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Updated: Feb 8, 2026
04:24
A Mouse Distraction Osteogenesis Model
Published on: November 14, 2018
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Does Mandibular Distraction Change the Laryngoscopy Grade in Infants With Robin Sequence?
Colleen B Heffernan1, Carly E Calabrese2, Cory M Resnick3
1Clinical Fellow, Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA.
Summary
Mandibular distraction osteogenesis (MDO) improves airway visualization in infants with Robin sequence (RS). This surgical intervention enhances laryngoscopy grades, potentially increasing airway safety and simplifying future intubations for these patients.
Area of Science:
- Pediatric Surgery
- Craniofacial Surgery
- Otolaryngology
Background:
- Robin sequence (RS) is a congenital condition characterized by micrognathia, glossoptosis, and airway obstruction.
- Obstructive sleep apnea (OSA) is a common complication in infants with RS, often necessitating surgical intervention.
- Mandibular distraction osteogenesis (MDO) is a surgical technique used to correct mandibular hypoplasia.
Purpose of the Study:
- To evaluate the impact of MDO on laryngoscopic view in infants with RS.
- To assess changes in airway visualization before and after MDO.
- To correlate MDO outcomes with the resolution of obstructive sleep apnea.
Main Methods:
- A retrospective review of infants with RS who underwent MDO between March 2005 and June 2017.
- Inclusion criteria: preoperative polysomnogram confirming OSA, failure of nonoperative management, MDO by the senior author, and complete documentation.
- Exclusion criteria: tracheostomy dependence or insufficient medical records. Laryngoscopic grades were assessed at three time points: pre-MDO, device removal, and latest follow-up.
Main Results:
- Thirteen infants with RS met the inclusion criteria. Mean age at MDO was 19.6 weeks.
- Preoperative mean apnea-hypopnea index (23.6) significantly decreased to 0.3 post-MDO (P = .011).
- Laryngoscopic view improved significantly post-MDO, with 69.2% achieving a Grade I view at device removal, compared to 23.1% preoperatively (P = .011).
Conclusions:
- MDO effectively resolves obstructive apnea in infants with Robin sequence.
- The procedure leads to a significant improvement in laryngoscopic view, enhancing airway safety.
- Improved airway visualization may simplify future intubations and reduce risks associated with home airway management.
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