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Mandibular Distraction Osteogenesis for the Treatment of Pierre Robin Sequence: The University of Pittsburgh Experience
Zoe MacIsaac, MD
Irene Ma, MD
Adam Henrie, BA
Wendy Chen, MD
Joseph Losee, MD
Jesse Goldstein, MD
UPMC
2017-02-15
Presenter: Zoe MacIsaac
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature.
Director Name: Vu T Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background and Purpose: Multiple approaches exist to managing patients with Pierre Robin Sequence (PRS), however, protocols differ between institutions, and the long-term follow up has been reported from few institutions. wWe report experience and objective outcomes of patients with PRS managed with mandibular distraction osteogenesis (MDO).
Methods: A retrospective cohort study of symptomatic PRS patients treated with MDO was performed using clinical data to determine demographic, operative, and postoperative data.
Results: Between 2013-16, 30 patients were operatively managed for PRS with MDO. Patients underwent evaluation by plastic surgery, otolaryngology, speech pathology, and pulmonology. Patients underwent flexible endoscopy, diagnostic laryngobronchoscopy, and polysomnography. 3 patients (10%) were intubated at birth. Average GILLS Score was 2.3. Average age at MDO was 44 days and patients were distracted an average of 17.3 mm. All but two (6%) were on room air at most recent follow up. Preoperative AHI was 23.7; OAHI was 21.3; average oxygen saturation was 94.5% with a nadir averaging 77.7%. Postoperatively this improved to AHI of 8.6, OAHI of 6.0, average oxygen saturation of 96.1% and nadir of 83.7% (p<0.05 pre- versus postoperatively.) Average follow up was 18 months.
Conclusion: When managed with a rigorous protocol for preoperative workup and selection, management of patients with symptomatic PRS with MDO demonstrates great success in improving airway status. Most patients required no further airway intervention, and transferred to oral feeding.
