Many children have obstructive sleep apnea due to the size and shape of their jaws.   Commonly, children with obstructive sleep apnea have small and narrowed upper and lower jaws. Maxillomandibular expansion is often performed in children with obvious jaw deformity or when there is residual obstructive sleep apnea after adenoidectomy and tonsillectomy have been performed.

The upper and lower jaws can be expanded by orthodontic treatment, usually without need of surgery. The goal of the treatment is to widen the upper and lower jaws with an orthodontic appliance. This can be performed in children as young as 5 years old.  Occasionally, limited surgery to facilitate expansion may be required in teenagers when a significant degree of jaw maturation has already occurred.

Before Maxillary Expansion		After Maxillary Expansion
Before Mandibular Expansion		After Mandibular Expansion

 

References:

Guilleminault C, Li KK.  Maxillomandibular Expansion by Distraction Osteogenesis for the Treatment of Sleep-Disordered Breathing: Preliminary Results.  Laryngoscope; 114:893-896, 2004.

Li KK.  Surgical Therapy for Obstructive Sleep Apnea Syndrome.  Seminars in Respiratory and Critical Care Medicine; 26:80-88, 2005.