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Device Malfunction Associated With Mandibular Distraction for Infants With Robin Sequence.

Monica Manrique1, Jeniffer L McGrath, Justin R Bryant

  • 1Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, DC.

The Journal of Craniofacial Surgery
|June 2, 2021
PubMed
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Mandibular distraction osteogenesis (MDO) devices for Robin sequence (RS) can malfunction, causing complications in infants. This study highlights device failures and their impact on patient outcomes.

Area of Science:

  • Pediatric surgery
  • Craniofacial surgery
  • Biomedical engineering

Background:

  • Mandibular distraction osteogenesis (MDO) is a key treatment for upper airway obstruction (UAO) in infants with Robin sequence (RS).
  • Current MDO devices often involve manual activation and have potential for complications.
  • Device hardware malfunction in MDO for RS has not been well-characterized.

Purpose of the Study:

  • To report on device/hardware malfunctions in young children undergoing MDO for severe UAO associated with RS.
  • To identify potential steps for mitigating future device-related complications.

Main Methods:

  • Review of a prospectively gathered database of children under 3 years old who underwent MDO for grade 3 RS.
  • Focus on complications directly attributable to the MDO device hardware.

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  • Inclusion criteria: MDO using buried internal devices from March 2007 to September 2019.

    • Main Results:

    • Nineteen patients and 40 devices met the inclusion criteria.
    • Four devices (10.5%) experienced postoperative complications related to hardware failure.
    • Complications included component breakdown and failure to maintain distraction distance, with two patients requiring device replacement.

    Conclusions:

    • Device/hardware malfunction can occur in MDO for severe UAO in infants with RS.
    • Despite development, MDO devices are susceptible to failure, potentially leading to patient morbidity.
    • Understanding these failures is crucial for improving MDO device reliability and patient care.