Nasal septum morphology after surgically assisted rapid maxillary expansion with different expanders: A retrospective tomographic analysis.
5 affiliations
- 1Postgraduate Program in Dentistry, Department of Oral and Maxillofacial Surgery, Federal University of Pará, Belém, PA, Brazil. [email protected].
- 2Postgraduate Program in Dentistry, Department of Oral and Maxillofacial Surgery, Federal University of Pará, Belém, PA, Brazil.
- 3Department of Otorhinolaryngology - Head and Neck Surgery, Federal University of São Paulo, São Paulo, SP, Brazil.
- 4Oral and Maxillofacial Surgery and Traumatology Unit, Samaritano Hospital, São Paulo, SP, Brazil.
- 5Department of Surgical and Diagnostic Sciences, School of Dentistry, Marquette University, Milwaukee, WI, USA.
Abstract
Objectives
to evaluate, through tomographic analysis, whether surgically assisted rapid maxillary expansion (SARME) promotes changes in the degree of nasal septal deviation in adult patients, and to investigate whether these changes are influenced by the type of expander used.Materials and methods
this retrospective, observational, and quantitative study included 33 adult patients submitted to SARME and treated with either a Hyrax expander (n = 21) or a transpalatal distractor (n = 12). Computed tomography scans were analyzed at the preoperative period (T0) and six months postoperatively (T1). Nasal cavity height and nasal septum contour were measured, and their ratio was used to determine the degree of septal deviation. Measurement reliability was assessed using the intraclass correlation coefficient.Results
Inter-examiner reliability was excellent (ICC 0.938-0.974). No statistically significant differences were demonstrated in intragroup or intergroup analyses. From T0 to T1, nasal cavity height changed by +0.14 mm (Hyrax) and -0.01 mm (transpalatal distractor), septal contour by -0.34 mm and +0.14 mm, and NSD by -0.011 and +0.003. Intragroup p-values ranged from 0.070 to 0.982, and intergroup p-values at T1 were 0.932, 0.936 and 0.901.Conclusion
SARME does not promote significant changes in nasal septal deviation in adult patients, regardless of the type of expander used. Biomechanical differences between tooth-borne and bone-borne expanders do not appear to influence this outcome, indicating that SARME can be performed without concern for inducing or worsening septal deviation in adults with transverse maxillary deficiency, and that the choice of expander may be guided by other clinical criteria CLINICAL RELEVANCE: these findings suggest that SARME can be safely performed without concern for inducing or worsening nasal septal deviation, supporting its use in adult patients with maxillary atresia, regardless of the expander type selected.
Related
- Multiplanar Skeletal and Dentoalveolar Changes Associated with Orthopedic and Surgically Assisted Maxillary Expansion: A Multicenter Retrospective Observational Study
- Nasolabial Soft Tissue Changes Following Maxillary Expansion: Influence of Baseline Morphology.
- The Condyle–Fossa Relationship After Maxillary Expansion with Tooth-Borne and Tooth-Bone-Borne Appliances: A Retrospective Cone-Beam Computed Tomography Study at the End of Retention
- Maxillary Labial Frenulum Morphology and Maxillary Anterior Dental Caries in Children: A Scoping Review
- Association between maxillary labial frenulum morphology and gingival health, midline diastema and anterior caries in children
BibTeX
@article{folhes2026nasal,
title = {{Nasal septum morphology after surgically assisted rapid maxillary expansion with different expanders: A retrospective tomographic analysis.}},
author = {Júlia Ferreira Folhes and Christian Ruben Cusi Fernandez and Carlos Augusto de Jesus Oliveira Gonçalves and Mario Cappelette Júnior and Daniel Falbo Martins de Souza and Nicolas Homsi and José Thiers Carneiro},
journal = {Oral and maxillofacial surgery},
year = {2026},
month = oct,
doi = {10.1007/s10006-026-01652-3},
url = {https://europepmc.org/article/MED/42909694},
note = {CC BY},
}
RIS
TY - JOUR
TI - Nasal septum morphology after surgically assisted rapid maxillary expansion with different expanders: A retrospective tomographic analysis.
AU - Júlia Ferreira Folhes
AU - Christian Ruben Cusi Fernandez
AU - Carlos Augusto de Jesus Oliveira Gonçalves
AU - Mario Cappelette Júnior
AU - Daniel Falbo Martins de Souza
AU - Nicolas Homsi
AU - José Thiers Carneiro
PY - 2026
DA - 2026/10/23
JO - Oral and maxillofacial surgery
DO - 10.1007/s10006-026-01652-3
UR - https://europepmc.org/article/MED/42909694
AB - Objectives to evaluate, through tomographic analysis, whether surgically assisted rapid maxillary expansion (SARME) promotes changes in the degree of nasal septal deviation in adult patients, and to investigate whether these changes are influenced by the type of expander used.Materials and methods this retrospective, observational, and quantitative study included 33 adult patients submitted to SARME and treated with either a Hyrax expander (n = 21) or a transpalatal distractor (n = 12). Computed tomography scans were analyzed at the preoperative period (T0) and six months postoperatively (T1). Nasal cavity height and nasal septum contour were measured, and their ratio was used to determine the degree of septal deviation. Measurement reliability was assessed using the intraclass correlation coefficient.Results Inter-examiner reliability was excellent (ICC 0.938-0.974). No statistically significant differences were demonstrated in intragroup or intergroup analyses. From T0 to T1, nasal cavity height changed by +0.14 mm (Hyrax) and -0.01 mm (transpalatal distractor), septal contour by -0.34 mm and +0.14 mm, and NSD by -0.011 and +0.003. Intragroup p-values ranged from 0.070 to 0.982, and intergroup p-values at T1 were 0.932, 0.936 and 0.901.Conclusion SARME does not promote significant changes in nasal septal deviation in adult patients, regardless of the type of expander used. Biomechanical differences between tooth-borne and bone-borne expanders do not appear to influence this outcome, indicating that SARME can be performed without concern for inducing or worsening septal deviation in adults with transverse maxillary deficiency, and that the choice of expander may be guided by other clinical criteria CLINICAL RELEVANCE: these findings suggest that SARME can be safely performed without concern for inducing or worsening nasal septal deviation, supporting its use in adult patients with maxillary atresia, regardless of the expander type selected.
SN - 1865-1550
SN - 1865-1569
ER -