Distraction osteogenesis as followed by CT scan in Pierre Robin sequence

Area of Science:

• Craniofacial Surgery
• Pediatric Radiology
• Orthognathic Surgery

Background:

• Pierre Robin sequence presents with micrognathia, glossoptosis, and airway obstruction.
• Distraction osteogenesis is a surgical technique to correct mandibular hypoplasia.
• Accurate imaging is crucial for assessing treatment outcomes in pediatric patients.

Purpose of the Study:

• To evaluate multislice CT scans for analyzing craniofacial changes in Pierre Robin sequence before and after distraction.
• To assess the efficacy of unidirectional internal distractors in managing this condition.

Main Methods:

• A cohort of 11 infants (2-7 months old) with Pierre Robin sequence underwent distraction osteogenesis.
• Patients were diagnosed clinically and via CT scan.
• Postoperative follow-up and analysis were performed using multislice CT.

Main Results:

• Significant increases were observed in the tongue-to-pharyngeal wall distance (141%) and mandibular length (26%).
• The hyoid bone to posterior pharyngeal wall distance increased by 42%, and to the genoid process by 9%.

Conclusions:

• Multislice CT is a practical imaging tool for evaluating airway and mandibular morphologic changes post-distraction osteogenesis, potentially replacing traditional methods.
• Unidirectional internal distractors yielded satisfactory maxillomandibular relationships due to infant mandibular plasticity, with good tolerance and acceptance.