Mandibular distraction osteogenesis to treat Braddock-Carey airway obstruction
10.3760/cma.j.issn.1009-4598.2018.08.009
- VernacularTitle: 下颌骨牵引治疗Braddock-Carey综合征呼吸道梗阻六例
- Author:
Jun YAN
1
;
Weimin SHEN
;
Jie CUI
;
Jianbing CHEN
;
Yi JI
;
Haini CHEN
;
Jijun ZOU
;
Qingwen GAO
Author Information
1. Department of Burn & Plastic Surgery, Children′s Hospital of Nanjing Medical University, Nanjing 210008, China
- Publication Type:Clinical Trail
- Keywords:
Braddock-Carey sequence;
Osteogenesis, distraction;
Mandible;
Infant, newborn
- From:
Chinese Journal of Plastic Surgery
2018;34(8):621-625
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the feasibility of mandibular distraction for the treatment of airway obstruction in neonates with Braddock-Carey syndrome.
Methods:From August 2007 to November 2017, 6 neonates with Braddock-Carey syndrome were treated in our center. All patients experienced the combined thrombopoietic treatment before operation. Bilateral oblique mandibular osteotomy was performed by extraoral approaches and the distraction was initiated on postoperative day 3 at a rate of 1.2 mm/d. It usually took around 2 weeks to get required length of distraction. Distractor was removed after 3-months fixation at second stage.
Results:The distraction distance of 6 cases was from 12 to 20 mm. The CT scan showed a widening gap of the airway by 6-10 mm, and the average width was around 7 mm. 5 patients had no bleeding and infection after the operation, while one patient experienced bleeding for 4 times treated by regional compression. All neonates felt painful during distraction, and got relieved after reduction of the frequency and pace. With mandibular advancement, all patients′ face type improved, while paroxysmal bruising, inspiratory dyspnea and difficulty in breastfeeding disappeared. After 6 months of follow-up, all patients′ weight and face type were basically the same as normal children.
Conclusions:With the treatment of thrombocytopenia before operation, complete hematischesis during the operation, and postoperative treatment of thrombocytopenia, mandibular distraction osteogenesis was a feasible and safe management of upper airway obstruction in neonates with Braddock-Carey syndrome.
