Feeding Outcomes After Mandibular Distraction for Airway Obstruction in Infants

Area of Science:

• Pediatric Surgery
• Craniofacial Surgery
• Neonatal Care

Background:

• Robin sequence presents significant challenges including airway obstruction and feeding difficulties.
• Mandibular Distraction Osteogenesis (MDO) is a surgical intervention for airway improvement in these infants.
• Limited data exists on the impact of MDO on feeding outcomes and weight gain in infants.

Purpose of the Study:

• To evaluate feeding outcomes in infants with Robin sequence following MDO for airway correction.
• To assess weight gain and the need for nutritional support post-MDO surgery.

Main Methods:

• Retrospective chart review of infants under 12 months undergoing MDO between December 2015 and July 2021.
• Data collected included cleft palate presence, distraction distance, polysomnography results, and feeding status.
• Primary outcomes: length of distraction, need for tube feeding at discharge, time to full oral feeds, and weight gain.

Main Results:

• Eight out of ten infants achieved full oral feeds, with an average time of 65.6 days.
• All infants demonstrated weight gain post-surgery (average 0.521 kg/month), with those on full oral feeds gaining more.
• Postoperative apnea-hypopnea index improved significantly, indicating successful airway management.

Conclusions:

• MDO is effective in improving airway obstruction and promoting weight gain in infants with Robin sequence.
• While most infants transition to oral feeds, some require temporary nutritional support.
• Further research is needed to optimize feeding strategies and care for infants undergoing MDO.