Precise osteotomies for mandibular distraction in infants with Robin sequence using virtual surgical planning

Area of Science:

• Craniofacial Surgery
• Pediatric Surgery
• Sleep Medicine

Background:

• Obstructive sleep apnea (OSA) in infants with Pierre Robin sequence (RS) often requires surgical intervention.
• Mandibular distraction osteogenesis (MDO) is a primary surgical option for refractory OSA in RS.
• Virtual surgical planning (VSP) may enhance MDO accuracy and safety.

Purpose of the Study:

• To evaluate the efficacy and safety of MDO for OSA in RS infants using VSP.
• To assess the precision of osteotomies created with 3D-printed cutting guides.
• To report airway outcomes and complication rates.

Main Methods:

• Retrospective study of 17 RS infants undergoing MDO with VSP and 3D-printed guides.
• Preoperative maxillofacial CT scans for VSP and guide fabrication.
• Analysis of osteotomy designs, surgical execution, bone formation, airway outcomes, and complications.

Main Results:

• All MDO procedures were performed as planned using VSP and cutting guides.
• Successful airway outcomes were achieved in all patients.
• Bone formation was evident in all cases; four minor complications occurred, with no major complications.

Conclusions:

• MDO is a successful and safe procedure for managing OSA in infants with RS.
• VSP significantly aids in the precise design and execution of MDO.
• This approach offers favorable outcomes for pediatric obstructive sleep apnea management.