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Early intervention: distraction osteogenesis of the mandible for severe airway obstruction

Pamela A Mudd1, Jonathan N Perkins, Jeri E F Harwood

  • 1Department of Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, Colorado 80045, USA. pamela.mudd@ucdenver.edu

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|December 6, 2011
PubMed

Insights

Early mandibular distraction osteogenesis in neonates with micrognathia significantly improves airway function and reduces the need for supportive care, including tracheostomy. This intervention facilitates oral feeding and simplifies future procedures.

Area of Science:

  • Craniofacial Surgery
  • Pediatric Surgery
  • Neonatal Care

Background:

  • Symptomatic micrognathia in neonates presents significant challenges, including airway obstruction and feeding difficulties.
  • Early intervention is crucial for improving outcomes in affected infants.

Purpose of the Study:

  • To evaluate the benefits of early bilateral mandibular distraction osteogenesis (within 90 days of life) in neonates with symptomatic micrognathia.
  • To assess the impact on growth, supportive care requirements, and the need for further invasive procedures.

Main Methods:

  • A case series with chart review was conducted at a tertiary care academic children's hospital.
  • Twenty-four neonates with symptomatic micrognathia who underwent mandibular distraction osteogenesis within the first 90 days of life were included.
  • Outcomes measured included hospital course, growth, home care needs, and airway status.

Main Results:

  • The mean age at distraction was 30 days, with an average postoperative discharge on day 14.
  • Only one patient required home oxygen; 50% achieved exclusive oral feeding.
  • No patients required tracheotomy, and 90% demonstrated objective airway improvement.

Conclusions:

  • Bilateral mandibular distraction osteogenesis in neonates with symptomatic micrognathia is effective.
  • Early intervention facilitates discharge with minimal support, avoiding tracheostomy and promoting oral feeding.
  • Significant and sustained airway improvement aids in subsequent procedures like cleft repair.
Abstract

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