Neonatal Mandibular Distraction Does Not Increase Inpatient Complications

Abstract

Objective: The purpose of this study was to determine whether performing mandibular distraction osteogenesis (MDO) during the neonatal period increased inpatient complications as measured through health-care burden. Materials and Methods: This was a retrospective cohort study of the Kids’ Inpatient Database from 2000 to 2011. Infants receiving MDO prior to 12 months of age were included. The primary study predictor was distraction age, classified as either neonatal or non-neonatal. Secondary predictors were patient demographics, hospitalization characteristics, diagnoses, and procedures. The outcomes were the number of procedures performed, postoperative length of stay (pLOS), hospital charges, and the discharge transfer rate. Outcomes were compared between the primary predictors using χ2 and independent 2-sample t tests. Multiple linear and logistic regression models were created using clinically relevant predictors to assess the independent effect of neonatal age on each outcome. Results: The study sample contained 102 patients, of who 50 (49.0%) were distracted in the neonatal period. Neonatal MDO patients were more likely to have a cleft palate (86.0% vs 55.8%; P < .001) and present with feeding difficulties (38.0% vs 19.2%; P = .036) that were treated through total parenteral nutrition (26.0% vs 9.6%; P = .030) but otherwise did not have significantly different characteristics compared to non-neonatal patients. The multiple regression models confirmed that neonatal age did not influence any of the study outcomes, although other secondary predictors were found to influence the pLOS, hospital charges, and number of inpatient procedures. Conclusions: Neonatal MDO was not associated with increased complications. At experienced centers, neonatal status should not be considered a contraindication to treatment.

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

“…This younger cohort had high rates of commodities found in the PRS patient population, including ventilator dependence, need for oxygen support, structural pulmonary or airway abnormalities, need for nutritional support, and congenital malformation diagnoses. The hospital length of stay of patients less than a year old (29.6 days) is similar to previous reports of PRS patients undergoing MDO (Runyan et al, 2014; Lee et al, 2019; Lee et al, 2020).…”

“…Complication rate, surgical success, and need for repeated distraction were not different among the 2 cohorts. Similarly, in a study of the Kids' Inpatient Database, Lee et al showed that neonatal age ( ≤ 28 days) did not result in increased postoperative stay, a number of additional procedures (including tracheostomy and gastrostomy), or hospital charges following MDO (Lee et al, 2020). The authors used health care burden as a surrogate for complications and concluded that neonatal age did not increase inpatient complications.…”

Study on the Effect of Bilateral Mandible Distraction Osteogenesis About the Nutrition Status of Infants With Pierre-Robin Sequence

“…According to the author's experience and previous case reports (13). There was no difference in the incidence of post-operative complications for PRS patients accepted surgery in neonatal or non-neonatal period.…”

Early MDO with a Virtually Planned Distractor in a Neonate with Pierre Robin Sequence

“…The literature considers neonatal mandibular distraction osteogenesis as a safe procedure. 6 There are only a few prospective studies on the surgical treatment of PRS. One prospective study with 28 cases showed the necessity for mandibular distraction in 10 cases.…”