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The Effect of Mandibular Distraction Osteogenesis on Weight Velocity in Infants With Severe Pierre Robin Syndrome

Dongyuan Luo1, Yiyang Chen, Hongtao Wang

  • 1Guangzhou Women and Children's Medical Center, Guangzhou City, China.

The Journal of Craniofacial Surgery
|June 5, 2018
PubMed

Insights

Early mandibular distraction osteogenesis (MDO) in Pierre Robin syndrome (PRS) patients significantly improves body weight recovery. Infants treated before one month of age showed better weight gain, enabling earlier palatoplasty surgery.

Area of Science:

  • Craniofacial surgery
  • Pediatric surgery
  • Developmental pediatrics

Background:

  • Pierre Robin syndrome (PRS) is characterized by micrognathia, glossoptosis, and airway obstruction.
  • Mandibular distraction osteogenesis (MDO) is a surgical technique used to correct mandibular hypoplasia.
  • The optimal timing for MDO in PRS patients to promote developmental outcomes remains debated.

Purpose of the Study:

  • To investigate the influence of patient age at the time of MDO on the developmental trajectory of children with PRS.
  • To analyze the impact of MDO timing on body weight gain and subsequent surgical interventions.

Main Methods:

  • Retrospective analysis of 41 children with PRS who underwent MDO between 2014 and 2016.
  • Recording of body weight percentiles at birth, first visit, MDO surgery, distractor removal, and palatoplasty.
  • Comparison of body weight outcomes based on age at MDO (<1 month, 1-3 months, 4-7 months) and presence of cleft palate.

Main Results:

  • Body weight percentile significantly decreased from birth (34.4±5.8) to MDO (13.1±3.6), then increased post-MDO (distractor removal: 28.3±5.3; palatoplasty: 42.4±6.5).
  • Infants undergoing MDO before 1 month of age maintained significantly higher body weight percentiles compared to older infants.
  • Post-MDO, PRS infants with cleft palate showed comparable body weight percentiles to those without at palatoplasty.

Conclusions:

  • Early MDO (<1 month) is beneficial for severe PRS cases, promoting body weight recovery.
  • Timely MDO facilitates earlier palatoplasty surgery in PRS patients.
  • MDO positively influences the nutritional status and overall development of PRS infants.

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