Neonatal Mandibular Distraction Does Not Increase Inpatient Complications

Area of Science:

• Craniofacial Surgery
• Pediatric Surgery
• Health Services Research

Background:

• Mandibular distraction osteogenesis (MDO) is a surgical procedure to correct mandibular hypoplasia.
• The optimal timing for MDO, particularly during the neonatal period, requires further investigation regarding potential complications.

Purpose of the Study:

• To determine if performing MDO during the neonatal period increases inpatient complications.
• To assess the health-care burden associated with neonatal MDO compared to later intervention.

Main Methods:

• Retrospective cohort study utilizing the Kids' Inpatient Database (2000-2011).
• Included infants (<12 months) undergoing MDO, comparing neonatal (<28 days) vs. non-neonatal distraction.
• Analyzed outcomes: procedures, postoperative length of stay (pLOS), hospital charges, and transfer rates using regression models.

Main Results:

• Of 102 patients, 50 underwent neonatal MDO. Neonatal MDO patients had higher rates of cleft palate and feeding difficulties.
• Neonatal MDO was not associated with increased procedures, pLOS, hospital charges, or transfer rates.
• Secondary predictors, not neonatal age, influenced pLOS, hospital charges, and procedure counts.

Conclusions:

• Neonatal MDO is not linked to increased inpatient complications or health-care burden.
• Neonatal status should not be a contraindication for MDO at experienced surgical centers.