Relief of upper airway obstruction with mandibular distraction surgery: Long-term quantitative results in young children.
OBJECTIVE
To evaluate the long-term benefits of mandibular distraction on sleep-related upper airway obstruction in young children with mandibular hypoplasia.


METHODS
Cross-sectional study. Subjects were examined for sleep-disordered breathing using medical history, physical examination results, and a written questionnaire. Subjects underwent standard overnight polysomnography, during which measures of sleep-disordered breathing were collected.


METHODS
Tertiary care hospital.


METHODS
Five children with upper airway obstruction from craniofacial anomalies treated with mandibular distraction, with a minimum follow-up of 12 months.


METHODS
Apnea-hypopnea index, oxygen saturation nadir, and peak end-tidal carbon dioxide value.


RESULTS
Of the 5 children, 3 were cured of upper airway obstruction as documented by polysomnography, with an apnea-hypopnea index of less than 1.5 and no snoring. The fourth child had primary snoring without apnea. The fifth child had severe obstructive sleep apnea, with an apnea-hypopnea index of 20.2.


CONCLUSIONS
Most children who undergo mandibular distraction for upper airway obstruction associated with mandibular hypoplasia demonstrate significant clinical improvement of obstructive sleep apnea. However, those children who continue to have symptoms of sleep-disordered breathing after surgery should undergo polysomnography for evaluation of persistent obstructive sleep apnea.
Lin
Sandra Y
SY
Department of Otolaryngology-Head & Neck Surgery, The Johns Hopkins School of Medicine, Baltimore, MD 21287, USA. slin30@jhmi.edu
Halbower
Ann C
AC
Tunkel
David E
DE
Vanderkolk
Craig
C
D019465:Craniofacial Abnormalities / Q000150:complications / Q000601:surgery; D003430:Cross-Sectional Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008334:Mandible / Q000002:abnormalities* / Q000601:surgery*; D019857:Osteogenesis, Distraction; D020181:Sleep Apnea, Obstructive / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome