Comprehensive Long-Term Outcomes Following Mandibular Distraction Osteogenesis.
| Autor: | Kosyk MS; Division of Plastic and Reconstructive Surgery, The Children's Hospital of Philadelphia, Philadelphia, USA., Salinero LK; Division of Plastic and Reconstructive Surgery, The Children's Hospital of Philadelphia, Philadelphia, USA., Morales CZ; Division of Plastic and Reconstructive Surgery, The Children's Hospital of Philadelphia, Philadelphia, USA., Shakir S; Division of Plastic and Reconstructive Surgery, The Children's Hospital of Philadelphia, Philadelphia, USA., Cielo CM; Division of Pulmonary and Sleep Medicine, The Children's Hospital of Philadelphia, Philadelphia, USA., Scott M; Division of Plastic and Reconstructive Surgery, The Children's Hospital of Philadelphia, Philadelphia, USA., Nah HD; Division of Plastic and Reconstructive Surgery, The Children's Hospital of Philadelphia, Philadelphia, USA., Bartlett SP; Division of Plastic and Reconstructive Surgery, The Children's Hospital of Philadelphia, Philadelphia, USA., Taylor JA; Division of Plastic and Reconstructive Surgery, The Children's Hospital of Philadelphia, Philadelphia, USA., Swanson JW; Division of Plastic and Reconstructive Surgery, The Children's Hospital of Philadelphia, Philadelphia, USA. |
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| Jazyk: | angličtina |
| Zdroj: | The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association [Cleft Palate Craniofac J] 2025 Jan; Vol. 62 (1), pp. 108-116. Date of Electronic Publication: 2023 Oct 17. |
| DOI: | 10.1177/10556656231206884 |
| Abstrakt: | Objective: To describe long-term outcomes and complications following mandibular distraction osteogenesis (MDO) in a diverse patient cohort. Design: Cross-sectional study. Setting: Single tertiary-care pediatric center. Patients: Forty-eight patients previously undergoing MDO with minimum 4-year follow-up. Main Outcome Measures: Respiratory outcomes, feeding patterns, dental development, motor/sensory nerve function, temporo-mandibular joint function, and postsurgical scarring. Results: Forty-six patients with a median age of 7 years were evaluated. Of 20 nonsyndromic patients, none required additional airway procedures, none required continuous positive airway pressure (CPAP) during sleep, and 19 (95%) fed exclusively by mouth. Among 26 syndromic patients, 7 (27%) required CPAP and 8 (31%) were tube fed. Permanent first molar differences were seen in the majority of subjects; patterns of damage interfering with function were more common in syndromic (13/28, 46%) compared to nonsyndromic (5/24, 21%; P = .014) subjects. MDO prior to age two was associated with more frequent and worse dental damage ( P = .001). Inferior alveolar nerve and marginal mandibular nerve function were fully intact in 37 (80%) and 39 (85%) of patients, respectively. Three patients (6%), all with associated genetic syndromes, demonstrated severe nerve impairment. By the Vancouver scar scale, ≥ 80% of surgical scars were rated in the most favorable category for each quality assessed. Temporomandibular joint dysfunction was rare. Conclusions: MDO shows highly favorable long-term respiratory, feeding, nerve, and scar outcomes in nonsyndromic patients, although permanent molar changes not precluding tooth viability are commonly seen. Patients with associated syndromes demonstrate respiratory and feeding benefits, but higher rates of dental and nerve abnormalities. Competing Interests: Declaration of Conflicting InterestsJWS has received an educational grant and developed educational content for KLS Martin and Depuy Synthes, both of which produce mandibular distraction devices. JAT is co-founder of Ostiio, LLC. |
| Databáze: | MEDLINE |
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