Mandibular Distraction Osteogenesis for the Treatment of Upper Airway Obstruction Due to Retrognathia and Glossoptosis

Abstract

Retrognathia and Glossoptozis in new borns and toddlers may cause severe respiratory insufficiency resulting with endotracheal intubation and/or tracheotomy. In this study four pediatric patients whom distraction osteogenesis was performed are presented. Two patients had tracheotomy and retrognathia and two new born patients had Pierre Robin sequence. Mandibular distraction osteogenesis was performed on two patients who were two, three years old and had temporomandibular joint ankylosis, micrognathia and glossopitosis. These patients had had tracheotomies opened under emergency conditions because of acute airway insufficiency. Later on two new borns who were four and fifteen days old and had Pierre Robin sequence went through mandibular distraction osteogenesis operation. Twelve to 22 mm of mandibular distraction was achieved. Two patients who had tracheotomies were decanullated. Two new borns were extubated without the need of tracheotomies. Mandibular distraction osteogenesis was accepted as a successful mode of theraphy for decanulation of tracheotomies and in prevention of opening tracheotomies in pediatric patients who has upper airway insufficiency due to retrognathia and glossopitosis.