Luo Dongyuan, Chen Yiyang, Wang Hongtao, Li Ting, Fan Li, Wenli Wu, Jiayu Liu, Jiansuo Hao
Guangzhou Women and Children's Medical Center, Guangzhou City, China.
J Craniofac Surg. 2018 Oct;29(7):1851-1854. doi: 10.1097/SCS.0000000000004650.
Mandibular distraction osteogenesis (MDO) effectively improves airway obstruction in Pierre Robin syndrome (PRS) patients. However, whether or not early MDO is beneficial to the development of children is still controversial. To observe the influence of PRS patient age at the time of MDO on their development, the authors retrospectively analyzed preoperative and postoperative body weight in 41 children with PRS who underwent MDO treatment from 2014 to 2016. The body weight of the infants at the time of birth, first visit, MDO surgery, distractor removal, and palatoplasty surgery was recorded. The body weight percentile significantly fell from 34.4 ± 5.8 at birth to 13.1 ± 3.6 at the time of MDO (P < 0.001), and increased to 28.3 ± 5.3 at distractor removal (P < 0.05) following MDO, finally reaching 42.4 ± 6.5 at palatoplasty surgery (P < 0.001). The infants who accepted MDO treatment at <1 month of age maintained a significantly higher body weight percentile than those who accepted MDO surgery at 1 to 3 months or 4 to 7 months of age, at the time of both MDO and palatoplasty surgeries (P < 0.05). After the MDO procedure, the body weight percentiles of the PRS infants with a cleft palate were comparable to those without a cleft palate at the time of palatoplasty surgery. The body weight percentile quickly climbed to 74.0 ± 35.2 at the time of distractor removal, from 46.7 ± 18.2 at the time of MDO. In conclusion, early MDO was beneficial in severe cases of PRS for patients to recover body weight and to allow for earlier palatoplasty surgery.
下颌骨牵张成骨术（MDO）可有效改善皮埃尔·罗宾综合征（PRS）患者的气道阻塞。然而，早期MDO对儿童发育是否有益仍存在争议。为观察MDO时PRS患者年龄对其发育的影响，作者回顾性分析了2014年至2016年接受MDO治疗的41例PRS儿童的术前和术后体重。记录了婴儿出生时、首次就诊时、MDO手术时、牵张器拆除时以及腭裂修复手术时的体重。体重百分位数从出生时的34.4±5.8显著下降至MDO时的13.1±3.6（P<0.001），MDO后牵张器拆除时增至28.3±5.3（P<0.05），最终在腭裂修复手术时达到42.4±6.5（P<0.001）。在MDO和腭裂修复手术时，1个月龄前接受MDO治疗的婴儿的体重百分位数显著高于1至3个月龄或4至7个月龄接受MDO手术的婴儿（P<0.05）。MDO手术后，腭裂的PRS婴儿在腭裂修复手术时的体重百分位数与无腭裂的婴儿相当。牵张器拆除时体重百分位数从MDO时的46.7±18.2迅速攀升至74.0±35.2。总之，早期MDO对严重PRS患者恢复体重和尽早进行腭裂修复手术有益。
