297 - Chronic Rhinosinusitis & RPE - RPE Improves Signs and Symptoms of Chronic Rhinosinusitis

Friday, May 27, 2022

3:40 PM – 3:55 PM PT

Location: Sails Pavilion

Has Audio

Presenting Author(s)

Eileen Welch, DDS

Pediatric Dental Resident
University of California Los Angeles, Los Angeles, CA
University of California, Los Angeles
Los Angeles, California, United States

Research Mentor(s)

Audrey Yoon, DDS

Adjunct Assistant Professor
University of California Los Angeles, Los Angeles, CA
Stanford University, Sleep Medicine
Bellflower, California, United States

Program Director(s)

DS

Daniela R. Silva, DDS, MS

Program Director
UCLA
Los Angeles, California, United States

Purpose: The purpose of this study was to identify if rapid palatal expansion is a treatment modality that may improve indicators of chronic rhinosinusitis in pediatric patients

Methods: Cone beam computed tomography (CBCT) scans of patients under 18 years of age were analyzed at two separate timepoints between two different orthodontic practices. Patients who had undergone maxillary expansion were placed in the study group, and those without expansion into the control group.

Following expansion, pre and post operative CBCT scans were analyzed for 20 different signs of chronic rhinosinusitus which included evaluating changes in turbinate hypertrophy and sinus pathology. Chart review for 13 different clinical symptoms of chronic rhinosinusitis were obtained on all patients in the study. The Glimmix model was used to analyze post vs pre for Control and Study group and was adjusted by age and gender.

Results: (data collection ongoing- preliminary results included here) Of a cohort of 70 patients, 46 (66%) study group patients underwent rapid maxillary expansion and the remaining 24 (34%) patients served as the control group. After maxillary expansion patients were 95% less likely (OR:0.05, CI: 0.02-0.17; P<0.0001) to have turbinate hypertrophy and there was no significant change in the control group. There was significant decrease in Lund Mackay Score in study group patients (-2.7, SE .36, P<0.0001) and there was no significant change in the control group.

Overall, rapid palatal expansion was associated with improvements in CBCT indicators of rhinosinusitis including decreased turbinate hypertrophy, and decreased opacification of the maxillary sinus, ethmoid sinus and overall Lund-Mackay sinus score. History of adenoidectomy, tonsillectomy, allergies, congestion and nasal obstruction were found to be predictors of positive outcomes regarding improvement of indicators of chronic rhinosinusitis after RPE

Conclusions: Rapid palatal expansion may help to alleviate signs and symptoms of rhinosinusitis in young patients.