title: Upper airway outcomes following midface distraction osteogenesis: a systematic review.
abstract: The objective of this paper is to systematically review the airway outcomes following distraction osteogenesis of midface with the goal of (1) deriving clinically oriented insights and (2) identifying gaps in knowledge to stimulate future research. Medline, EMBASE and Cochrane databases were searched and studies were included if subjects of any age had midface retrusion/hypoplasia and underwent midface distraction osteogenesis. Outcome measures of interest were any respiratory or airway associated measures, and reports of adverse events. A total of 368 abstracts were generated from the literature searches; 16 studies met the criteria for data extraction and analysis. All 16 studies were observational. Generally, midface distraction osteogenesis was reported to improve respiratory status and was well tolerated. Specifically, favorable outcomes in cephalometry (9 studies), polysomnography (9 studies), and decannulation rates (8 studies) were reported. In conclusion, upper airway status was improved in most patients who underwent midface distraction osteogenesis, yet long-term results and consistent objective measures are lacking. Studies reviewed were retrospective case series and details regarding patients who did not improve were deficient. A standardized prospective multicenter cohort trial with long-term patient follow up is required.
authors.affiliation: IWK Health Centre, Dalhousie Pediatric Craniofacial Group, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: B A
authors.initials: BA
authors.lastname: Taylor
authors.affiliation: IWK Health Centre, Dalhousie Pediatric Craniofacial Group, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada. Electronic address: matthew.brace@dal.ca.
authors.forename: M
authors.initials: M
authors.lastname: Brace
authors.affiliation: IWK Health Centre, Dalhousie Pediatric Craniofacial Group, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada; School of Human Communication Disorders, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Hong
mesh_terms: D000402:Airway Obstruction / Q000601:surgery*; D002508:Cephalometry; D020878:Device Removal; D005147:Facial Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D064887:Observational Studies as Topic; D019857:Osteogenesis, Distraction / Q000009:adverse effects; D017286:Polysomnography; D011859:Radiography; D020181:Sleep Apnea, Obstructive / Q000601:surgery; D014139:Tracheostomy
keywords: Distraction osteogenesis; Functional outcomes; Le Fort III osteotomy; Upper airway obstruction