Original article
Effects of semirapid maxillary expansion on conductive hearing loss

https://doi.org/10.1016/j.ajodo.2006.05.047Get rights and content

Introduction:Conductive hearing loss is affected by physical changes imposed on the mechanical system of the outer or middle ear. Maxillary expansion can affect conductive hearing loss, and the changes have been investigated with pure-tone audiograms. Semirapid and slow methods of maxillary expansion have some advantages over rapid maxillary expansion, but the effects on conductive hearing loss have not been investigated. The purpose of this study was to investigate long-term effects of semirapid maxillary expansion (SRME) with an acrylic bonded appliance on conductive hearing loss by using audiometric and tympanometric records. Methods:The effects of SRME with a bonded appliance were studied in 19 growing subjects who had narrow maxillary arches and conductive hearing loss. Hearing levels were determined with pure-tone audiometric and tympanometric records. Four records were taken from each subject. The first records were taken before SRME, the second after maxillary expansion (mean, 3.4 months later), the third after retention (mean, 6 months later), and the fourth after fixed-appliance treatment (approximately 2 years later). The data were analyzed with ANOVA. The least-significant difference test was also used to determine when the changes in the measurements were significant. Results:Hearing improved and air-bone gaps decreased at a statistically significant level after active expansion, and these changes remained relatively stable during the last 2 periods. Middle-ear volume increased at a statistically significant level after maxillary expansion and continued to increase until the end of treatment. No significant change was observed in the static compliance value. Conclusions:SRME treatment has a positive and statistically significant effect on both hearing and normal functioning of the eustachian tubes in patients with transverse maxillary deficiency and conductive hearing loss.

Section snippets

Material and methods

We studied 19 patients (14 girls, 5 boys) who underwent SRME at the Department of Orthodontics, Faculty of Dentistry, Atatürk University, Erzurum, Turkey. Each patient had severe maxillary width deficiency, bilateral crossbite, and deep palatal vault. Their age range was 12 years to 14 years 9 months (mean, 13 years 5 months ± 1 year).

The design of the acrylic bonded appliance used in this study and its activation program during SRME were described by Iseri and Özsoy.23

The hearing of each

Results

Table I, Table II summarize the mean values and the standard deviations of the pure-tone thresholds and the air-bone gaps at the different speech frequencies for each ear. Means and standard deviations of the tympanometric measurements are shown in Table III. The results of the ANOVA testing the changes at the hearing levels, middle-ear volumes, and static compliance values are summarized in Table IV. The results of the LSD test applied to explain the significances in the ANOVA are given in

Discussion

RME appliances widen the maxillary arch in the transversal direction mainly by separating the maxillary halves by tipping and extrusion of the maxillary posterior teeth.12, 27, 28, 29 Bonded RME appliances with occlusal acrylic coverage seem to have certain advantages, such as greater skeletal expansion, long-term stability, and reduced bite opening than conventional expanders.21, 23 In addition, it has been thought that expanding the maxillary arch slowly is more physiologic and stable.24, 30

Conclusions

  • 1

    Hearing levels of the patients with conductive hearing loss improved and air-bone gaps decreased at a statistically significant level (P <0.001) during the active expansion period.

  • 2

    The healing remained stable during the retention and fixed-appliance treatment periods.

  • 3

    Middle-ear volume increased at a statistically significant level (P <0.001) in all observation periods, except the retention period.

  • 4

    Slight increases were observed in the static compliance values in all observation periods, but these

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