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Mandibular Distraction in Patients With Pierre Robin Sequence: A Multisurgeon Experience
Shelby D Goza1, Madyson I Brown1, Samuel J Hopper1
1From the University of Mississippi Medical Center School of Medicine.
Annals of Plastic Surgery
|May 10, 2024
Summary
Mandibular distraction osteogenesis (MDO) safely manages Pierre Robin sequence by advancing the jaw. Shorter activation periods in MDO correlate with better feeding and respiratory outcomes, allowing for earlier hospital discharge.
Area of Science:
- Craniofacial Surgery
- Pediatric Surgery
- Otolaryngology
Background:
- Pierre Robin sequence (PRS) presents significant airway and feeding challenges.
- Mandibular distraction osteogenesis (MDO) is a key intervention for severe PRS.
- This study evaluates a decade of institutional experience with MDO.
Purpose of the Study:
- To assess the outcomes of MDO in patients with severe Pierre Robin sequence.
- To identify factors influencing respiratory and feeding status post-MDO.
- To evaluate the safety and efficacy of varying MDO protocols.
Main Methods:
- Retrospective chart review of 27 patients undergoing MDO from 2012-2022.
- Data collected included demographics, respiratory/feeding status, and distraction parameters.
- Primary outcomes: gastrostomy tube avoidance, tracheostomy avoidance, room air discharge, and complications.
Main Results:
- Average age at MDO: 135 days; mean distraction: 14.9 mm.
- Shorter activation phases correlated with improved oral feeding and room air discharge.
- Shorter latency periods were found to be safe and associated with better outcomes.
Conclusions:
- MDO effectively improves feeding and respiratory function in PRS patients.
- Optimizing MDO timing (activation and latency phases) is crucial for successful outcomes.
- Short latency periods are safe and facilitate achieving the goals of MDO.
