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Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects

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CT analysis after distraction osteogenesis in Pierre Robin Sequence.

Saswata Roy¹, Patrick D Munson, Linping Zhao

¹Division of Pediatric Otolaryngology, Nemours Children's Clinic, Jacksonville, FL 32207-8426, USA. saswataroy@mac.com

The Laryngoscope

|January 23, 2009

Summary

This summary is machine-generated.

Mandibular distraction osteogenesis significantly improves airway obstruction in infants with Pierre Robin sequence (PRS). This technique enhances hypopharyngeal airway volume and posterior airway space, offering a viable alternative to traditional airway management.

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Area of Science:

Craniofacial Surgery
Pediatric Airway Management
Orthognathic Surgery

Background:

Pierre Robin sequence (PRS) presents challenges in airway management due to micrognathia.
Mandibular distraction osteogenesis is an alternative to conventional methods for airway obstruction in PRS.
Limited quantitative data exists on skeletal and soft tissue changes following mandibular distraction in PRS.

Purpose of the Study:

To quantitatively assess skeletal, soft tissue, and hypopharyngeal airway changes after mandibular distraction in infants with PRS.
To evaluate the efficacy of internal, unidirectional distraction osteogenesis devices in managing airway obstruction.

Main Methods:

Prospective analysis of three infants with PRS undergoing mandibular distraction using an internal, unidirectional device.
Serial computed tomography (CT) scans were obtained and analyzed for mandibulo-maxillary arch harmony, symmetry, airway volume, and distances.
Measurements included hypopharyngeal airway volume, geniohyoid distance, bone volume, and mandibular length.

Main Results:

Mandibular lengthening increased total mandibular length by 26.2%.
Hypopharyngeal airway volume increased by 192%, and the posterior airway space (tongue base to pharyngeal wall) increased by 198.9%.
Good mandibulo-maxillary arch harmony was achieved, with corrected distances of 0.5 mm and no significant open-bite or cross-bite deformities.

Conclusions:

Internal unidirectional microdistraction devices effectively improve mandibulo-maxillary arch harmony in PRS.
Significant increases in hypopharyngeal airway volume and posterior airway space are achieved.
Mandibular distraction osteogenesis represents a substantial advancement for managing airway obstruction in infants with micrognathia.