| Presenter: Carmen Morovic, MD, Luis Calvo Mackenna Hospital
Carmen Morovic, MD
Luis Calvo Mackenna Hospital
Since the beginning of 90īs mandibular distraction (DO) was adopted as a useful tool to treat patients with severe mandibular hypoplasia. Unless many teams have been sceptic to perform DO at neonatal period because there were not long term follow up studies. Lip-tongue adhesion, nasopharyngeal tube, tracheotomy, between others has been used to management airway obstruction of Pierre Robin patients with not successful results. PURPOSE: To report our experience and results after long term follow up of Pierre Robin patients that were performed early distraction to improve airway obstruction
This prospective study involved a consecutive PRS infants with severe mandibular hypoplasia and airway obstruction that were performed mandibular distraction between 1997 and 2012. After DO we registered: airway condition before and after cleft palate closure, oral feeding, presence of GER, dentition characteristic / eruption, skeletal growth evolution and language development.
67 PRS patients were performed DO before 3 months age. 100% of the cases improving airway obstruction (even 3 previously tracheostomized patients). Mean age of cleft palate closure was 10 months with no cases of respiratory obstruction after surgery. None cases required a second DO procedure. Weight charts showed significant weight gain, improvement of oral feeding and GER. Language development and VPI was similar to patients with isolated cleft palate. Primary and permanent dentition evolution was normally in eruption and teeth characteristics. No alteration of mandibular morphology and growth direction was found in our series.
Mandibular distraction at early age has shown to be a successful procedure to improve airway obstruction, oral feeding, language development with no alteration of dentition and mandibular growth, at long term follow up.