History
- Orthodontic expansion first described by Emersen Angell about 145 years ago
- Kole in 1959 first person to speak about corticotomy procedure in adults with maxillary constriction
- Brown first described surgical technique for SARPE in 1938
- Steinhauser first described technique involving segmental left/right split of maxilla along with placement of graft in 1972

Indications
- Skeletal maturity or adult patients
- Fused intermaxillary suture
- Transverse maxillary hypoplasia
- Bilateral posterior crossbite
- Previous failure of use of any other expansion devices

Procedure
- SARPE performed to address transverse dimension changes in a patient
- Surgery followed by Le Fort 1 in a second surgery to address vertical and anterior-posterior changes
- Rapid maxillary expander device placed in maxilla for first surgery
- Le Fort fracture of skull without downfracture of maxilla performed under local anesthesia and iv sedation or general anesthesia
- Midpalatal osteotomy performed to allow break in inter-maxillary suture

Stability of Procedure
- Chamberland and Profitt observed skeletal changes of about 3-4mm after SARPE, which were stable
- One-third of transverse dental expansion obtained with SARPE may be lost, but skeletal expansion remains the same
- Post-surgical relapse with SARPE similar to changes in dental arch dimensions after non-surgical rapid palatal expansion
- Stability of procedure not superior to other known expansion techniques
- Study by Northway et al. suggested long-term buccogingival expansion more acceptable in adults expanded with surgical augmentation

Disadvantages
- Unaesthetic period after expansion with RME
- Implementation of palatal expander post-operatively
- Patient compliance necessary
- Second surgery likely

[REFERENCES]
- Koudstaal, M. J.; Poort, L. J.; van der Wal, K. G. H.; Wolvius, E. B.; Prahl-Andersen, B.; Schulten, A. J. M. (2005). Surgically assisted rapid maxillary expansion (SARME): a review of the literature.
- Catalog of Copyright Entries. Part 1. A Group 1. Books. New Series. 1938.
- Steinhauser, E. W. (1972). Midline splitting of the maxilla for correction of malocclusion.
- Hamedi Sangsari, Adrien; Sadr-Eshkevari, Pooyan; Al-Dam, Ahmed; Friedrich, Reinhard E.; Freymiller, Earl; Rashad, Ashkan (2016). Surgically Assisted Rapid Palatomaxillary Expansion With or Without Pterygomaxillary Disjunction: A Systematic Review and Meta-Analysis.
- Chamberland, Sylvain; Proffit, William R. (2016). Short-term and long-term stability of surgically assisted rapid palatal expansion revisited.
- Chamberland, Sylvain; Proffit, William R. (2016). Closer Look at the Stability of Surgically Assisted Rapid Palatal Expansion.
- Northway, W. M.; Meade, J. B. (1997). Surgically assisted rapid maxillary expansion: a comparison of technique, response, and stability.