The Role of Craniofacial Abnormalities and Orthodontic Interventions in Residual Obstructive Sleep Apnea…

ReviewMedical journal of the Islamic Republic of Iran· 2026

The Role of Craniofacial Abnormalities and Orthodontic Interventions in Residual Obstructive Sleep Apnea after Adenotonsillectomy in Children: A Scoping Review.

Mehdi Abrishami, Pegah Alizadeh Pahlavan, Nasim Nikoubakht

Craniofacial & CleftReviewTreatmentQ3IF 1.0

Rapid maxillary expansion linked to up to 70% reduction in apnea-hypopnea index in children

The Role of Craniofacial Abnormalities and Orthodontic Interventions in Residual Obstructive Sleep Apnea after Adenotonsillectomy in Children: A Scoping Review.

Mehdi Abrishami … Nasim Nikoubakht

Medical journal of the Islamic Republic of Iran · 2026 · Q3 in General Medicine

Background

Obstructive sleep apnea (obstructive sleep apnea) in children is often treated with adenotonsillectomy, yet residual or persistent obstructive sleep apnea occurs in 20-75% of cases, particularly in children with craniofacial abnormalities.

Purpose

The objective of this scoping review was to map the evidence on craniofacial and dentofacial contributions to residual obstructive sleep apnea and assess the potential role of orthodontic interventions, particularly rapid maxillary expansion (rapid maxillary expansion), within a multidisciplinary framework.

Methods

This scoping review followed PRISMA-ScR guidelines and Joanna Briggs Institute methodology.

70%

Results

70%

apnea events dropped sharply after rapid maxillary expansion in kids with narrow maxillas

More results

Six studies met the inclusion criteria.

Craniofacial features such as high/narrow palate, maxillary constriction, retrognathia, and Class II tendencies were consistently associated with residual obstructive sleep apnea, with prevalence up to 93%.

More results

Multidisciplinary approaches involving ENT, sleep specialists, and orthodontists were emphasized for optimal assessment and management.

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Conclusion · 1 of 3

Craniofacial abnormalities are important but under-recognized contributors to persistent pediatric obstructive sleep apnea post-adenotonsillectomy.

Conclusion · 2 of 3

Orthodontic treatments, especially rapid maxillary expansion, offer a valuable non-surgical adjunct in multidisciplinary care. Current evidence is limited by small sample sizes and few long-term trials.

Conclusion · 3 of 3

Future research should focus on high-quality, phenotype-driven studies to guide evidence-based management of residual obstructive sleep apnea in children.

The Role of Craniofacial Abnormalities and Orthodontic Interventions in Residual Obstructive Sleep Apnea after Adenotonsillectomy in Children: A Scoping Review.

The Role of Craniofacial Abnormalities and Orthodontic Interventions in Residual Obstructive Sleep Apnea after Adenotonsillectomy in Children: A Scoping Review.

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