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Study on the Effect of Bilateral Mandible Distraction Osteogenesis About the Nutrition Status of Infants With
Liu Jiayu1, Sun Jing2, Chen Yiyang1
1Oral and Maxillofacial Surgery, Guangzhou Women and Children's Medical Center, Guangzhou, China.
Insights
Bilateral mandible distraction osteogenesis surgery significantly improves the nutritional status of infants with Pierre-Robin Sequence (PRS). Post-surgery, patients show enhanced weight, length, and blood albumin levels, indicating better overall health outcomes.
Area of Science:
- Craniofacial Surgery
- Pediatric Nutrition
- Skeletal Development
Background:
- Pierre-Robin Sequence (PRS) is a congenital condition characterized by a hypoplastic mandible, glossoptosis, and airway obstruction.
- Infants with PRS often experience feeding difficulties, leading to malnutrition and impaired growth.
- Surgical intervention, such as bilateral mandible distraction osteogenesis, is employed to address the mandibular deficiency.
Purpose of the Study:
- To evaluate the impact of bilateral mandible distraction osteogenesis on the nutritional status of infants diagnosed with Pierre-Robin Sequence.
- To analyze changes in key anthropometric and biochemical indicators before and after surgical intervention.
Main Methods:
- A retrospective study was conducted on pediatric patients with PRS who underwent bilateral mandible distraction osteogenesis.
- Pre- and post-operative data on food intake, weight, body length, Body Mass Index (BMI), and serum albumin levels were collected and analyzed.
- Statistical analysis, including t-tests for independent samples, was performed to compare pre- and post-operative measurements.
Main Results:
- Pre-operative nutritional intake was significantly below recommended standards (91.8 kcal/kg).
- Post-surgery, significant improvements were observed in weight-for-age (WFA) percentile and z-score, length-for-age (LFA) percentile and z-score, and BMI z-score.
- Serum albumin levels increased significantly from 37.06 ± 0.51 g/L to 42.85 ± 0.30 g/L (P < 0.001), indicating improved nutritional status.
Conclusions:
- Bilateral mandible distraction osteogenesis is an effective surgical procedure for improving the nutritional status of children with Pierre-Robin Sequence.
- The positive effects are primarily evidenced by significant improvements in physical growth parameters and biochemical markers post-operatively.
Abstract:
Objective: By comparing and studying the changes of food intake, weight, body length, BMI, blood albumin level and other indicators of infants with Pierre-Robin Sequence (PRS) before and after Bilateral Mandible Distraction Osteogenesis operation, to explore the effect of distraction osteogenesis on PRS patients about the improvement of nutrition status. Methods: The children with PRS who admitted to the Oral and Maxillofacial Surgery Department of Guangzhou Women and Children's Medical Center from July 2015 to December 2020 were selected. All patients accepted bilateral mandible distraction osteogenesis surgery, and the pre- and post-operative indicators were recorded, such as food intake, weight, length, blood albumin level and others. BMI was calculated based on the indicators mentioned above, and comparative statistical analysis was performed. Results: 1. All patients were fed with whole milk before the first surgery, and the average calorie per kg was 91.8 kcal/kg, significantly lower than the standard (100-150 kcal/kg), suggesting the overall nutritional intake of PRS patients is low; 2. t tests for independent samples were used to analyze the pre-operative and post-operative indicators. The WFA percentile increased from 14.16 ± 2.17 to 15.01 ± 1.85% (P = 0.0048), WFA z score increased from -2.40 ± 0.18 to -1.90 ± 0.14 after the surgery (P = 0.0010), LFA percentile increased from 20.04 ± 3.48 to 33.67 ± 4.29% (P = 0.0098), LFA z score increased from -2.09 ± 0.19 to -1.42 ± 0.23 (P = 0.0009), BMI z score increased from -1.95 ± 0.22 to -1.39 ± 0.16 (P = 0.0408), ALB raised from 37.06 ± 0.51 to 42.85 ± 0.30 g/L (P < 0.001), which indicating that the physique of patients improved after the distraction osteogenesis surgery, mainly was reflected by the lifting of weight and length growth curves; the body shape also improved, indicating that the patients' nutrition status after the surgery is also improved. Conclusion: Bilateral mandible distraction osteogenesis surgery has a positive effect on the nutrition status of children with PRS. This effect is mainly reflected by the improvements of the body physical indicators after surgery.
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