External mandibular distraction in unusual pediatric syndromes with micrognathia and airway obstruction

Mandibular hypoplasia is a craniofacial malformation that can cause airway obstruction and may affect the eating process. This anomaly is common in many polimalformed Syndromes, including the Pierre Robin Sequence and the Moebius Syndrome. It is also common in cases related to the dysgenesis of the brainstem. In order to avoid tracheostomy, or to allow for early decannulation in severely affected children, external distraction devices were employed in 3 clinical cases to repair mandibular deficiencies. A successful external mandibular distraction induces the removal of the airway obstruction, allowing spontaneous ventilation without devices, an independent eating process with no need of nasogastric or gastrostomy tubes, apart from the linguistic and facial asymmetry improvement.