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Mandibular Morphology After Distraction Osteogenesis In Syndromic Pierre Robin Patients
Chen WC, Goldstein JA, Maricevich R.
University of Pittsburgh Medical Center
2016-02-14
Presenter: Wendy Chen
Affidavit:
Joseph E. Losee
Director Name: Joseph E. Losee
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Pierre Robin patients exist on a spectrum of mandibular morphology, individual- and diagnosis-specific response to mandibular distraction. No studies have reported the short- or long-term changes to mandibles after MDO; Controversy exists regarding mandibular growth. Our goal is to characterize growth response to MDO in syndromic patients.
Methods
Included PRS patients were diagnosed by medical genetics as syndromic, underwent MDO, and had pre- and post-operative CT scans (at least 1yr). Control group were age-matched syndromic PRS patients who had not undergone MDO. Scans were evaluated for gonial angle and ratio of mandible length to height. Averages were compared used t-test (p<0.05).
Results
250 PRS patients were identified, 114 underwent genetics evaluation, 84 syndromic, 41 underwent MDO, 6 met imaging criteria. There was no difference in average preoperative gonial angle; post op angle was increased (p=0.05 right, 0.009 left). There was no difference in pre- or post-op length to height ratio, but approached significance for increase after distraction (p=0.17 right, 0.09 left). There was no difference in %change in gonial angle (p=0.26 Right, 0.40 Left) or in length to height ratio (p=0.05 Right, 0.26 Left), but approached significance.
Discussion/Conclusion
Our observations are limited by small sample size. However, compared to non-distracted counterparts, syndromic PRS patients after MDO demonstrate increased gonial angle, increased length-to-height ratio, increased %change in length-to-height ratio. Interestingly, there was no difference in %change of gonial angle. There was no difference in %change of length-to-height ratio, but approached significance, continuing to bring into question rate of growth in PRS mandibles.
