Changes in Airway Dimensions After Face-Mask Therapy in Cleft Lip and Palate and Non-cleft Patients: Systematic Review and Meta-Analysis

Context Maxillary deficiency can lead to the reduction of airway space and increase the chances of development of obstructive airway disorders. Facemask therapy is one of the main treatment protocols in developing maxillary deficient patients. Objectives The purpose of this systematic review and meta-analysis was to assess the changes in the airway dimensions after face-mask therapy in both cleft lip and palate and non-cleft patients. Methods A systematic search in different electronic databases (EMBASE, Pubmed, Cochrance Central register of controlled trials), IADR proceedings and a hand search by October ۲۰۲۰ were conducted and a meta-analysis and systematic review was performed. Results In patients without cleft lip and palate, upper pharyngeal width was significantly increased by mean of ۲.۰۵ mm (CI = ۹۵%, ۰.۶۱ - ۳.۵۰) following facemask therapy in comparison to patients who did not receive the treatment. Other upper pharyngeal (nasopharyngeal) measurements also showed a statistically significant improvement after therapy: S-PNS by ۴.۶۴ mm (CI = ۹۵%, ۳.۳۴ - ۵.۹۴), AD۱-PNS by ۳.۸۱ mm (CI = ۹۵%, ۲.۴۰ - ۵.۲۱), AD۲-PNS by ۲.۹۰ mm (CI = ۹۵%, ۰.۱۳ - ۵.۶۷) and Pm’-SPL by ۲.۵۳ (CI = ۹۵%, ۰.۵۴ - ۴.۵۱). Lower pharyngeal measurments did not show any significant changes after the treatment (P > ۰.۰۵). In the analysis of studies with ۳D imaging modalities, upper pharyngeal volume was also significantly increased by ۴۹۹.۲۹ mm۳ (CI = ۹۵%, ۶۹.۵۸-۹۲۹.۰۰) after the treatment. In addition, a review of articles that included cleft lip and palate patients also showed after the treatment, the upper pharyngeal measurements all showed a significant improvement (P < ۰.۰۵), whereas the oropharyngeal region was relatively stable. Conclusions In maxillary deficient patients with or without an orofacial cleft, facemask therapy can improve the nasopharyngeal area dimensions; however, this treatment protocol appears not to have an effect on the oropharyngeal area of the airway tract.

کلیدواژه ها:

Airway ، CBCT ، Facemask