Expansión rápida del maxilar superior y sus efectos en la dimensión nasal
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2012-06-15
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Universidad de Guayaquil. Facultad Piloto de Odontología
Resumen
Han pasado más de 100 años desde que se propusiera la idea de que la
disyunción del maxilar, aplicando una fuerza a través de las arcadas
dentarias, podría mejorar la función respiratoria nasal. El origen de esta
idea partió de un rinólogo de Kassel, Alemania, que presentó el esquema
original en la reunión de la sección médica de la Sociedad de Filosofía
Natural de Berlín1. Sin embargo, ni su presentación fue bien recibida, ni
las expectativas que había creado fueron corroboradas clínicamente. Pero
si tenemos en cuenta los conocimientos adquiridos y los avances
tecnológicos habidos en los últimos 120 años, su fracaso clínico se puede
atribuir a que utilizó un método de expansión maxilar lenta en vez de
disyunción rápida.
La obstrucción nasal se puede definir como la sensación que se produce
cuando se incrementa la resistencia al paso del aire a través de las fosas
nasales. La gran lista de trastornos que pueden acompañarse de
obstrucción nasal ha ido aumentando al largo de los últimos años gracias
a la investigación. Entre ellos hay que destacar procesos ORL como la
rinitis, la sinusitis, la otitis media y la faringitis; asimismo patología
respiratoria y cardiopulmonar como la bronquitis, el asma, la hipo
ventilación alveolar, la hipoxia, la hipercapnia, la hipertensión pulmonar, el
corpulmonale y algunas alteraciones torácicas. También se produce
obstrucción nasal en patología aparentemente poco relacionada como los
trastornos del sueño, entre ellos la apnea obstructiva, la hipersomnolencia
y el letargo; trastornos endocrinos como la obesidad, alteraciones del
comportamiento como los síndromes de hiperactividad y patología
miscelánea como la eneuresis nocturna. La relación entre la obstrucción
nasal y algunos de estos trastornos y enfermedades puede parecer que
carece de base fisiopatológica, pero la evidencia clínica acumulada, cuya
descripción excede los objetivos de esta introducción, indica que la
obstrucción nasal puede realmente ser un factor coadyuvante en la
génesis de estas patologías. Teniendo en cuenta que la obstrucción nasal
2
es un problema meramente físico, sería lógico pensar que su resolución
debería ser también física y de hecho los alergólogos y los
otorrinolaringólogos utilizan medicación y en muchos casos técnicas
quirúrgicas para reducir el tamaño o eliminar los tejidos hipertrofiados que
causan obstrucción al paso del aire. En este sentido se ha afirmado que la
expansión rápida del maxilar, al producir un incremento del volumen de la
vía respiratoria nasal, podría perfilarse como un procedimiento terapéutico
no sólo ortodóncico, sino también médico de carácter más permanente
para este tipo de pacientes.
It's been over 100 years since the idea was proposed that the maxillary disjunction , applying a force through the arcades teeth could improve nasal respiratory function. The origin of this idea came a rhinologist of Kassel , Germany , who presented the scheme Original at the meeting of the medical section of the Society for Philosophy Natural Berlin1 . However, neither presentation was well received , and expectations he had created were confirmed clinically . but if we consider the knowledge acquired and the progress technology have occurred in the past 120 years , clinical failure can be attributed to a method used slow maxillary expansion rather than Fast disjunction . Nasal obstruction can be defined as the sensation that occurs when the resistance increases the airflow through the passages nasal . The big list of disorders that may be accompanied by nasal obstruction has been increasing over the recent years thanks research . These should be noted as processes ORL rhinitis, sinusitis, otitis media and pharyngitis , also pathology respiratory and cardiopulmonary as bronchitis , asthma, hiccups alveolar ventilation , hypoxia , hypercapnia , pulmonary hypertension, corpulmonale chest and some alterations . It also occurs nasal obstruction apparently little related pathology as sleep disorders , including obstructive sleep apnea , hypersomnolence and lethargy ; endocrine disorders such as obesity , impaired behavior as hyperactivity syndromes pathology miscellany as nocturnal enuresis . The relationship between the obstruction nasal and some of these disorders and diseases may appear to no pathophysiological basis but accumulated clinical evidence , as description is beyond the scope of this introduction , indicates that the nasal obstruction may actually be a contributing factor in the genesis of these diseases. Considering that nasal obstruction 2 is a purely physical problem , it would be logical to think that its resolution should also be physical and do allergists and Otolaryngologists use medication and in many cases technical surgery to reduce the size or remove tissues that hypertrophied causing obstruction to airflow . In this regard it has been argued that the rapid expansion of the maxilla , to produce an increase in the volume of the nasal respiratory route , it could emerge as a therapeutic procedure orthodontic not only , but also more permanent medical for these patients.
It's been over 100 years since the idea was proposed that the maxillary disjunction , applying a force through the arcades teeth could improve nasal respiratory function. The origin of this idea came a rhinologist of Kassel , Germany , who presented the scheme Original at the meeting of the medical section of the Society for Philosophy Natural Berlin1 . However, neither presentation was well received , and expectations he had created were confirmed clinically . but if we consider the knowledge acquired and the progress technology have occurred in the past 120 years , clinical failure can be attributed to a method used slow maxillary expansion rather than Fast disjunction . Nasal obstruction can be defined as the sensation that occurs when the resistance increases the airflow through the passages nasal . The big list of disorders that may be accompanied by nasal obstruction has been increasing over the recent years thanks research . These should be noted as processes ORL rhinitis, sinusitis, otitis media and pharyngitis , also pathology respiratory and cardiopulmonary as bronchitis , asthma, hiccups alveolar ventilation , hypoxia , hypercapnia , pulmonary hypertension, corpulmonale chest and some alterations . It also occurs nasal obstruction apparently little related pathology as sleep disorders , including obstructive sleep apnea , hypersomnolence and lethargy ; endocrine disorders such as obesity , impaired behavior as hyperactivity syndromes pathology miscellany as nocturnal enuresis . The relationship between the obstruction nasal and some of these disorders and diseases may appear to no pathophysiological basis but accumulated clinical evidence , as description is beyond the scope of this introduction , indicates that the nasal obstruction may actually be a contributing factor in the genesis of these diseases. Considering that nasal obstruction 2 is a purely physical problem , it would be logical to think that its resolution should also be physical and do allergists and Otolaryngologists use medication and in many cases technical surgery to reduce the size or remove tissues that hypertrophied causing obstruction to airflow . In this regard it has been argued that the rapid expansion of the maxilla , to produce an increase in the volume of the nasal respiratory route , it could emerge as a therapeutic procedure orthodontic not only , but also more permanent medical for these patients.
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