title: Airway characteristics of infants with Pierre Robin sequence who undergo mandibular distraction osteogenesis.
abstract: Newborn upper airway obstruction secondary to micrognathia and Pierre Robin sequence can be managed with conservative and surgical interventions. Mandibular distraction osteogenesis has been used to relieve micrognathia associated with severe airway obstruction. We conducted a retrospective chart review to identify patients with Pierre Robin sequence who underwent mandibular distraction osteogenesis during a 2-year period. Our study group was made up of 16 infants-11 boys and 5 girls, aged 21 to 112 days (mean: 55.9). In addition to demographic data, we compiled data on their baseline characteristics, airway characteristics, pre- and perioperative findings, and postoperative airway outcomes. Although most patients experienced documented improvements in Cormack-Lehane laryngoscopy grades postoperatively, the severity of micrognathia and airway obstruction did not always correlate with the higher grades. As well, the degree of improvement on laryngoscopic findings was not always evident, even though patients experienced a clinical benefit. All patients who had undergone a preoperative tracheostomy were decannulated successfully. We found that mandibular distraction osteogenesis was a safe and effective intervention for newborns with severe micrognathia and airway obstruction in our study population. It is interesting that the degree of micrognathia was not always correlated with the degree of airway compromise and laryngoscopy grades.
authors: Department of Otolaryngology, IWK Health Centre, 5850/5980 University Ave., PO Box 9700, Halifax, NS B3K 6R8, Canada. Paul.Hong@iwk.nshealth.ca.
authors: Paul
authors: P
authors: Hong
authors: Donald
authors: D
authors: Kearns
mesh_terms: D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008334:Mandible / Q000601:surgery*; D008844:Micrognathism / Q000150:complications / Q000601:surgery*; D019857:Osteogenesis, Distraction; D010855:Pierre Robin Syndrome / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies