Impacto da adenotonsilectomia e da expansão rápida da maxila nas vias aéreas superiores em crianças com Síndrome da Apneia Obstrutiva do Sono (SAOS): estudo clínico randomizado

Abstract

Introduction: The purpose of this 2-arm parallel study was to evaluate the volume upper airway change in children diagnosed with Obstructive Sleep Apnea after receiving both types of treatments, adenotonsillectomy and rapid maxillary expansion. Methods: A sample of thirty children with Obstructive Sleep Apnea. Eligibility criteria included participants in the clinical symptoms of breathing disorder, such as snoring, and mouth breathing, palatine tonsil hypertrophy, adenoid hypertrophy, constricted maxillary arch, high palate, unilateral or bilateral posterior crossbite, and/or some degree of mandibular retrusion. The participants were consecutively divided into 2 study groups. The first group received adenotonsillectomy as the first treatment and later the rapid maxillary expansion; the second group received the rapid maxillary expansion as the first treatment and later the adenostonsillectomy. Cone-beam computed tomography examinations were obtained before of first treatment, 5-6 months post first treatment, and 5-6 months post second treatment. The images were imported and displayed in the imaging software: Mimics Research 21.0 for analysis the volumetric upper airways. Intragroup analysis was performed using Friedman test, intergroup analysis was performed using the Mann Whitney test (α = 0.05). Results: There was a statistically significant difference in the both groups when comparing the total volume between initial and final. Intergroup analysis was statistically significant differences in the volume total upper airway and oropharyngx. Conclusion: Adenotonsillectomy and rapid maxillary expansion contributed to the increase of airway volume; and that the combined use of two types treatments greatest volumetric upper airway gain occurs when adenotonsillectomy was made as the first treatment option.