{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T14:05:24Z","timestamp":1780063524090,"version":"3.54.0"},"reference-count":38,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec id=\"st1\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine whether dysfunctional Eustachian tubes of children with resistant otitis media with effusion (OME), ventilation tube placement indication, and maxillary constriction will recover after rapid maxillary expansion (RME).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>The RME group consisted of 15 children (mean age: 10.07 years) with maxillary constriction, Eustachian tube dysfunction (ETD), and resistant OME. The control group consisted of 11 healthy children (mean age: 8.34 years) with no orthodontic and\/or rhinologic problems. Recovery of Eustachian tube dysfunction was evaluated by Williams' test at three timepoints: before RME\/at baseline (T0); after RME (T1); and after an observation period of 10 months (T2). The control group was matched to all these periods, except T1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the control group, functioning Eustachian tubes were observed in all ears at baseline (T0), and tubes showed no worsening and no change during the observation period (T2) (\n                      <jats:italic>P<\/jats:italic>\n                      &gt; .05). In the RME group, functioning Eustachian tubes were observed in eight of 30 ears and ETD was observed in the remaining 22 ears at baseline (T0). The RME group showed significant improvements in tube functions after RME and the observation period (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05). Fifteen of 22 dysfunctional ears recovered (68.2%) and started to exhibit normal Eustachian tube function after RME (T1) and the observation period (T2).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings suggest that ears having poorly functioning Eustachian tubes are restored and recovered after RME in most of children with maxillary constriction and resistant OME. Thus, RME should be preferred as a first therapy alternative for children with maxillary constriction and serous otitis media.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/021421-127.1","type":"journal-article","created":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T10:50:22Z","timestamp":1626173422000},"page":"772-777","source":"Crossref","is-referenced-by-count":6,"title":["An alternative treatment approach for patients with resistant otitis media with effusion and dysfunctional Eustachian tube:"],"prefix":"10.2319","volume":"91","author":[{"given":"Nihat","family":"K\u0131l\u0131\u00e7","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zg\u00fcr","family":"Y\u00f6r\u00fck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song\u00fcl C\u00f6mert","family":"K\u0131l\u0131\u00e7","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-91-6-772-b01","series-title":"Otitis Media in Infants and Children. 4th ed","first-page":"1","author":"Bluestone","year":"2007","unstructured":"Bluestone\n              CD,\n            \n            \n              Klein\n              JO.\n            \n          \n          \n            Otitis Media in Infants and Children. 4th ed.\n\t\t\t\t\tPhiladelphia:\n\t\t\t\t\tW. B. Saunders Company;2007:\n\t\t\t\t\t1\u2013\n\t\t\t\t\t70."},{"key":"i0003-3219-91-6-772-b02","series-title":"Infect Drug Resist","first-page":"15","article-title":"Update on otitis media-prevention and treatment","volume":"7","author":"Qureishi","year":"2014","unstructured":"Qureishi\n              A,\n            \n            \n              Lee\n              Y,\n            \n            \n              Belfield\n              K.,\n            \n            \n              Birchall\n              JP,\n            \n            \n              Daniel\n              M.\n            \n          \n          Update on otitis media-prevention and treatment.\n\t\t\t\t\tInfect Drug Resist.\n\t\t\t\t\t2014;\n\t\t\t\t\t7:\n\t\t\t\t\t15\u2013\n\t\t\t\t\t24."},{"key":"i0003-3219-91-6-772-b03","series-title":"Lancet","first-page":"465","article-title":"Otitis media","volume":"363","author":"Rovers","year":"2004","unstructured":"Rovers\n              MM,\n            \n            \n              Schilder\n              AG,\n            \n            \n              Zielhuis\n              GA,\n            \n            \n              Rosenfeld\n              RM.\n            \n          \n          Otitis media.\n\t\t\t\t\tLancet.\n\t\t\t\t\t2004;\n\t\t\t\t\t363:\n\t\t\t\t\t465\u2013\n\t\t\t\t\t473."},{"key":"i0003-3219-91-6-772-b04","series-title":"Angle Orthod","first-page":"293","article-title":"Does the rhythm and appliance type of rapid maxillary expansion have an effect on root resorption?: A comparative clinical study using micro-computed tomography","volume":"91","author":"Malko\u00e7","year":"2021","unstructured":"Malko\u00e7\n              S,\n            \n            \n              Al\u00e7in\n              R,\n            \n            \n              Uzel\n              A.\n            \n          \n          Does the rhythm and appliance type of rapid maxillary expansion have an effect on root resorption?: A comparative clinical study using micro-computed tomography.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2021;\n\t\t\t\t\t91:\n\t\t\t\t\t293\u2013\n\t\t\t\t\t300.\n\t\t\t\t\tdoi: 10.2319\/052220-465.1."},{"key":"i0003-3219-91-6-772-b05","series-title":"Int J Pediatr Otorhinolaryngol","first-page":"1595","article-title":"Effects of rapid maxillary expansion on nasal breathing and some naso-respiratory and breathing problems in growing children: a literature review","volume":"72","author":"Kili\u00e7","year":"2008","unstructured":"Kili\u00e7\n              N,\n            \n            \n              Oktay\n              H.\n            \n          \n          Effects of rapid maxillary expansion on nasal breathing and some naso-respiratory and breathing problems in growing children: a literature review.\n\t\t\t\t\tInt J Pediatr Otorhinolaryngol.\n\t\t\t\t\t2008;\n\t\t\t\t\t72:\n\t\t\t\t\t1595\u2013\n\t\t\t\t\t1601."},{"key":"i0003-3219-91-6-772-b06","series-title":"Angle Orthod","first-page":"761","article-title":"Rapid maxillary expansion versus middle ear tube placement: comparison of hearing improvements in children with resistance otitis media with effusion","volume":"86","author":"Kilic","year":"2016","unstructured":"Kilic\n              N,\n            \n            \n              Yoruk\n              O,\n            \n            \n              Kilic\n              SC,\n            \n            \n              \u00c7atal\n              G,\n            \n            \n              Kurt\n              S.\n            \n          \n          Rapid maxillary expansion versus middle ear tube placement: comparison of hearing improvements in children with resistance otitis media with effusion.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2016;\n\t\t\t\t\t86:\n\t\t\t\t\t761\u2013\n\t\t\t\t\t767."},{"key":"i0003-3219-91-6-772-b07","series-title":"B-ENT","first-page":"13","article-title":"Management of recurrent otitis media with rapid maxillary expansion: our experience","volume":"5","author":"De Stefano","year":"2009","unstructured":"De Stefano\n              A,\n            \n            \n              Baffa\n              C,\n            \n            \n              Cerrone\n              D,\n            \n            \n              Mathur\n              N,\n            \n            \n              Cascini\n              V,\n            \n            \n              Petrucci\n              AG,\n            \n            \n              Neri\n              G.\n            \n          \n          Management of recurrent otitis media with rapid maxillary expansion: our experience.\n\t\t\t\t\tB-ENT.\n\t\t\t\t\t2009;\n\t\t\t\t\t5:\n\t\t\t\t\t13\u2013\n\t\t\t\t\t17."},{"key":"i0003-3219-91-6-772-b08","series-title":"Angle Orthod","first-page":"752","article-title":"Correlations between rapid maxillary expansion (RME) and the auditory apparatus","volume":"76","author":"Villano","year":"2006","unstructured":"Villano\n              A,\n            \n            \n              Grampi\n              B,\n            \n            \n              Fiorentini\n              R,\n            \n            \n              Gandini\n              P\n            \n          .\n\t\t\t\t\tCorrelations between rapid maxillary expansion (RME) and the auditory apparatus.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2006;\n\t\t\t\t\t76:\n\t\t\t\t\t752\u2013\n\t\t\t\t\t758."},{"key":"i0003-3219-91-6-772-b09","series-title":"Otolaryngol Head Neck Surg","first-page":"499","article-title":"Middle ear and auditory tube: middle ear clearance, gas exchange, and pressure regulation","volume":"116","author":"Sad\u00e9","year":"1997","unstructured":"Sad\u00e9\n              J,\n            \n            \n              Ar\n              A.\n            \n          \n          Middle ear and auditory tube: middle ear clearance, gas exchange, and pressure regulation.\n\t\t\t\t\tOtolaryngol Head Neck Surg.\n\t\t\t\t\t1997;\n\t\t\t\t\t116:\n\t\t\t\t\t499\u2013\n\t\t\t\t\t524."},{"key":"i0003-3219-91-6-772-b10","series-title":"ORL J Otorhinolaryngol Relat Spec","first-page":"164","article-title":"Repetitive tympanometric screenings in 4-year-old children. Seasonal influence on secretory otitis and tubal dysfunction","volume":"43","author":"Holm-Jensen","year":"1981","unstructured":"Holm-Jensen\n              S,\n            \n            \n              S\u00f8rensen\n              CH,\n            \n            \n              Tos\n              M.\n            \n          \n          Repetitive tympanometric screenings in 4-year-old children. Seasonal influence on secretory otitis and tubal dysfunction.\n\t\t\t\t\tORL J Otorhinolaryngol Relat Spec.\n\t\t\t\t\t1981;\n\t\t\t\t\t43:\n\t\t\t\t\t164\u2013\n\t\t\t\t\t174."},{"key":"i0003-3219-91-6-772-b11","series-title":"Dental Cadmos","first-page":"41","article-title":"Rapid maxillary expansion in the treatment of recurrent middle ear otitis","volume":"77","author":"Neri","year":"2009","unstructured":"Neri\n              G,\n            \n            \n              Baffa\n              C,\n            \n            \n              De Stefano\n              A,\n            \n            \n              Conte\n              E.\n            \n          \n          Rapid maxillary expansion in the treatment of recurrent middle ear otitis.\n\t\t\t\t\tDental Cadmos.\n\t\t\t\t\t2009;\n\t\t\t\t\t77:\n\t\t\t\t\t41\u2013\n\t\t\t\t\t48."},{"key":"i0003-3219-91-6-772-b12","series-title":"Int J Pediatr Otorhinolaryngol","first-page":"1184","article-title":"Effects of rapid maxillary expansion on middle ear function: one-year follow-up","volume":"76","author":"Micheletti","year":"2012","unstructured":"Micheletti\n              KR,\n            \n            \n              de Mello\n              JA,\n            \n            \n              de Almeida Barreto Ramos\n              SR,\n            \n            \n              Scheibel\n              PC,\n            \n            \n              Scheibel\n              GG,\n            \n            \n              Ramos\n              AL.\n            \n          \n          Effects of rapid maxillary expansion on middle ear function: one-year follow-up.\n\t\t\t\t\tInt J Pediatr Otorhinolaryngol.\n\t\t\t\t\t2012;\n\t\t\t\t\t76:\n\t\t\t\t\t1184\u2013\n\t\t\t\t\t1187."},{"key":"i0003-3219-91-6-772-b13","series-title":"Acta Otorhinolaryngol Ital","first-page":"386","article-title":"Association between oral habits, mouth breathing and malocclusion","volume":"36","author":"Grippaudo","year":"2016","unstructured":"Grippaudo\n              C,\n            \n            \n              Paolantonio\n              EG,\n            \n            \n              Antonini\n              G,\n            \n            \n              Saulle\n              R,\n            \n            \n              La Torre\n              G,\n            \n            \n              Deli\n              R.\n            \n          \n          Association between oral habits, mouth breathing and malocclusion.\n\t\t\t\t\tActa Otorhinolaryngol Ital.\n\t\t\t\t\t2016;\n\t\t\t\t\t36:\n\t\t\t\t\t386\u2013\n\t\t\t\t\t394."},{"key":"i0003-3219-91-6-772-b14","series-title":"Int J Pediatr Otorhinolaryngol","first-page":"27","article-title":"Acoustic rhinometric measurements in children undergoing rapid maxillary expansion","volume":"70","author":"Compadretti","year":"2006","unstructured":"Compadretti\n              CG,\n            \n            \n              Tasca\n              I,\n            \n            \n              Alessandri-Bonetti\n              G,\n            \n            \n              Peri\n              S,\n            \n            \n              D'Addario\n              A.\n            \n          \n          Acoustic rhinometric measurements in children undergoing rapid maxillary expansion.\n\t\t\t\t\tInt J Pediatr Otorhinolaryngol.\n\t\t\t\t\t2006;\n\t\t\t\t\t70:\n\t\t\t\t\t27\u2013\n\t\t\t\t\t34."},{"key":"i0003-3219-91-6-772-b15","series-title":"Angle Orthod","first-page":"409","article-title":"Effects of rapid maxillary expansion on conductive hearing loss","volume":"78","author":"Kilic","year":"2008","unstructured":"Kilic\n              N,\n            \n            \n              Kiki\n              A,\n            \n            \n              Oktay\n              H,\n            \n            \n              Selimoglu\n              E.\n            \n          \n          Effects of rapid maxillary expansion on conductive hearing loss.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2008;\n\t\t\t\t\t78:\n\t\t\t\t\t409\u2013\n\t\t\t\t\t414."},{"key":"i0003-3219-91-6-772-b16","series-title":"Arch Otolaryngol","first-page":"1","article-title":"Functional anatomy of the tensor palatini. Its relevance in cleft palate surgery","volume":"93","author":"Ross","year":"1971","unstructured":"Ross\n              MA.\n            \n          \n          Functional anatomy of the tensor palatini. Its relevance in cleft palate surgery.\n\t\t\t\t\tArch Otolaryngol.\n\t\t\t\t\t1971;\n\t\t\t\t\t93:\n\t\t\t\t\t1\u2013\n\t\t\t\t\t3."},{"key":"i0003-3219-91-6-772-b17","series-title":"Ann Otol Rhinol Laryngol (Suppl)","first-page":"47","article-title":"Effect of surgical alterations of the tensor velipalatini muscle on eustachian tube function","volume":"89","author":"Cantekin","year":"1980","unstructured":"Cantekin\n              EI,\n            \n            \n              Phillips\n              DC,\n            \n            \n              Doyle\n              WJ,\n            \n            \n              Bluestone\n              CD,\n            \n            \n              Kimes\n              KK.\n            \n          \n          Effect of surgical alterations of the tensor velipalatini muscle on eustachian tube function.\n\t\t\t\t\tAnn Otol Rhinol Laryngol (Suppl).\n\t\t\t\t\t1980;\n\t\t\t\t\t89:\n\t\t\t\t\t47\u2013\n\t\t\t\t\t53."},{"key":"i0003-3219-91-6-772-b18","series-title":"Ear Nose Throat J","first-page":"242","article-title":"Rapid maxillary expansion in the treatment of nasal obstruction and respiratory disease","volume":"66","author":"Timms","year":"1987","unstructured":"Timms\n              DJ.\n            \n          \n          Rapid maxillary expansion in the treatment of nasal obstruction and respiratory disease.\n\t\t\t\t\tEar Nose Throat J.\n\t\t\t\t\t1987;\n\t\t\t\t\t66:\n\t\t\t\t\t242\u2013\n\t\t\t\t\t247."},{"key":"i0003-3219-91-6-772-b19","series-title":"BMC Oral Health","first-page":"2","article-title":"Changes in pharyngeal aerobic microflora in oral breathers after palatal rapid expansion","volume":"6","author":"Cazzolla","year":"2006","unstructured":"Cazzolla\n              MP,\n            \n            \n              Campisi\n              G,\n            \n            \n              Lacaita\n              MG,\n            \n            et al.\n          \n          Changes in pharyngeal aerobic microflora in oral breathers after palatal rapid expansion.\n\t\t\t\t\tBMC Oral Health.\n\t\t\t\t\t2006;\n\t\t\t\t\t6:\n\t\t\t\t\t2\u2013\n\t\t\t\t\t2."},{"key":"i0003-3219-91-6-772-b01","series-title":"Otitis Media in Infants and Children. 4th ed","first-page":"1","author":"Bluestone","year":"2007","unstructured":"Bluestone\n              CD,\n            \n            \n              Klein\n              JO.\n            \n          \n          \n            Otitis Media in Infants and Children. 4th ed.\n\t\t\t\t\tPhiladelphia:\n\t\t\t\t\tW. B. Saunders Company;2007:\n\t\t\t\t\t1\u2013\n\t\t\t\t\t70."},{"key":"i0003-3219-91-6-772-b02","series-title":"Infect Drug Resist","first-page":"15","article-title":"Update on otitis media-prevention and treatment","volume":"7","author":"Qureishi","year":"2014","unstructured":"Qureishi\n              A,\n            \n            \n              Lee\n              Y,\n            \n            \n              Belfield\n              K.,\n            \n            \n              Birchall\n              JP,\n            \n            \n              Daniel\n              M.\n            \n          \n          Update on otitis media-prevention and treatment.\n\t\t\t\t\tInfect Drug Resist.\n\t\t\t\t\t2014;\n\t\t\t\t\t7:\n\t\t\t\t\t15\u2013\n\t\t\t\t\t24."},{"key":"i0003-3219-91-6-772-b03","series-title":"Lancet","first-page":"465","article-title":"Otitis media","volume":"363","author":"Rovers","year":"2004","unstructured":"Rovers\n              MM,\n            \n            \n              Schilder\n              AG,\n            \n            \n              Zielhuis\n              GA,\n            \n            \n              Rosenfeld\n              RM.\n            \n          \n          Otitis media.\n\t\t\t\t\tLancet.\n\t\t\t\t\t2004;\n\t\t\t\t\t363:\n\t\t\t\t\t465\u2013\n\t\t\t\t\t473."},{"key":"i0003-3219-91-6-772-b04","series-title":"Angle Orthod","first-page":"293","article-title":"Does the rhythm and appliance type of rapid maxillary expansion have an effect on root resorption?: A comparative clinical study using micro-computed tomography","volume":"91","author":"Malko\u00e7","year":"2021","unstructured":"Malko\u00e7\n              S,\n            \n            \n              Al\u00e7in\n              R,\n            \n            \n              Uzel\n              A.\n            \n          \n          Does the rhythm and appliance type of rapid maxillary expansion have an effect on root resorption?: A comparative clinical study using micro-computed tomography.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2021;\n\t\t\t\t\t91:\n\t\t\t\t\t293\u2013\n\t\t\t\t\t300.\n\t\t\t\t\tdoi: 10.2319\/052220-465.1."},{"key":"i0003-3219-91-6-772-b05","series-title":"Int J Pediatr Otorhinolaryngol","first-page":"1595","article-title":"Effects of rapid maxillary expansion on nasal breathing and some naso-respiratory and breathing problems in growing children: a literature review","volume":"72","author":"Kili\u00e7","year":"2008","unstructured":"Kili\u00e7\n              N,\n            \n            \n              Oktay\n              H.\n            \n          \n          Effects of rapid maxillary expansion on nasal breathing and some naso-respiratory and breathing problems in growing children: a literature review.\n\t\t\t\t\tInt J Pediatr Otorhinolaryngol.\n\t\t\t\t\t2008;\n\t\t\t\t\t72:\n\t\t\t\t\t1595\u2013\n\t\t\t\t\t1601."},{"key":"i0003-3219-91-6-772-b06","series-title":"Angle Orthod","first-page":"761","article-title":"Rapid maxillary expansion versus middle ear tube placement: comparison of hearing improvements in children with resistance otitis media with effusion","volume":"86","author":"Kilic","year":"2016","unstructured":"Kilic\n              N,\n            \n            \n              Yoruk\n              O,\n            \n            \n              Kilic\n              SC,\n            \n            \n              \u00c7atal\n              G,\n            \n            \n              Kurt\n              S.\n            \n          \n          Rapid maxillary expansion versus middle ear tube placement: comparison of hearing improvements in children with resistance otitis media with effusion.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2016;\n\t\t\t\t\t86:\n\t\t\t\t\t761\u2013\n\t\t\t\t\t767."},{"key":"i0003-3219-91-6-772-b07","series-title":"B-ENT","first-page":"13","article-title":"Management of recurrent otitis media with rapid maxillary expansion: our experience","volume":"5","author":"De 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Grampi\n              B,\n            \n            \n              Fiorentini\n              R,\n            \n            \n              Gandini\n              P\n            \n          .\n\t\t\t\t\tCorrelations between rapid maxillary expansion (RME) and the auditory apparatus.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2006;\n\t\t\t\t\t76:\n\t\t\t\t\t752\u2013\n\t\t\t\t\t758."},{"key":"i0003-3219-91-6-772-b09","series-title":"Otolaryngol Head Neck Surg","first-page":"499","article-title":"Middle ear and auditory tube: middle ear clearance, gas exchange, and pressure regulation","volume":"116","author":"Sad\u00e9","year":"1997","unstructured":"Sad\u00e9\n              J,\n            \n            \n              Ar\n              A.\n            \n          \n          Middle ear and auditory tube: middle ear clearance, gas exchange, and pressure regulation.\n\t\t\t\t\tOtolaryngol Head Neck Surg.\n\t\t\t\t\t1997;\n\t\t\t\t\t116:\n\t\t\t\t\t499\u2013\n\t\t\t\t\t524."},{"key":"i0003-3219-91-6-772-b10","series-title":"ORL J Otorhinolaryngol Relat Spec","first-page":"164","article-title":"Repetitive tympanometric screenings in 4-year-old children. Seasonal influence on secretory otitis and tubal dysfunction","volume":"43","author":"Holm-Jensen","year":"1981","unstructured":"Holm-Jensen\n              S,\n            \n            \n              S\u00f8rensen\n              CH,\n            \n            \n              Tos\n              M.\n            \n          \n          Repetitive tympanometric screenings in 4-year-old children. 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