Journal
OTOLARYNGOLOGY-HEAD AND NECK SURGERY
Volume 157, Issue 2, Pages 345-348Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/0194599817707168
Keywords
obstructive sleep apnea; nasal obstruction; high arched palate; maxillary expansion; distraction osteogenesis; mini-implant assisted rapid maxillary expander; bone-borne maxillary expander; rapid palatal expander
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A narrow maxilla with high arched palate characterizes a phenotype of obstructive sleep apnea (OSA) patients that is associated with increased nasal resistance and posterior tongue displacement. Current maxillary expansion techniques for adults are designed to correct dentofacial deformity. We describe distraction osteogenesis maxillary expansion (DOME) tailored to adult patients with OSA with narrow nasal floor and high arched palate without soft tissue redundancy. DOME is performed with placement of maxillary expanders secured by mini-implants along the midpalatal suture. This minimizes the maxillary osteotomies necessary to re-create sutural separation for reliable expansion at the nasal floor and palatal vault. We report the safety and efficacy profile of the first 20 patients at Stanford who underwent DOME.
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