Mid-Term Outcome of Mandibular Distraction Osteogenesis in Pierre Robin Sequence

• Published in: The Journal of craniofacial surgery Vol. 30; no. 6; p. 1667
• Main Authors: Konofaos, Petros, Puente-Espel, Jordi, Askandar, Sameh, Wallace, Robert D
• Format: Journal Article
• Language: English
• Published: United States 01.09.2019
• Subjects: Airway Extubation; Child, Preschool; Continuous Positive Airway Pressure - adverse effects; Humans; Infant; Infant, Newborn; Mandible - surgery; Osteogenesis, Distraction; Pierre Robin Syndrome - surgery; Postoperative Complications; Retrospective Studies; Sleep Apnea, Obstructive; Tracheostomy - adverse effects; Tracheotomy - adverse effects; Treatment Outcome
• ISSN: 1536-3732
• DOI: 10.1097/SCS.0000000000005436

The aim of the present study was to present a single center's experience with mandibular distraction osteogenesis (MDO) in Pierre Robin sequence (PRS) patients. A retrospective chart review was performed to identify patients with PRS that underwent MDO at our institution from 2003 to 2012. Inclusion criteria were as follows:Evaluation included demographic information, postoperative complications, and surgical outcomes. Twenty-four patients met the inclusion criteria. No complications related to our distraction technique were reported. Most of the patients who had a tracheostomy were successfully decannulated and the rest were able to avoid a tracheostomy. Two patients had superficial infections that were treated conservatively with topical antibiotics. One patient, who was our first case in the series, required 3 episodes of distraction osteogenesis. Another patient demonstrated recurrent symptoms of obstructive sleep apnea after MDO and was treated with continuous positive airway pressure. Over-correction during MDO in PRS is an efficient method for preventing future airway problems. Patients who required a tracheotomy pre-distraction and cases in whom distraction was performed at older age (>2 months of age), had a lower success rate in achieving de-cannulation and a higher rate of complications. Laryngomalacia, gastro-esophageal reflux disease, cardiac, and GI anomalies are not associated with increased failure rates of MDO in PRS.