Maxillary expansion in children with obstructive sleep apnea (OSA): meta-analysis

Introduction Obstructive Sleep Apnea (OSA) in childhood leads to physical impairment and psychomotor important. Thus, it must be recognized and treated early, in an attempt to prevent or mitigate the consequences, as they may be harmful to the proper development of the child. The adenotonsillectomy, and in selected cases, the Continuous Positive Airway Pressure (CPAP) have been the treatments of choice for OSAS in children, without having absolute success in treating this syndrome. Minimally invasive treatments have been proposed more recently, intra-oral devices, extra-oral and speech therapy. Objective: To perform a meta-analysis of maxillary expansion in OSA in children. Materials and methods Citations to potentially relevant published trials were located by searching PubMed, Embase, Scopus and Medline. Inclusion criteria were (1) randomized controlled trials, case-control trials, or cohort studies with controls; (2) studies in nonsyndromic children 0 to 12 years of age (3) polysomnography with apnea- hypopnea index (AHI) before and after treatment; and (4) maxillary expansion treatment. The quality of the studies selected was evaluated by assessing their methodologies. Treatment effects were combined by meta-analysis with the random-effects method. Results The total sample of these articles was 116 children with a mean age of 6.7 years. Of the six items assessed four underwent two periods of follow-up. Mean AHI in the first follow-up was −4.958 ( p p Conclusion Meta-analysis of six international papers, we concluded that maxillary expansion in children with OSA is an effective method in the treatment of this syndrome being supplementary maintained in the medium term. Further studies are needed to assess whether this effectiveness remains in adulthood. Acknowledgement FAPESP process 2012/00092–0.