title: Mandibular distraction to relieve airway obstruction in children with cerebral palsy.
abstract: OBJECTIVE
  To determine the effectiveness of distraction osteogenesis of the mandible for relief of airway obstruction in neurologically impaired children.
  
  
  METHODS
  Prospective pilot study.
  
  
  METHODS
  Tertiary care children's hospital.
  
  
  METHODS
  Five children with upper airway obstruction secondary to hypotonia were identified by airway endoscopy, pulse oximetry, and polysomnography. Four children were tracheotomy-dependent because of upper airway obstruction, and 1 was being considered for tracheotomy because of progressive airway obstruction.
  
  
  METHODS
  All patients underwent distraction osteogenesis of the mandible for relief of their airway obstruction.
  
  
  METHODS
  Treatment success was determined by endoscopy, continuous pulse oximetry, and polysomnography.
  
  
  RESULTS
  Four of the 5 children underwent distraction osteogenesis of the mandible with successful resolution of airway obstruction or tracheotomy decannulation. One child did not show adequate improvement of upper airway obstruction and remained tracheotomy-dependent. Follow-up was 2 to 40 months.
  
  
  CONCLUSIONS
  Children with cerebral palsy and hypotonia of the upper airway may achieve relief of their chronic airway obstruction following distraction osteogenesis of the mandible. Appropriate selection criteria must be adhered to, including demonstration of tongue base obstruction on flexible laryngoscopy.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minn, USA
authors.forename: Diego A
authors.initials: DA
authors.lastname: Preciado
authors.forename: James D
authors.initials: JD
authors.lastname: Sidman
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Sampson
authors.forename: Frank L
authors.initials: FL
authors.lastname: Rimell
mesh_terms: D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery*; D002547:Cerebral Palsy / Q000150:complications*; D002675:Child, Preschool; D020878:Device Removal; D004314:Down Syndrome / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D008297:Male; D008334:Mandible / Q000601:surgery*; D009123:Muscle Hypotonia / Q000150:complications; D019857:Osteogenesis, Distraction; D011446:Prospective Studies; D014140:Tracheotomy