Neonatal Mandibular Distraction Without a Consolidation Period: Is It Safe? Is it Effective?. Issue 8 (November 2017)

• Record Type: Journal Article
• Authors: Biskup, Nataliya; Altman, Ashley L.; Runyan, Christopher M.; Gendron, Craig; Babiker, Haithem Elhadi; Gordon, Christopher B.; Pan, Brian S.
• Is Part Of: Journal of craniofacial surgery. Volume 28:Issue 8(2017)
• Publication Date: 2017-11
• Subjects: Consolidation -- mandibular distraction -- micrognathia -- Pierre Robin sequence; Facial bones -- Surgery -- Periodicals; Skull -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; 617.52
• DOI: 10.1097/SCS.0000000000003962
• Languages: English
• ISSNs: 1049-2275

Abstract

Abstract : Purpose: Consolidation is a standard part of most post-distraction protocols. This study aims to determine whether the deliberate omission of a consolidation period following mandibular distraction (MD) in neonates with Pierre Robin sequence (PRS) affected the airway outcomes and complication rates. Patients and Methods: A retrospective chart review of 28 neonates with PRS who underwent MD for severe airway obstruction between 2009 and 2014 was performed. Neonates were split into 2 cohorts: those with a very short or no consolidation (no consolidation group, n = 18) and those with a traditional consolidation period (consolidation group, n = 10). Results: Mean consolidation length was 25 days in the conventional consolidation group and 1.5 days in the no consolidation group ( P < 0.01). Postoperatively, both groups showed equivalent improvements in their obstructive index as measured by polysomnography. Compared with the patients who underwent convention consolidation, patients in the "no consolidation" group did not require a greater number of repeat distraction, supplemental oxygen, or tracheostomy. Nor was there any significant difference in the number of complications between the 2 groups. Conclusion: In neonates with PRS treated with MD for severe airway obstruction, the omission of a consolidation period does not appear to significantly affect the complication rate or resolution of airway obstruction.