[Distraction osteogenesis for treatment of unilateral temporomandibular joint ankylosis and secondary OSAHS in children: report of 4 cases].
OBJECTIVE
To evaluate the efficiency of distraction osteogenensis for treatment of unilateral temporomandibular joint ankylosis and secondary OSAHS in children.


METHODS
4 children with temporomandibular joint ankylosis and secondary OSAHS were retrospectively reviewed for their treatment. There were 2 males and 2 females, ranging from 5 to 13 years in age with the median of 6.5 years. Based on the history of the disease, the clinical manifestations, CT scan and PSG findings, the diagnosis was confirmed to be unilateral temporomandibular joint ankylosis and secondary OSAHS. All the patients were treated by gap arthroplasty to restore mouth opening, combined with mandibular body distraction osteogenesis for treatment of OSAHS. One-stage operation was performed on 3 patients, and two-stage operation on 1 patient. Unilateral and bilateral mandibular distraction osteogenesis was undergone on 2 patients individually. At the end of consolidation period of 3 months, the PSG examination was performed again and the distractor was removed.


RESULTS
OSAHS was cured, the average AHI was lowered from 42.7 to 4.9, the average lowest saturation of blood oxygen rose from 74.3% to 89.8%, the average incisor distance reached 25.5mm compared to 6.5mm before surgery and facial deformity was corrected satisfactorily. Following up 38.1 months (13-58 months), no relapse appeared.


CONCLUSIONS
Mandibular body distraction osteogenesis, combined with gap arthroplasty, could be the potential treatment modality for children with unilateral temporomandibular joint ankylosis, secondary OSAHS and facial asymmetry; it is recommended that both procedures be performed at the same time.
Ma
Yi-ke
YK
Department of Oral and Maxillofacial Surgery, School of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai 200011, China.
Shen
Guo-fang
GF
Lu
Xiao-feng
XF
Wang
Xu-dong
XD
Tang
You-sheng
YS
D000293:Adolescent; D000844:Ankylosis / Q000150:complications / Q000601:surgery*; D001178:Arthroplasty; D002648:Child; D002675:Child, Preschool; D005145:Face / Q000002:abnormalities; D005146:Facial Asymmetry / Q000151:congenital; D005260:Female; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008334:Mandible; D019857:Osteogenesis, Distraction; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000601:surgery*; D013704:Temporomandibular Joint; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome