Pterygopalatine disjunction-associated SARME and the nasal cavity - A systematic literature review

This study aimed to evaluate the effect of surgically assisted rapid maxillary expansion (SARME) with pterygopalatine disjunction (PD) on the nasomaxillary complex structures. A systematic two-phase review, recorded in the PROSPERO database, was conducted. Search strategies were performed using PubMed, Scopus, Web of Science, COCHRANE, LILACS and DOSS databases, including gray literature (Open Grey, Google Scholar, and ProQuest). The methodological quality and evidence of the included studies were assessed. Out of 1017 studies, 10 met the inclusion criteria. Generally, a moderate risk of bias was noted. The studies involved 236 adults evaluated preoperatively and postoperatively. Key outcomes assessed included nasal cavity volume, minimum cross-sectional area (MCSA), nasal septum positioning, nasal cavity width, and nose volume (soft tissues). Although findings indicated increased MCSA, nasal cavity, and nasopharynx volumes, and no changes in nasal septum post-SARME + PD, the current evidence is insufficient for definitive clinical recommendations due to study limitations, particularly the small number of included studies. More clinical studies with robust methodologies and low risk of bias are needed. Nasal septum, nasal cavity, palatine expansion technique.