OBJECTIVES: The influence of respiratory function on craniofacial development and head posture has previously been demonstrated. This study evaluated the effect of rapid palatal expansion (RPE) on nasopharyngeal airway adequacy, head posture and facial morphology in children with nasal obstruction. METHODS: Fifty-five girls (8 - 15 years of age) who needed palatal expansion, showed reduced nasopharyngeal airway adequacy (pm-Ad 2) and subjectively assessed mouth breathing, were randomly allocated into two groups. The 23 subjects in the first group were treated with RPE and the 22 subjects in the other group were followed about eight months before beginning therapy and became untreated controls. Dental casts and lateral skull radiographs exposed in natural head position were obtained at the first visit and six months later for all subjects. RESULTS: In the girls under active treatment there was a statistically significant increase of pm-Ad 2 (P <.0001), a significant increase of the cervical lordosis angle (P <.0001), a flexion of the head (P <.0001), and a decrease in the cranio-cervical angulation (P <.0001) (paired t tests). No significant changes were seen in the control group. The correlation coefficients indicated a mild correlation between pm-Ad 2 distance and cranio-cervical angulation (SN/OPT angle) (r = 0.61 at P <.001). CONCLUSION: RPE is capable of increasing nasopharyngeal airway adequacy in girls and this leads to a decrease in cranio-cervical angulations. The clinical importance of these results is yet to be clarified.

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