combined anti-inflammatory agents, rapid maxillary expansion, and myofunctional therapy are all part of the armamentarium, albeit with currently low-grade evidence supporting their efficacy. In this context, there is urgent need for prospective evidence that will readily identify the correct candidate for a specific intervention, and thus enable some degree of scientifically based precision in the current one approach fits all model of pediatric OSA medical care.

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