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Facial Nerve Dysfunction After Mandibular Distraction Osteogenesis in Patients with Robin Sequence: A Systematic
Elina Kapoor1, Esperanza Mantilla-Rivas1, Md Sohel Rana2
1Division of Plastic and Reconstructive Surgery, 8404Children's National Hospital, Washington, D.C, USA.
Summary
Facial nerve dysfunction (FND) occurs in 6.40% of patients undergoing mandibular distraction osteogenesis (MDO) for Robin Sequence (RS). While often transient, permanent FND can occur, highlighting the need for better documentation.
Area of Science:
- Craniofacial Surgery
- Pediatric Surgery
- Otolaryngology
Background:
- Robin Sequence (RS) involves micrognathia, glossoptosis, and airway obstruction, often treated with mandibular distraction osteogenesis (MDO).
- Facial nerve dysfunction (FND) is a potential complication of MDO, but its prevalence and characteristics require further elucidation.
Approach:
- A systematic review and meta-analysis were conducted following PRISMA guidelines.
- Searched databases for studies on MDO and RS, including original Spanish and English articles.
- Analyzed outcomes such as FND prevalence, affected nerve branches, permanence, device type, and distraction parameters.
Key Points:
- Pooled prevalence of FND following MDO for RS was 6.40% (moderately heterogeneous).
- Marginal mandibular nerve involvement was most common; both transient and permanent FND were reported.
- Smaller study sample size was inversely associated with the rate of FND (p=0.04).
Conclusions:
- MDO-associated FND in RS patients is not uncommon, with a notable risk of permanent dysfunction.
- The current analysis reveals inconsistent documentation regarding FND after MDO.
- Improved documentation is crucial to understand the mechanisms and optimize management of FND in RS patients undergoing MDO.
