Early Adverse Events Following Pediatric Mandibular Advancement: Analysis of the ACS NSQIP-Pediatric Database

Abstract

Objective This study aims to assess early adverse events and patient factors associated with complications following mandible distraction osteogenesis (MDO). Materials and Methods The American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-Pediatric) database, years 2012 to 2019, was queried for patients undergoing mandible advancement via relevant Current Procedural Terminology and postoperative diagnosis codes. Thirty-day adverse events and co-morbidities are assessed. Results A total of 208 patients were identified with 17.3% (n = 36) experiencing an adverse event, reoperation (n = 14), and readmission (n = 11) being most common. Patients < 365 days old at the time of operation were more likely to experience an adverse event (26.1% vs 10.8%; P = .005). However, among patients less than 1 year of age, differences in the complication rates between patients ≤ 28 days and >28 days (30.2% vs 22.2%; P = .47) and those weighing ≤ 4 kg and >4 kg (31.7% vs 11.5%; P = .063) did not reach statistical significance. Conclusions Adverse events following mandible advancement are relatively common, though often minor. In our analysis of the NSQIP-Pediatric database, neonatal age ( ≤ 28 days) or weight ≤ 4 kg did not result in a statistically significant increase in complications among patients less than 1 year of age. Providers should consider early intervention in patients who may benefit from MDO.

Early Outcomes and Risk Factors in Orthognathic Surgery for Mandibular and Maxillary Hypo- and Hyperplasia: A 13-Year Analysis of a Multi-Institutional Database

“…The National Surgical Quality Improvement Program of the American College of Surgeons (NSQIP) collects validated data from more than 700 US hospitals, resulting in a large and diverse patient collection. Specifically, in the field of oral and maxillofacial surgery, the current literature includes numerous studies evaluating the NSQIP data [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ]. Accordingly, analyses of the NSQIP records can provide valuable and insightful information that facial surgeons may wish to implement into their perioperative workflow.…”

Disruptive Therapy Using a Nonsurgical Orthodontic Airway Plate for the Management of Neonatal Robin Sequence: 1-Year Follow-up

“…Despite effectively resolving the infants' breathing difficulties, these surgical options are highly morbid with debilitating lifelong consequences. 15,16 We previously published the 3-month follow-up on two neonates with severe RS treated with OAP and presented its immediate success as the first cases reported in the United States. 11 This case series from Lucile Packard Children's Hospital at Stanford University Medical Center illustrates the course of OAP treatment of these two patients with a focus on feeding, breathing, facial growth, and global development during their first year of life.…”

“…Despite effectively resolving the infants’ breathing difficulties, these surgical options are highly morbid with debilitating life-long consequences. 15, 16…”