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- W2972778047 abstract "Introduction: Neonates & infants with craniofacial anomalies often present with varying degrees of upper airway obstruction (UAO) due to micrognathia. Mandibular distraction osteogensis (MDO) has been described as an effective method of managing severe upper airway obstruction in selected patients. This study describes the outcome of the management of a sample of neonatal & infants who have undergone mandibular distraction. Methods: A retrospective review of the medical records of 73 patients under 5 years of age, who had undergone MDO between 2000 - 2012, was undertaken. Parameters recorded included airway status, feeding, laryngoscopy, time of intubation, medical conditions, weight and complications. Results: Of the 73 patients 42 were syndromic (TCS, Stickler, Craniofacial Microsomia & others). The mean age of distraction was 2.0 months for non-syndromic, 3.3 months for syndromic patients. Initial management with nasopharyngeal tubes (NPT) was performed in 69 %, non-invasive therapy 18% (prone positioning, CPAP) and 9 syndromic patients (13%) had tracheotomies. Post-distraction none of the NPT or CPAP-dependent patients required any further airway support. Of the tracheostomy dependent group, 56 % were successfully decannulated within one year. Most patients required supplemented feeding and 77% were oral feeding by the end of the first year. The majority of syndromic PEG patients were still being fed by PEG at 1-year. The average growth of patients followed within 1-centile of their birth projected trajectories but 10% of syndromic patients had a low birth weight. Two patients died at home: at tracheotomy tube change and aspiration & respiratory arrest. Conclusion: MDO is a predictable and effective technique for managing severe UAO in selected patients. Differences in the outcomes of the syndromic and non-syndromic patients were demonstrated. Although successful, MDO may not be appropriate for all syndromic patients as long-term airway management with tracheosotomy may still be indicated." @default.
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- W2972778047 date "2019-08-01" @default.
- W2972778047 modified "2023-09-27" @default.
- W2972778047 title "S7B-13 SESSION 7B" @default.
- W2972778047 doi "https://doi.org/10.1097/01.gox.0000583540.59968.86" @default.
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