title: A systematic review on the outcome of mandibular distraction osteogenesis in infants suffering Robin sequence.
abstract: OBJECTIVE
  Mandibular distraction osteogenesis (MDO) has been successfully applied in infants suffering Robin sequence (RS) with severe upper airway obstruction, but no comparative studies for the different types of MDO exist to date. The objective of the current study was to systematically review the published data considering this matter, providing a fundament for protocols and a more conscious treatment strategy for infants with RS in the near future.
  
  
  METHODS
  For the period from January 1966 to January 2012, the Pubmed, EMBASE, and Cochrane Library databases were searched. Abstracts were screened based on predetermined selection criteria. Relevant full-text articles were retrieved. The articles were analyzed on the type of MDO used, preoperative workup, patient characteristics, postoperative outcome, and complications.
  
  
  RESULTS
  The search yielded 109 articles. After checking abstracts and full texts on predetermined inclusion and exclusion criteria, 12 studies (four describing external MDO, five internal MDO, and three both types) were extracted for further analyses.
  
  
  CONCLUSIONS
  Internal MDO seems very feasible in infants suffering RS, minimizing side effects such as hypertrophic scarring, nerve damage, and extensive care needs, although the indications for usage are more limited compared to the external device. Corresponding protocols and long-term outcome studies are needed to make a better comparison and the use and indication of the different types of distraction even more distinct.
  
  
  CONCLUSIONS
  A base for a guideline to support the choice of a designated operative management for neonates with RS is provided, hereby obviating possible complications of the different types of MDO in the future.
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, Wilhelmina Children's Hospital, PO Box 85500, 3508 GA, Utrecht, the Netherlands, emmapaes@gmail.com.
authors.forename: Emma C
authors.initials: EC
authors.lastname: Paes
authors.forename: Aebele B
authors.initials: AB
authors.lastname: Mink van der Molen
authors.forename: Marvick S M
authors.initials: MS
authors.lastname: Muradin
authors.forename: Lucienne
authors.initials: L
authors.lastname: Speleman
authors.forename: Frea
authors.initials: F
authors.lastname: Sloot
authors.forename: Moshe
authors.initials: M
authors.lastname: Kon
authors.forename: Corstiaan C
authors.initials: CC
authors.lastname: Breugem
mesh_terms: D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008334:Mandible / Q000601:surgery*; D019857:Osteogenesis, Distraction / Q000379:methods*; D010855:Pierre Robin Syndrome / Q000601:surgery*