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Timing and Duration of Facial Nerve Dysfunction After Mandibular Distraction Osteogenesis for Robin Sequence
Hannah R Crowder1, Esperanza Mantilla-Rivas1, Elina Kapoor1
1Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, D.C., USA.
Summary
Facial nerve dysfunction (FND) is a common complication following mandibular distraction osteogenesis (MDO) in infants with Robin Sequence (RS). While most cases of FND are temporary, a significant portion experience long-term issues, necessitating further research into prevention strategies.
Area of Science:
- Craniofacial Surgery
- Pediatric Surgery
- Otolaryngology
Background:
- Mandibular distraction osteogenesis (MDO) is a surgical procedure used to correct craniofacial abnormalities.
- Robin Sequence (RS) is a congenital condition characterized by a small jaw, backward displacement of the tongue, and airway obstruction.
- Facial nerve dysfunction (FND) is a known but poorly documented complication following MDO in infants with RS.
Purpose of the Study:
- To analyze mandibular distraction osteogenesis (MDO) protocols.
- To characterize the incidence, timing, and duration of facial nerve dysfunction (FND) after MDO in infants with Robin Sequence (RS).
- To identify potential risk factors and prevention strategies for FND after MDO.
Main Methods:
- An anonymous 16-question survey was digitally distributed to members of the American Cleft Palate-Craniofacial Association and the International Society of Craniofacial Surgery (ISCFS).
- Data collected included demographic information, MDO perioperative variables, surgeon experience with FND, and the timing and duration of FND.
- Eighty-four responses were collected, with 80 included for analysis.
Main Results:
- Over 60% of respondent surgeons reported FND as a complication of MDO in patients with RS.
- Transient FND was reported by 58.8% of surgeons, while 5% reported permanent facial nerve palsy.
- FND was most commonly observed immediately following device placement/osteotomies (45.1%) or during distraction (45.1%).
- Over half of reported FND cases resolved between 1 and 3 months.
Conclusions:
- FND is a frequent complication of MDO in infants with RS, with most cases being temporary.
- A notable percentage of patients experience long-term FND, highlighting the need for further investigation.
- Further research should focus on identifying risk factors and developing surgical and perioperative prevention strategies for FND.
