Rapid maxillary expansion may be associated with improved hearing outcomes and middle ear function in pediatric patients with otitis media with effusion, with some findings comparable to surgical treatment, according to a systematic review.
In the study, investigators evaluated orthodontic and craniofacial interventions among patients with otitis media with effusion (OME), focusing on rapid maxillary expansion (RME). A structured search of PubMed, Embase, and Web of Science through December 2024 identified five prospective, nonrandomized studies involving 150 patients aged 4.5 to 15 years. The studies assessed outcomes using audiometry, tympanometry, and related measures of Eustachian tube function.
Across the studies, RME was associated with improvements in hearing thresholds and middle ear status. In one comparative study, patients treated with RME showed improved hearing levels compared with untreated controls, with no statistically significant differences between RME and ventilation tube placement outcomes. In a separate study, tympanometry findings shifted toward normal patterns following RME, alongside reductions in air-bone gaps and increases in nasal fossae width. An additional study reported complete recovery of auditory function and tympanic membrane elasticity following the retention period.
Secondary findings indicated that RME was associated with changes in nasal and airway dimensions, resulting in improved middle ear ventilation, Eustachian tube function, hearing outcomes, and otitis media with effusion prevention.
The findings weren't consistent across all of the included studies. One study reported no statistically significant difference in hearing improvement between RME and control groups over time, and spontaneous improvement was observed in untreated patients. The reported benefits were most evident in patients with craniofacial abnormalities, including maxillary constriction or cleft palate.
The review was limited by the small number of studies, all of which were nonrandomized and subject to moderate risk of bias. Differences in study design, intervention protocols, and outcome measures precluded meta-analysis. No included studies reported on incidence or recurrence of otitis media, and long-term durability of improvements remained uncertain.
“RME emerges as a promising preventive option for managing OME, particularly in patients with orthodontic indications,” wrote lead study author Elisa Boccalari, of the Department of Biomedical, Surgical, and Dental Sciences at the University of Milan, and colleagues, noting that further studies are needed to confirm long-term outcomes and generalizability.
The study authors reported no conflicts of interest. The study was partially funded by the Italian Ministry of Health.