Department of Oral and Maxillofacial Surgery, A & P Kyriakou Children's Hospital, Dental School, University of Athens, Athens, Greece.
J Craniomaxillofac Surg. 2010 Sep;38(6):431-5. doi: 10.1016/j.jcms.2009.10.019. Epub 2009 Dec 11.
Mandibular distraction osteogenesis (MDO) has been increasingly gaining interest over the last decade as a treatment alternative for the challenging airway management in infants with the Robin Sequence (RS). This paper is a case report of a male child diagnosed with RS, suffering from life-threatening airway obstruction and feeding difficulties, treated with tracheostomy and gastrostomy since infancy. After evaluation of the patient by a multidisciplinary team of specialists, MDO performed as soon as possible, was considered the optimal treatment, not only to address the severe micrognathia but also to allow early tracheal decannulation. As the lack of space intraorally contraindicated the use of internal distractors, they were placed externally bilaterally. The patient was successfully decannulated 3 weeks postoperatively and the gastrostomy was removed 1 month postoperatively. The mandibular expansion exceeded 20mm bilaterally and the maxilla-mandible discrepancy was fully corrected. There were no complications related to device placement, activation or removal. Follow-up clinical and radiographic examinations of the patient 1 year after the removal of the distractors revealed improved mandibular projection and continued mandibular growth. No significant scarring occurred at the surgical site and the patient has normal respiratory and feeding function.
下颌骨牵引成骨术（MDO）在过去十年中越来越受到关注，作为治疗 Robin 序列（RS）婴儿挑战性气道管理的替代方法。本文是一名男性患儿的病例报告，该患儿被诊断为 RS，患有危及生命的气道阻塞和喂养困难，自婴儿期以来一直接受气管造口术和胃造口术治疗。在多学科专家团队对患者进行评估后，尽快进行 MDO 被认为是最佳治疗方法，不仅可以解决严重的小下颌畸形，还可以允许早期气管拔管。由于口腔内空间不足，不建议使用内置牵开器，因此将其双侧外置。术后 3 周患者成功拔管，术后 1 个月拔除胃造口管。双侧下颌骨扩展超过 20mm，上颌-下颌骨差异完全矫正。没有与设备放置、激活或移除相关的并发症。在移除牵开器 1 年后对患者进行的临床和影像学随访显示，下颌骨的突出度得到改善，下颌骨继续生长。手术部位无明显瘢痕形成，患者呼吸和进食功能正常。
