title: Mandibular distraction osteogenesis: at what age to proceed.
abstract: OBJECTIVE
  To evaluate if there is a difference in mandibular distraction osteogenesis (MDO) treatment success rates and adverse outcomes in newborns, early infants, and older pediatric patients.
  
  
  METHODS
  Retrospective medical review spanning a nine-year period. Ten newborn (≤ 35 days old), five early infant (36 days-5 months) and eight older pediatric (> 5 months) patients underwent MDO for treatment of micrognathia with a severe tongue-based obstruction. Success was defined as avoidance of tracheostomy or CPAP, and decannulation of patients with tracheotomies. Postoperative complications were grouped into minor and major.
  
  
  RESULTS
  MDO successfully treated 90% of newborns, 100% of early infants and 100% of older pediatric patients. There was no difference in the rates of success (p=0.48), minor (p=1.00) and major (p=1.00) postoperative complications between newborns and early infants. Older pediatric patients had no treatment failures, tended to have fewer minor (p=0.18) and significantly fewer major (p= 0.04) postoperative complications compared to younger patients. The distractor pin mobility (9%) and scar revisions (13%) were uncommon.
  
  
  CONCLUSIONS
  Mandibular distraction osteogenesis is a reliable method for relieving severe tongue-based obstructions in pediatric patients. When comparing newborns and early infant patients, treatment success rates and the occurrence of complications were not found to be different. Older pediatric patients had no treatment failures, and tended to have fewer postoperative complications compared to younger patients.
authors: UC Davis Health System, Department Otolaryngology, 2521 Stockton Blvd, Ste 7200, Sacramento, CA 95817, United States. ckkolstad@aol.com
authors: C K
authors: CK
authors: Kolstad
authors: C W
authors: CW
authors: Senders
authors: B K
authors: BK
authors: Rubinstein
authors: T T
authors: TT
authors: Tollefson
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D019465:Craniofacial Abnormalities / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008334:Mandible / Q000002:abnormalities* / Q000601:surgery*; D019857:Osteogenesis, Distraction / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome