Date: January 2023.
Source: The American Surgeon; 0(0). doi:10.1177/00031348221148349.
Background: Surgically assisted rapid palatal expansion (SARPE) is an established method to treat transverse maxillary hypoplasia in skeletally mature adult patients. SARPE affects the surrounding soft tissue. In addition, effects on the airway and breathing have been described. Aim of this study was to assess the effects of SARPE on the nasal soft tissue and the upper airway by means of three-dimensional stereophotogrammetry and cone beam computed tomography (CBCT).
Methods: This retrospective study used preoperative and postoperative cone beam computed tomography (CBCT) scans and three-dimensional stereophotogrammetry. Ten skeletally adult patients (4 male, 6 female; mean age 27.68 years) with transverse maxillary hypoplasia were included. Patients had undergone SARPE procedure, performed by the same surgical team using the same technique. Nasal soft tissue changes were analyzed, using three-dimensional stereophotogrammetry records taken preoperatively (t0) and at the postoperative checkup appointment (t1). The upper airway was assessed using CBCT scans for surgical planning (t0) and the first scan taken after SARPE (t1).
Results: In stereophotogrammetry, it was shown that only a few soft tissue nasal parameters increased significantly and SARPE leads to mainly clinically irrelevant changes in nasal soft tissue. In CBCT, only a significant increase in nasopharyngeal airway volume was found.
Discussions: Results were in alignment with literature. The effects of SARPE on the nasal soft tissue are mostly statistically insignificant and clinically irrelevant. Airway volume significantly increased in the nasopharyngeal area. Further research on SARPE effects should be conducted to reinforce SARPE as a treatment option for sleep apnea patients.
Key Takeaways:
• Soft tissue changes after SARPE are mostly insignificant
• Airway volume changes can be demonstrated in CBCT scans
• SARPE can be considered a treatment option for OSAS

Article: Three-Dimensional Analyses of Postoperative Effects of Surgically Assisted Rapid Palatal Expansion (SARPE) on the Soft Tissue of the Midface Region and the Upper Airway Space Using Stereophotogrammetry and Cone Beam Computed Tomography (CBCT).
Authors: Wiebke Heldmaier, DDS; Daniel Lonic, MD; and Denys J. Loeffelbein, MD, DDS. Maxillofacial Center Munich, Munich, Germany.