title: Three-dimensional airways reconstruction in syndromic pedriatric patients following mandibular distraction osteogenesis.
abstract: BACKGROUND
  Airway obstruction, associated with mandibular hypoplasia, is a frequent complication in syndromic pediatric patients. The clinical signs of airway obstruction change from mild positional obstruction to severe respiratory distress with cyanosis. The young age of the patients makes medical management extremely complex.
  
  
  METHODS
  The purpose was to evaluate the success of surgery, evaluating the expansion of the respiratory volumes measured by computer tomography analyzed through a software (SimPlant Pro 15). Twelve patients with mandibular hypoplasia and respiratory distress were treated between December 2010 and December 2013. Eleven of them had tracheostomy in the preoperative period. The goal of surgery was to prevent permanent tracheostomy or to remove it, if present.
  
  
  RESULTS
  Volume and surface area increased by an average of 279.2% and 89.4%, respectively. Tracheostomy was avoided in 1 patient who underwent surgery precociously, and it was removed in 10 patients. Only 1 case failed in volume airway augmentation, and tracheostomy was not removed.
  
  
  CONCLUSIONS
  Computer tomography can calculate the cross-sectional areas of the airway in 3 planes of space: coronal, sagittal, and axial. In most patients, changes in airways have been accompanied by improvements in sleep and breathing, allowing for the removal of tracheostomy with an improved quality of life. Three-dimensional reconstruction of airways revealed a useful tool to better understand the success of surgery.
  
  
  METHODS
  IV.
authors.affiliation: Department of Maxillo-Facial Surgery, CTO-AOUC, University of Florence, Florence, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Spinelli
authors.forename: Tommaso
authors.initials: T
authors.lastname: Agostini
authors.forename: Francesco
authors.initials: F
authors.lastname: Arcuri
authors.forename: Marco
authors.initials: M
authors.lastname: Conti
authors.forename: Mirco
authors.initials: M
authors.lastname: Raffaini
mesh_terms: D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D008297:Male; D008310:Malocclusion / Q000601:surgery*; D019857:Osteogenesis, Distraction / Q000009:adverse effects*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D013577:Syndrome; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014132:Trachea / Q000601:surgery*