Orthodontics meets otorhinolaryngology: a collaborative approach to otitis media prevention

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ABSTRACT

Aim

To evaluate the role of orthodontic and craniofacial orthopaedic interventions in the prevention and management of otitis media with effusion (OME), focusing particularly on rapid maxillary expansion (RME) and its implications for Eustachian tube function.

Methods

A comprehensive search was conducted in PubMed, Embase, and Web of Science using a structured combination of MeSH terms by two expert researchers from inception to December 2024. Randomised and non-randomised prospective studies involving pediatric patients (2–18 years) with chronic OME were included. The effectiveness of preventive measures was compared with alternative treatments or no interventions. Study quality was assessed using the ROBINS-I v2 tool.

Results

Out of 217 initially identified studies, only 5 met the inclusion criteria and were included in the qualitative analysis. These prospective observational studies, conducted in Italy and Turkey, involved 150 patients aged 4.5 to 15 years. A standardised data extraction form was utilised to collect information, including author names, publication dates, sample sizes, patient demographics, details of the interventions, and primary outcomes. RME demonstrated improvements in Eustachian tube function and audiometric parameters, comparable to surgical interventions such as ventilation tube placement. However, study heterogeneity precluded a meta-analysis.

Conclusion

RME emerges as a promising preventive option for managing OME particularly in patients with orthodontic indications. By addressing structural contributors to Eustachian tube dysfunction, RME improves middle ear health and complements otolaryngological interventions. Integrating orthodontic and otolaryngological strategies represents an effective multidisciplinary approach to reducing OME incidence and recurrence. Further studies are needed to confirm the long-term stability and the generalisability of these observed benefits.

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