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Mandibular distraction osteogenesis in children with Pierre Robin sequence: impact on health-related quality of life
Paul Hong1, Michael McNeil, Donald B Kearns
1IWK Health Centre, Division of Pediatric Otolaryngology, Department of Pediatric Surgery, Halifax, Nova Scotia, Canada. Paul.Hong@iwk.nshealth.ca
Insights
Mandibular distraction osteogenesis (MDO) significantly improves health-related quality of life (QOL) in children with Pierre Robin sequence (PRS). This study provides the first QOL assessment following MDO for airway obstruction.
Area of Science:
- Pediatric surgery
- Craniofacial anomalies
- Quality of Life research
Background:
- Pierre Robin sequence (PRS) often causes severe upper airway obstruction in children, potentially requiring surgical intervention.
- Mandibular distraction osteogenesis (MDO) is effective for relieving airway obstruction, but its impact on quality of life (QOL) remains unassessed.
- This study addresses the gap by evaluating health-related QOL outcomes after MDO in pediatric PRS patients.
Purpose of the Study:
- To conduct the first health-related quality of life (QOL) assessment in children with Pierre Robin sequence (PRS) following mandibular distraction osteogenesis (MDO).
- To determine the subjective benefit and domain-specific improvements in QOL after MDO for severe upper airway obstruction.
Main Methods:
- A retrospective study utilizing the Glasgow Children's Benefit Inventory (GCBI) questionnaire.
- Data collected from caregivers of children who underwent MDO between January 2007 and December 2010.
- Exclusion of patients with other major surgical procedures to isolate MDO's impact.
Main Results:
- An 84% response rate was achieved (21 of 25 questionnaires).
- The mean GCBI score of +54 (SD, 19.5) indicated a subjective overall benefit in health-related QOL post-MDO.
- Positive scores across all GCBI domains suggested improvements in specific QOL areas, with no significant differences between syndromic/isolated PRS or tracheostomy/no tracheostomy groups.
Conclusions:
- Mandibular distraction osteogenesis (MDO) provides a subjective overall benefit in health-related quality of life (QOL) for children with Pierre Robin sequence (PRS) and severe upper airway obstruction.
- The findings support MDO as a treatment that positively impacts QOL in this pediatric population.
Background:
Upper airway obstruction in children with Pierre Robin sequence (PRS) may be severe enough to require surgical intervention. Although many studies have demonstrated the effectiveness of mandibular distraction osteogenesis (MDO) in relieving airway obstruction, no study has reported health-related quality of life (QOL) outcomes. The objective of the present study was to conduct the first health-related QOL assessment post-MDO.
Methods:
The Glasgow Children's Benefit Inventory (GCBI) questionnaire was distributed in a retrospective manner to the caregivers of all children who had undergone MDO at the authors' institutions between January 2007 and December 2010. Patients who had other major surgical procedures were excluded.
Results:
The response rate was 84% (21 of 25 questionnaires completed). The total mean GCBI score was +54 (SD, 19.5), which demonstrated a subjective overall benefit in health-related QOL post-MDO. All of the domains within the GCBI also scored in the positive range, indicating domain specific improvements in health-related QOL. There were no significant differences in the GCBI scores between syndromic-PRS patients and isolated PRS patients; similar results were observed between tracheostomy patients and no tracheostomy patients.
Summary:
In treating children with PRS and severe upper airway obstruction, MDO resulted in a subjective overall benefit in health-related QOL in our study population.
