 Enlarged adenoids and tonsils in children often lead to breathing problems. This includes obstructive sleep apnea, which is linked to, among other things, poor school performance and learning difficulties. While removal of the tonsils is currently the first-line treatment, respiratory issues often reappear, especially in children with dentofacial deformities. A new study suggests that rapid palatal expansion could be considered a viable and safe treatment option for certain children. Rapid palatal expansion is a commonly performed orthodontic treatment. This treatment separates the mid-palatal suture of the palate and improves breathing by widening the upper jaw and nasal floor. The result is increased nasal volume, raised tongue posture, and an enlarged airway. But whether rapid palatal expansion alleviates enlarged adenoids and tonsils has remained unclear until now. Researchers examine two groups of 60 children with narrow and high arch palates as well as enlarged tonsils. These included a control group undergoing no treatment and an experimental group undergoing rapid palatal expansion over the course of four to six weeks. The team looked at image scans obtained by cone beam computational tomography. This technique provides a three-dimensional view of a patient's anatomy and allowed the team to analyze the volume of the adenoids and tonsils of the children. Scans were performed before rapid palatal expansion and afterwards, on average 13 months later. Participants also completed a pediatric sleep questionnaire before and after expansion. The questionnaire asked about common symptoms of sleep-disordered breathing, including snoring, difficulty breathing during sleep, and attention issues. Compared to the control group, the expansion group experienced a statistically significant decrease in both adenoid and tonsil volume. 90% of patients in the expansion group experienced a decrease in adenoid volume and 97.5% experienced a decrease in tonsil volume. The average adenoid volume reduction was 16.8%, and average tonsil volume reduction was 38.5%. In addition, questionnaire responses indicated significant improvements in sleep-disordered breathing symptoms after expansion. One limitation of the study was the 3D imaging technique used in the study. This technique shows poor contrast resolution for soft tissue. As such, hard tissue landmarks were used for measurements, creating the possibility that adenoid and tonsil reduction amounts may have been underestimated. In addition, the sample size used was relatively small, and other factors such as allergy treatments or presence of infections were not monitored daily. The findings, however, could be instructive. For the first time, researchers have quantified volumetric changes to adenoids and tonsils following rapid palatal expansion. The significant decreases observed highlight the potential role of expansion treatment in reducing the size of the adenoids and tonsils among children who experienced related obstructive sleep apnea.