Distraction osteogenesis can be very effective in improving upper airway obstruction in children with micrognathia, said a pediatric otolaryngologist during the session focused on sleep medicine, held at the Triological Society Combined Sections Meeting. The session also included a review of oral appliances designed to help with obstructive sleep apnea (OSA) and surgical options other than uvulopalatopharyngoplasty.
Explore this issue:March 2016
Micrognathia comes in three forms—“isolated” and not associated with a syndrome; “syndromic,” caused by a syndrome such as Trisomy 13; and Pierre Robin Sequence, a combination of micrognathia, glossoptosis, and cleft palate, said Andrew Scott, MD, assistant professor, pediatric otolaryngologist, and pediatric facial plastic surgeon at Tufts University School of Medicine in Boston.
In distraction osteogenesis, a mandiblular osteotomy is made and a distractor device is attached to either side of the gap. The bone is allowed to heal for several days, after which the bone segments are pulled apart by approximately 1 mm to 2 mm a day as new bone grows in the gap. Typically, only one out of three children with Pierre Robin Sequence needs the surgery.