Basic and patient-oriented researchMandibular Distraction Osteogenesis for Pediatric Airway Management
Section snippets
Patients and Methods
This is a retrospective hospital record review of 35 consecutively treated patients at the University of Nebraska Medical Center, Children's Hospital of Omaha, and Creighton University Medical Center by a single surgeon (M.M.), with the assistance of oral and maxillofacial surgery residents, between October 2002 and October 2006. Inclusion criteria for the study included a history of repetitive intermittent upper airway obstruction (UAO), patients who had a tracheostomy for UAO or in whom a
Patient Demographic Analysis
Thirty-five consecutive children (20 boys and 15 girls) with UAO were evaluated retrospectively using clinic and hospital records. The mean age was 3.5 months (range, 36 weeks of gestation to 4 years). At the time of distraction, 28 of 35 patients were less than 9 months of age, and 30 patients were less than 1 month of age; 25 patients were treated at less than 1 week of age. The patient group consisted of Pierre Robin sequence (moderate to severe),19 Stickler syndrome,3 Opitz syndrome,2 Down
Discussion
The multidisciplinary management of the neonate with airway obstruction remains controversial with a lack of standardization in patient evaluation and management.21, 22 The need for any airway management in the Pierre Robin patient may be less than predicted in the past.23, 24 The usefulness of the tongue-lip adhesion procedure remains variable.25 Despite the fact that distraction osteogenesis is becoming an accepted treatment modality,26 the specific techniques of distraction, when performed
References (32)
- et al.
Hypoventilation and cor pulmonale due to chronic upper airway obstruction
J Pediatr
(1965) Clinical outcome of fetuses with sonographic diagnosis of isolated micrognathia
Obstet Gynecol
(2003)- et al.
Effects of mandibular setback surgery on oropharyngeal airway and arterial oxygen saturation
Int J Oral Maxillofac Surg
(2008) - et al.
Bilateral mandibular distraction for patients with compromised airway analyzed by three-dimensional CT
Int J Oral Maxillofac Surg
(2005) - et al.
Effect of bilateral sagittal split ramus osteotomy setback on the soft palate and pharyngeal airway space
Int J Oral Maxillofac Surg
(2008) - et al.
Predicting the pharyngeal airway space after mandibular setback surgery
J Oral Maxillofac Surg
(2005) - et al.
Distraction osteogenesis in management of the pediatric airway: Evidence to support its use
J Oral Maxillofac Surg
(2005) - et al.
Airway management in babies with micrognathia: The case against early distraction
J Oral Maxillofac
(2005) - et al.
Airway interventions in children with Pierre Robin's sequence
Otolaryngol Head Neck Surg
(2008) - et al.
Biomechanical evaluation of the pins of a mandibular external distractor
J Oral Maxillofac Surg
(2004)