Introduction: Distraction Osteogenesis (DO) is a good solution solving respiratory distress when other proceduresare failed in severe micrognathia. it is an alternative treatment correcting mandibular hypoplasia. In this study, distraction with a dynamic osteosynthesis system (MD-DOS) for gradual lengthen the mandible with severe hypoplasia. Latency period was seven days. Distraction was performed three times daily for 14 days with rate 0.33 mm. Retention was nine weeks. The mandible had been elongated improving the air way and relive of obstruction.
Aim of the study: Evaluation of airway improvement following mandibular distraction osteogenesis in pediatric population with mandibular micrognathia with severe upper airway obstruction.
Materials and Methods: Twenty patients aged from 5 month and 5 years (mean age is 3.86 years) with micrognathia and sever airway obstruction had been treated with mandibular distraction osteogenesis (MDO). All patients had been evaluated by a multidisciplinary team. Indications for surgery included frequent apneic episodes with severe desaturation (70%). The study treats patients with congenital anomalies as congenital ankylosis, Pierre Robin sequence (PRS), Hemifacial microsomia, Treacher Collins syndrome and Goldenhar syndrome. Detection of airway obstruction correction were done by comparing pre-operative and post-operative sleep lab study (polysomnography).
Results: Cephalometric radiograph, OPG and CT get data for planning the mandibular osteotomy and distractor application for mandibular lengthening and restoring the airway with accepted variable complications on 20 patients age from 5 months to 5 years.
Conclusions: Mandibular distraction osteogenesis is a valuable treatment for severe airway obstruction due to mandibular hypoplasia when other procedures are failed .