Transfacial Two-pin External Mandibular Distraction Osteogenesis: A Technique for Neonatal Airway Obstruction from Robin Sequence.

Autor:	Babiker HE; From the Division of Plastic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio., Runyan CM; Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Medical Center, Winston Salem, N.C., Bins GP; Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Medical Center, Winston Salem, N.C., Oliver JD; Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah.; School of Dentistry, University of Maryland, Baltimore, Md., Massary DA; Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Medical Center, Winston Salem, N.C., Lor LS; Division of Plastic Surgery, Rochester University, Rochester, N.Y., Rapp SJ; Norton Children's Hospital, Louisville, Ky., Pan BS; From the Division of Plastic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio., Gordon CB; Dayton Children's Hospital, Dayton, Ohio.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2023 Jun 15; Vol. 11 (6), pp. e5085. Date of Electronic Publication: 2023 Jun 15 (Print Publication: 2023).
DOI:	10.1097/GOX.0000000000005085
Abstrakt:	Surgical management in those with moderate-to-severe airway obstruction includes tongue-lip adhesion, tracheostomy, and/or mandibular distraction osteogenesis. This article describes a transfacial two-pin external device technique for mandibular distraction osteogenesis, utilizing minimal dissection. Methods: The first percutaneous pin is transcutaneously placed just inferior to the sigmoid notch parallel to the interpupillary line. The pin is then advanced through the pterygoid musculature at the base of the pterygoid plates, toward the contralateral ramus, and exits the skin. A second parallel pin is placed spanning the bilateral mandibular parasymphysis distal to the region of the future canine. With the pins in place, bilateral high ramus transverse corticotomies are performed. Using univector distractor devices, the length of activation varies, with the goal of overdistraction to achieve a class III relationship of the alveolar ridges. Consolidation is limited to a 1:1 period with the activation phase, and removal is performed by cutting and pulling the pins out of the face. Results: To guide optimal transcutaneous pin placement, transfacial pins were then placed through twenty segmented mandibles. Mean upper pin (UP) distance was 20.7 ± 1.1 mm from the tragus. The distance between the cutaneous entry of the UP and lower pin was 23.5 ± 0.9 mm, and the tragion-UP-lower pin angle was 118.7 ± 2.9°. Conclusions: The two-pin technique has potential advantages regarding nerve injury and mandibular growth, given an intraoral approach with limited dissection. It may safely be performed on neonates whose small size may preclude the use of internal distractor devices. Competing Interests: The authors have no financial interest to declare in relation to the content of this article. Disclosure statements are at the end of this article, following the correspondence information. (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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