OBJECTIVETo evaluate the treatment of obstructive sleep apnea syndrome (OSAS) in children with congenital micrognathia using mandibular distraction osteogenesis and to discuss the advantages and disadvantages of this approach.

METHODS6 patients (4 males, 2 females) had undergone mandibular distraction osteogenesis, 12 distraction devices were placed through extraoral incision for bilateral distraction. The mean age of treatment was 1 year and 9 months (range 4 months to 9 years). Every patient had been evaluated pre and postoperatively with cephalometry. The period of consolidation was 4 - 11 weeks. The period of follow-up was from 2 to 10 months.

RESULTSThe average distraction distance was 19.2 mm (range 15 to 25 mm). The osteotomy and distraction processes were smooth in all the cases, the osteogenesis was good, without infection and other complications. The posterior airway space was increased from averaged 4.5 mm preoperatively to 10. 1mm after surgery. Five children had normal respiration and sleep restored with naso-pharyngeal airway removal or tracheostomy decannulation. One patient is to receive a planned second stage of distraction with a horizontal vector. The results were stable without relapse during a follow-up period of 2 to 10 months.

CONCLUSIONSApplication of mandibular distraction osteogenesis is an important component and effective in the treatment of OSAS and permits mandibular advancement in the younger child. As more experience is gained with distraction osteogenesis in the treatment of children with OSAS, the role of distraction will become better defined.

Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Micrognathism ; complications ; surgery ; Osteogenesis, Distraction ; methods ; Sleep Apnea, Obstructive ; complications ; surgery

OBJECTIVETo study the feasibility of midface distraction for correction of severe syndromic Four consecutive patients with severe syndromic midface retrusion underwent midface retrusion.

METHODSdistraction osteogenesis. The patients(three girls and one boy) aged from 4 to 12 years. Two were with Crouzon syndrome, one with Apert and one with Marfan syndrome. One was treated with Le Fort III external distraction, two with Le Fort III internal distraction, and the other with monobloc internal distraction. The distraction devices were activated on the fourth postoperative day at 1 mm per day.

RESULTSAll patients completed the distraction as activated on the fourth postoperative day at 1 mm per day. Results was planned. Successful advancement of 8 to 20 mm was obtained at the occlusal level in all patients as measured by cephalograms. The facial appearance was significantly improved,especially in the orbits and the upper part of the nose. Follow-up from 4 months to one year demonstrated that the face was symmetrical. All patients obtained This study shows that although midface distraction osteogenesis needs to be satisfactory results.

CONCLUSIONSThis study shows that although midface distraction osteogenesis needs to be improved to increase its controllability, it has obvious advantages over the traditional way of bone graft and rigid fixation. Midface distraction avoids bone grafts and alleviates the restriction of the soft tissue to midfacial bone advancement. Midface distraction osteogenesis is an effective and practical way to correct severe syndromic midfacial hypoplasia.

Australia ; Child ; Child, Preschool ; Feasibility Studies ; Female ; Humans ; Male ; Maxillofacial Abnormalities ; surgery ; Osteogenesis, Distraction ; methods ; Syndrome

OBJECTIVETo evaluate the correction of fronto-orbital deformation in infant craniosynostosis and to discuss the timing of treatment and surgical technique.

METHODSEleven consecutive patients with craniosynostoses underwent bilateral fronto-orbital osteotomies and advancement via coronal approaches. There were two females and 9 males with an age range from 6 to 9 months. Among the patients, six had trigonocephaly secondary to metopic synostosis, two had non-syndromic plagiocephaly secondary to unilateral coronal synostosis, one had turricephaly secondary to multi-sutural synostosis and two patients had brachycephaly due to syndromic synostosis (Apert syndrome and Saethre-Chotzen syndrome).

RESULTSThe shape of forehead, bilateral orbit and bilateral temples in all patients markedly improved with 2-11 months follow-up. There were not obvious complications except that the unilateral parietal bossing happened to the child with turricephaly postoperatively.

CONCLUSIONSSatisfactory results show that fronto-orbital advancement is safe and effective way to correct frontal and orbital retrusion secondary to craniosynostosis.

Craniosynostoses ; surgery ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Reconstructive Surgical Procedures ; methods ; Skull ; surgery ; Time Factors ; Treatment Outcome