Clinical Outcomes and Complications Following Mandibular Distraction Osteogenesis in Pierre Robin Sequence

Area of Science:

• Craniofacial Surgery
• Pediatric Surgery
• Congenital Anomalies

Background:

• Pierre Robin sequence (PRS) is a congenital condition causing micrognathia, glossoptosis, and airway obstruction.
• Mandibular distraction osteogenesis (MDO) is a key surgical intervention for severe airway obstruction in PRS infants.
• Concerns exist regarding MDO's efficacy and complication rates, particularly facial nerve dysfunction.

Purpose of the Study:

• To evaluate the efficacy and safety of MDO in infants with PRS.
• To assess the incidence of postoperative complications, including facial nerve dysfunction.
• To identify potential predictors of complications following MDO.

Main Methods:

• Retrospective review of a prospectively collected database of PRS patients undergoing MDO.
• Inclusion criteria: PRS diagnosis, MDO surgery, and ≥6 months follow-up.
• Univariate logistic regression analysis to identify complication predictors.

Main Results:

• 55 PRS patients met inclusion criteria; 78.57% of 70 total MDO patients.
• Mean distraction length: 11.14±2.08 mm; weight Z-scores trended toward improvement.
• Complications: 10.9% procedure-related (5 facial nerve dysfunction), 27.27% pulmonary infection. No significant predictors identified.

Conclusions:

• MDO is effective and safe for severe airway obstruction in PRS infants.
• High symptom relief rates with low major surgery-related complications.
• Future improvements focus on surgical techniques for nerve injury reduction and perioperative respiratory care optimization.