Objectives There is a lack of evidence whether hyoid bone position changes with surgically assisted rapid palatal expansion (SARPE), which could improve the airway. The aim of this study was to (1) evaluate the differences in hyoid bone position with SARPE, (2) assess whether there are differences between bone-borne or tooth-borne expansion appliances, and (3) investigate possible relationships between expansion values and hyoid bone position. Materials and Methods Eligible for inclusion in this retrospective cohort study were adult patients who underwent SARPE using bone-borne or tooth-borne expansion appliances. The Hyrax group (n=32; female/male 20/12; mean age 26.0 ± 9.1 years) was treated with a hyrax appliance and the TPD group (n=33; female/male 15/18; mean age 25.0 ± 8.0 years) was treated with a transpalatal distractor. The position of the hyoid bone was determined on lateral cephalograms before (<InlineEquation ID="IEq1"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="784_2025_6529_Article_IEq1.gif" Format="GIF" Height="16" Rendition="HTML" Resolution="72" Type="Linedraw" Width="14" /> </InlineMediaObject> <EquationSource Format="TEX">\({t}_{\text{0}}\)</EquationSource> </InlineEquation>) and after SARPE (<InlineEquation ID="IEq2"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="784_2025_6529_Article_IEq2.gif" Format="GIF" Height="16" Rendition="HTML" Resolution="72" Type="Linedraw" Width="14" /> </InlineMediaObject> <EquationSource Format="TEX">\({t}_{\text{1}}\)</EquationSource> </InlineEquation>) using eight measurements and five landmarks. Arch width was measured at dental landmarks on STL files and the amount of maxillary expansion was calculated. Results Hyoid bone position remained generally stable, with changes not exceeding 2 mm. The only statistically significant change in the overall cohort was observed for the sagittal distance Hy-Me, which decreased from 44.23 mm to 43.40 mm (<InlineEquation ID="IEq3"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="784_2025_6529_Article_IEq3.gif" Format="GIF" Height="16" Rendition="HTML" Resolution="72" Type="Linedraw" Width="67" /> </InlineMediaObject> <EquationSource Format="TEX">\({p}\, {=0.005}\)</EquationSource> </InlineEquation>). Significant differences between groups were noted for the vertical distance Hy-Me’, with the Hyrax group showing a mean change of -1.95 mm (<InlineEquation ID="IEq4"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="784_2025_6529_Article_IEq4.gif" Format="GIF" Height="16" Rendition="HTML" Resolution="72" Type="Linedraw" Width="67" /> </InlineMediaObject> <EquationSource Format="TEX">\({p}\, {=0.001}\)</EquationSource> </InlineEquation>) and the TPD group showing an increase of 0.75 mm (<InlineEquation ID="IEq5"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="784_2025_6529_Article_IEq4.gif" Format="GIF" Height="16" Rendition="HTML" Resolution="72" Type="Linedraw" Width="67" /> </InlineMediaObject> <EquationSource Format="TEX">\({p}\, {=0.001}\)</EquationSource> </InlineEquation>), while the craniocervical inclination <InlineEquation ID="IEq6"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="784_2025_6529_Article_IEq6.gif" Format="GIF" Height="10" Rendition="HTML" Resolution="72" Type="Linedraw" Width="14" /> </InlineMediaObject> <EquationSource Format="TEX">\(\alpha\)</EquationSource> </InlineEquation> decreased by 1.25<InlineEquation ID="IEq7"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="784_2025_6529_Article_IEq7.gif" Format="GIF" Height="7" Rendition="HTML" Resolution="72" Type="Linedraw" Width="9" /> </InlineMediaObject> <EquationSource Format="TEX">\(^{\circ }\)</EquationSource> </InlineEquation> in the TPD group (<InlineEquation ID="IEq8"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="784_2025_6529_Article_IEq8.gif" Format="GIF" Height="16" Rendition="HTML" Resolution="72" Type="Linedraw" Width="67" /> </InlineMediaObject> <EquationSource Format="TEX">\({p}\, {=0.036}\)</EquationSource> </InlineEquation>). All other measurements showed no significant changes and possible correlations between the expansion values and the position of the hyoid bone were inconclusive. Conclusions While the results indicate small, statistically significant, but probably clinically negligible movements of the hyoid bone after SARPE, the hyoid position remained generally stable and changes were not dependent on the appliance used or the amount of expansion. Clinical Relevance Overall, the observed changes were not substantial enough to support any clinically meaningful effects of SARPE on airway function through hyoid bone movements.

Hyoid bone position with bone-borne or tooth-borne surgically assisted rapid palatal expansion: a retrospective cohort study

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2025年10月23日

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Jonas Q. Schmid,
Thomas Stamm,
Claudius Middelberg,
Bernhard Wiechens,
Ariane Hohoff,
Moritz Kanemeier

摘要

Objectives

There is a lack of evidence whether hyoid bone position changes with surgically assisted rapid palatal expansion (SARPE), which could improve the airway. The aim of this study was to (1) evaluate the differences in hyoid bone position with SARPE, (2) assess whether there are differences between bone-borne or tooth-borne expansion appliances, and (3) investigate possible relationships between expansion values and hyoid bone position.

Materials and Methods

Eligible for inclusion in this retrospective cohort study were adult patients who underwent SARPE using bone-borne or tooth-borne expansion appliances. The Hyrax group (n=32; female/male 20/12; mean age 26.0 ± 9.1 years) was treated with a hyrax appliance and the TPD group (n=33; female/male 15/18; mean age 25.0 ± 8.0 years) was treated with a transpalatal distractor. The position of the hyoid bone was determined on lateral cephalograms before ( \({t}_{\text{0}}\) ) and after SARPE ( \({t}_{\text{1}}\) ) using eight measurements and five landmarks. Arch width was measured at dental landmarks on STL files and the amount of maxillary expansion was calculated.

Results

Hyoid bone position remained generally stable, with changes not exceeding 2 mm. The only statistically significant change in the overall cohort was observed for the sagittal distance Hy-Me, which decreased from 44.23 mm to 43.40 mm ( \({p}\, {=0.005}\) ). Significant differences between groups were noted for the vertical distance Hy-Me’, with the Hyrax group showing a mean change of -1.95 mm ( \({p}\, {=0.001}\) ) and the TPD group showing an increase of 0.75 mm ( \({p}\, {=0.001}\) ), while the craniocervical inclination \(\alpha\) decreased by 1.25 \(^{\circ }\) in the TPD group ( \({p}\, {=0.036}\) ). All other measurements showed no significant changes and possible correlations between the expansion values and the position of the hyoid bone were inconclusive.

Conclusions

While the results indicate small, statistically significant, but probably clinically negligible movements of the hyoid bone after SARPE, the hyoid position remained generally stable and changes were not dependent on the appliance used or the amount of expansion.

Clinical Relevance

Overall, the observed changes were not substantial enough to support any clinically meaningful effects of SARPE on airway function through hyoid bone movements.