Facial plast Surg 2007; 23(2): 107-112
DOI: 10.1055/s-2007-979279
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Treatment of Upper Airway Obstruction in Infants with Micrognathia Using Mandibular Distraction Osteogenesis

Shane Zim1
  • 1Department of Head and Neck Surgery, Kaiser Permanente, San Diego, California
Further Information

Publication History

Publication Date:
21 May 2007 (online)

ABSTRACT

Mandibular distraction osteogenesis has become an accepted alternative treatment for infants and children with upper airway obstruction associated with micrognathia. Several reports exist that purport the efficacy of mandibular distraction in these patients, such as preventing tracheostomy or facilitating tracheostomy removal. However, the majority of these studies are retrospective reviews with small cohorts and relatively short-term follow-up. Consequently, the ideal indications, pre- and postoperative evaluation, timing, and treatment are subject to controversy and not currently well established. Significantly less attention has been given to short- and long-term complications of mandibular distraction, such as effects on the developing tooth buds, impact on future mandibular development, and temporomandibular joint abnormalities. This article reviews the basic principles of distraction osteogenesis, summarizes the outcomes of recent literature involving pediatric mandibular distraction including this author's experience, and discusses the known and potential adverse sequelae of mandibular distraction. Before a clearly defined role of mandibular distraction in the treatment of infants with micrognathia-associated upper airway obstruction can be established, additional prospective studies are necessary to delineate its benefits and limitations.