Airway changes in patients treated with MARPE: a literature review

Aim of the study: the aim of this research was to highlight the change in airways after mini implants assisted rapid palatal expansion (MARPE), a suitable treatment for the correction of the maxillary transverse constriction in post pubertal children and young adults and its potential application in the treatment of obstructive sleep apnea (OSA). Materials and methods: The research was conducted on two online databases (Medline via PubMed and Web of Science) and on the main paper magazines in the sector and we analysed the most relevant papers on the top-ic. The research was focused on MARPE changes in the airways. Only papers published after 2008 and written in English or Italian were considered. Results and conclusions: Rapid maxillary expansion (RME) is an effective treatment for OSA in children, due to the changes in nasal complex that are produced along with the correction of the transverse constriction of the palate even though there are conflicting studies on its long-term effects. Similarly, few studies have been carried out on MARPE and its effects on the nasomaxillary complex. In the short term MARPE has proved to reduce airway resistance and increase respiratory muscle strength and nasal airway flow which could help treating OSA patients since nasal resistance are thought to be a contributing factor for mild OSA. Studies regarding long term effects suggest, with mixed results, that MARPE, compared to RME, maintains an increase in the nasopharyngeal volume whereas in the long period other parameters, such as nasal cavity volume, while significant in the short time are matched by controls in the longer period. Long-terms randomized trials with larger sample size, adequate controls and appropriate diagnostic tools will be needed in order to establish whether is a promising tool to treat patients.