Treated Pierre Robin Sequence Using Placed Allogenic Acellular Bone Matrix and Mandibular Distraction Osteogenesis in...

Area of Science:

• Craniofacial Surgery
• Pediatric Surgery
• Regenerative Medicine

Background:

• Severe Pierre Robin sequence (PRS) presents significant challenges in neonates, including airway obstruction and feeding difficulties.
• Current management strategies for PRS often involve complex surgical interventions.

Purpose of the Study:

• To evaluate the efficacy and safety of allogenic acellular bone matrix combined with mandibular distraction osteogenesis in neonates with severe PRS.
• To explore the role of distraction forces in promoting osteogenesis within the allogenic bone graft.

Main Methods:

• A cohort of 428 neonates with severe PRS underwent bilateral mandibular distraction osteogenesis with placement of allogenic acellular bone.
• The procedure involved oblique osteotomy, distractor fixation, immediate gap distraction (4-6 mm), and bone graft insertion.
• Distraction was performed at 0.6 mm twice daily until 20% overcorrection was achieved.

Main Results:

• All 428 neonates were successfully extubated post-operatively, with immediate improvement in breathing.
• Mandibular distraction ranged from 15-20 mm, and oral feeding was initiated within 6 hours to 6 days.
• Hospital stay averaged 18-20 days with no major complications reported; medium to long-term results were good.

Conclusions:

• Bilateral mandibular distraction osteogenesis with allogenic acellular bone is a safe and accurate primary treatment for severe PRS.
• Distraction tension likely enhances osteogenesis in the allogenic bone, improving the overall mandibular distraction outcome.