Faculty Collaboration Database

Mandibular Distraction Osteogenesis in Low-Weight Neonates with Robin Sequence: Is It Safe? Plast Reconstr Surg 2015 Nov;136(5):1037-1044

Date

07/15/2015

Pubmed ID

26171753

DOI

10.1097/PRS.0000000000001710

Scopus ID

2-s2.0-84945913646 (requires institutional sign-in at Scopus site)   27 Citations

Abstract

BACKGROUND: The aim of this study was to evaluate the efficacy, safety profile, and complications associated with mandibular distraction osteogenesis performed in infants weighing less than 4 kg with Robin sequence.

METHODS: An 11-year retrospective review of all infants (younger than 6 months) with mandibular distraction osteogenesis-treated Robin sequence was performed. Patients weighing less than 4 kg (experimental) and 4 kg or more (control) who underwent mandibular distraction osteogenesis were compared. Demographics, medical comorbidities, improvement in apnea/hypopnea index, need for tracheostomy, repeated distraction, and complications were evaluated.

RESULTS: One hundred twenty-one patients underwent mandibular distraction osteogenesis. Eighty-one patients weighed less than 4 kg and 40 weighed 4 kg or more. The mean follow-up was 2.8 years in patients weighing less than 4 kg and 3.0 years in the control group. Mean age and weight at the time of distraction were 23 days and 3.1 kg, respectively, in the study group; and 2.7 years and 11 kg, respectively, in the control group. There was no significant difference in success of mandibular distraction osteogenesis to treat airway obstruction in the group weighing less than 4 kg compared with the control group (92.6 percent versus 88.9 percent; p = 0.49). The most common complication in each group was surgical-site infection (9.9 percent and 20.0 percent; p = 0.15). Overall complication rates were similar between the two groups (17.3 percent versus 25.0 percent; p = 0.34). The rates of repeated distraction were similar between the two groups (6.3 percent and 13.5 percent; p = 0.28).

CONCLUSIONS: Mandibular distraction osteogenesis is a safe and effective treatment modality for infants weighing less than 4 kg with severe airway obstruction. The efficacy, safety, and complication profiles are not significantly different from those of larger patients.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Author List

Tahiri Y, Greathouse ST, Tholpady SS, Havlik R, Sood R, Flores RL

Author

Robert Havlik MD Chair, Professor in the Plastic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Case-Control Studies
Female
Follow-Up Studies
Humans
Infant
Infant, Low Birth Weight
Infant, Newborn
Male
Mandible
Osteogenesis, Distraction
Patient Safety
Pierre Robin Syndrome
Postoperative Complications
Reference Values
Retrospective Studies
Risk Assessment
Statistics, Nonparametric
Treatment Outcome