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Neonatal Mandibular Distraction Without a Consolidation Period: Is It Safe? Is it Effective?
Nataliya Biskup1, Ashley L Altman, Christopher M Runyan
1*Cincinnati Children's Hospital Medical Center, Division of Plastic Surgery. Cincinnati, OH †Department of Plastic Surgery, Wake Forest Baptist Health, Winston-Salem, NC ‡Department of Plastic Surgery, University of Saskatchewan, Saskatoon, Canada.
Purpose:
Consolidation is a standard part of most post-distraction protocols. This study aims to determine whether the deliberate omission of a consolidation period following mandibular distraction (MD) in neonates with Pierre Robin sequence (PRS) affected the airway outcomes and complication rates.
Patients And Methods:
A retrospective chart review of 28 neonates with PRS who underwent MD for severe airway obstruction between 2009 and 2014 was performed. Neonates were split into 2 cohorts: those with a very short or no consolidation (no consolidation group, n = 18) and those with a traditional consolidation period (consolidation group, n = 10).
Results:
Mean consolidation length was 25 days in the conventional consolidation group and 1.5 days in the no consolidation group (P < 0.01). Postoperatively, both groups showed equivalent improvements in their obstructive index as measured by polysomnography. Compared with the patients who underwent convention consolidation, patients in the "no consolidation" group did not require a greater number of repeat distraction, supplemental oxygen, or tracheostomy. Nor was there any significant difference in the number of complications between the 2 groups.
Conclusion:
In neonates with PRS treated with MD for severe airway obstruction, the omission of a consolidation period does not appear to significantly affect the complication rate or resolution of airway obstruction.
