Neonatal and Infant Mandibular Distraction as an Alternative to Tracheostomy in Severe Obstructive Sleep Apnea

Abstract

Infants with micrognathia and obstructive sleep apnea may avoid tracheostomy and its inherent risks and complications by undergoing internal mandibular distraction, which is a viable alternative to tracheostomy.

Outcomes of Mandibular Distraction Osteogenesis in the Treatment of Severe Micrognathia

“…The that there was a greater proportion of syndromic diagnoses (56% overall, 43% among patients treated with MDO first) than in other recent studies in which the proportion of syndromic diagnoses ranged from 24% to 35%. [8][9][10][11]20 The most frequently encountered syndromic diagnosis among all patients with micrognathia is Stickler syndrome. 2,21,22 However, in our study the 2 most frequent syndromic diagnoses were Treacher- …”

“…5,6 In recent years, there have been an increasing number of reports on the results of MDO as an alternative to tracheotomy. [7][8][9][10][11][12][13][14][15] The goals of this study were to assess the surgical success and complication rates of MDO for treatment of severe micrognathia and to identify potential predictors of surgical success and complications. Surgical success was defined as either (1) avoidance of tracheotomy or (2) decannulation among those patients treated initially with a tracheotomy.…”

Mandibular Distraction Osteogenesis in Low-Weight Neonates with Robin Sequence

“…Mandibular Distraction Osteogenesis (MDO) has been demonstrated to be a safe 3,[11][12][13][14][15][16][17] and effective 3,6,8,12,13,[15][16][17] intervention to relieve airway obstruction in infants with severe RS.…”

Distraction Osteogenesis as a Treatment for Retrognathia and Obstructive Sleep Apnea Resulting From Temporomandibular Joint Septic Arthritis: A Case Report

“…15 However, these procedures, especially tongue-lip adhesion, are not well tolerated and interfere with normal feeding in a young child. 18 In cases of severe OSA in infants, tracheotomy has been considered the treatment of choice when con- 19 This treatment cures OSA by bypassing the upper airway, but the procedure is certainly not without complications. Significant perioperative and postoperative complications include hemorrhage, pneumothorax, and tracheal stenosis, 19 and the procedure has a reported mortality rate as high as 3.6%.…”

“…18 In cases of severe OSA in infants, tracheotomy has been considered the treatment of choice when con- 19 This treatment cures OSA by bypassing the upper airway, but the procedure is certainly not without complications. Significant perioperative and postoperative complications include hemorrhage, pneumothorax, and tracheal stenosis, 19 and the procedure has a reported mortality rate as high as 3.6%. 20 In addition, long-term use of a tracheostomy tube in young children can result in delayed language development and have a negative psychosocial impact.…”