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Published on: February 5, 2019
Sensory-Motor-Oral Stimulation Combined with Early Sucking During the Mandibular Distraction Osteogenesis Process in
Marisa Gasparin1, Fabiola Luciane Barth1, Cláudia Schweiger1,2
1Postgraduate Program in Child and Adolescent Health, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Insights
Sensory-motor-oral stimulation with early sucking during mandibular distraction osteogenesis (MDO) in children with Robin Sequence (RS) did not increase surgical complications. This suggests current protocols against sucking during MDO may need revision to include potential benefits for child development.
Area of Science:
- Pediatric Surgery
- Craniofacial Anomalies
- Developmental Pediatrics
Background:
- Robin Sequence (RS) presents significant feeding and airway challenges.
- Mandibular distraction osteogenesis (MDO) is a surgical intervention for RS.
- Early oral stimulation is often contraindicated during MDO recovery.
Purpose of the Study:
- To evaluate the safety and impact of sensory-motor-oral stimulation with early sucking during MDO in children with RS.
- To compare surgical complication rates between children receiving early sucking stimulation and those who did not.
Main Methods:
- Quasi-experimental study comparing an intervention group (early sucking) with a historical control group (no sucking).
- Patients with RS undergoing MDO at a tertiary hospital.
- Outcomes assessed included MDO complications and oral feeding status at 6 months post-surgery.
Main Results:
- No significant difference in MDO complication rates between the intervention (72.7%) and control (72.2%) groups.
- Surgical site infection requiring antibiotic therapy was the most common complication (76.2%).
- 75.9% of children achieved full oral feeding or used associated feeding methods by 6 months post-MDO.
Conclusions:
- Sensory-motor-oral stimulation including early sucking during MDO is not associated with increased surgical complications in children with RS.
- Current protocols that contraindicate sucking during MDO may warrant revision.
- Early oral stimulation could potentially benefit child development and feeding outcomes in RS patients undergoing MDO.
Abstract:
ObjectiveTo describe the findings of children with Robin Sequence (RS) who received sensory-motor-oral stimulation combined with early sucking during mandibular distraction osteogenesis (MDO), compared with children who did not receive the intervention.DesignA quasi-experimental study.
Setting:
A tertiary public hospital.
Patients:
Children with RS referred to MDO. A historical group from the same population but managed according to the institution's standard protocol (no sucking) served as a control group.
Interventions:
Sensory-motor-oral stimulation, including sucking, starting 24 h after MDO (intervention group).
Main Outcome Measure:
Our hypothesis is that sensory-motor-oral stimulation, including sucking during the DOM process, do not negatively affect surgical outcomes.ResultsTwenty-nine children were included. Eight (72.7%) of the 11 patients in the intervention group and 13 (72.2%) of the 18 controls had MDO complications, with no significant difference between the groups (p = 1.000). The most common surgical outcome was antibiotic therapy for surgical site infection (76.2%). Six months after MDO, 22 (75.9%) children attained full oral feeding or associated with alternative feeding methods.ConclusionThe intervention group did not have higher complication rates, from a surgical point of view, than control group. The protocol adopted by some centers that contraindicates sucking during MDO should be revised to consider the benefits of such stimulation.
