Mandibular distraction osteogenesis in Pierre Robin sequence: application of a new internal single-stage resorbable device.
Pierre Robin sequence may result in physiologically significant obstructive apnea in the neonatal and infant period. This may be life threatening and is most often treated by tracheostomy. To avoid tracheostomy or allow for early decannulation in severely affected infants and children, the authors have developed a new class of neonatal and infant mandibular bone distraction devices. These devices require a single operative procedure for placement and no operative removal is necessary. Fifteen infants (aged 7 days to 11 months; mean age, 3 months) and five children (aged 2 to 8 years; mean age, 5.5 years), 10 boys and 10 girls, with severe obstructive apnea and Pierre Robin sequence were treated with the mandibular infant devices over a 24-month period. Tracheostomy was avoided in 14 patients, whereas five of six patients who had previous tracheostomy were decannulated after mandibular distraction. The final tracheostomy status in one patient will be determined after surgery for gastroesophageal reflux. There were no major complications and no structural device failures.
Burstein
Fernando D
FD
Center for Craniofacial Disorders, Children's Healthcare of Atlanta, and the Division of Plastic and Reconstructive Surgery, Emory University, Atlanta, Ga, USA. fburstein@atlplastic.com
Williams
Joseph K
JK
D000015:Abnormalities, Multiple; D020341:Absorbable Implants; D000402:Airway Obstruction / Q000209:etiology; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016268:Internal Fixators; D008297:Male; D019186:Mandibular Advancement / Q000295:instrumentation*; D019857:Osteogenesis, Distraction / Q000295:instrumentation*; D010855:Pierre Robin Syndrome / Q000150:complications / Q000601:surgery*; D014139:Tracheostomy; D016896:Treatment Outcome