Collect data from craniofacial surgeons to analyze mandibular distraction osteogenesis (MDO) protocols, and facial nerve dysfunction (FND) to characterize this common, but poorly documented complication after MDO in infants with Robin Sequence (RS).
Design, Setting, and Participants
A 16-question anonymous survey designed through REDCap was digitally distributed to members of the American Cleft Palate-Craniofacial Association and International Society of Craniofacial Surgery (ISCFS).
Main Outcome Measure(s)
Demographic information, MDO perioperative variables, surgeon experience with FND after MDO for patients with RS, and the timing and duration of FND were analyzed.
Results
Eighty-four responses were collected, with 80 included for analysis. Almost two-thirds of respondent surgeons reported FND as a complication of MDO in patients with RS (51, 63.8%); 58.8% (n = 47) transient FND and 5% (n = 4) with permanent facial nerve palsy only. Both transient and permanent FND was documented by 13 (16.3%) respondents. Among respondents, FND was observed immediately following initial device placement/osteotomies in 45.1%, during distraction in 45.1%, during consolidation in 19.6%, and following device removal in 43.1%. Twenty-five of these respondent surgeons reported resolution of FND between 1 and 3 months (53.2%, n = 25).
Conclusions
FND after MDO in patients with RS was noted by most respondents in this survey study. While most surgeons noted temporary FND, one-fifth reported long-term dysfunction. FND was documented most commonly following device placement/osteotomies or during active distraction. Further research should seek to establish risk factors associated with FND and identify surgical and perioperative prevention strategies
IzumiKKonczalLLMitchellALJonesMC. Underlying genetic diagnosis of pierre robin sequence: retrospective chart review at Two children's Hospitals and a systematic literature review. J Pediatr.2012;160(4):645-650. e2.
2.
JudgeBHamlarDRimellF. Mandibular distraction osteogenesis in a neonate. Archives of Otolaryngology - Head and Neck Surgery. 1999;125(9):1029-1032.
3.
SchaeferRBStadlerJAGosainAK. To distract or Not to distract : an algorithm for airway management in isolated pierre robin sequence. Plast Reconstr Surg.2004;113(4):1113-1125.
4.
GangopadhyayNMendoncaDAWooAS. Pierre robin sequence. Semin Plast Surg.2012;26(2):76-82.
5.
CôtéAFanousAAlmajedALacroixY. Pierre robin sequence : review of diagnostic and treatment challenges. Int J Pediatr Otorhinolaryngol.2015;79(4):451-464.
6.
FanKLMandelbaumMBuroJRokniARogersGFChaoJWOhAK. Current trends in surgical airway management of neonates with robin sequence. Plastic and Reconstructive Surgery, Global Open. 2018;6(11):e1973.
7.
HicksKEBillingsKRPurnellCACarterJMBhushanBGosainAKThompsonDMRastatterJC. Algorithm for airway management in patients With pierre robin sequence. Journal of Craniofacial Surgery. 2018;29(5):1187-1192.
8.
RunyanCMUribe-RiveraATorkSShikaryTAEhsanZWeaverKNHossainMMGordonCBPanBS. Management of airway obstruction in infants with pierre robin sequence. Plastic and Reconstructive Surgery - Global Open. 2018;6(5):1-7.
9.
DennyADTalismanRHansonPRRecinosRF. Mandibular distraction osteogenesis in very young patients to correct airway obstruction. Plast Reconstr Surg.2001;108(2):302-311.
10.
MackayDR. Controversies in the diagnosis and management of the robin sequence. Journal of Craniofacial Surgery. 2011;22(2):415-420.
11.
LamDJTabanginMEShikaryTAUribe-riveraAMeinzen-derrJKAlarconADe, BillmireDAGordonCB. Outcomes of mandibular distraction osteogenesis in the treatment of severe micrognathia. JAMA Otolaryngology - Head and Neck Surgery. 2014;140(4):338-345.
12.
Van LieshoutMJSJoostenKFMHoeveHLJMathijssenIMJKoudstaalMJWolviusEB. Unravelling robin sequence: considerations of diagnosis and treatment. Laryngoscope. 2014;124(5):E203-E209.
13.
BütowKWNaidooSZwahlenRAMorkelJA. Pierre robin sequence: subdivision, data, theories, and treatment - part 4: recommended management and treatment of pierre robin sequence and its application. Ann Maxillofac Surg.2016;6(1):44-49.
14.
KhansaIHallCMadhounLLSplaingardMBaylisAKirschnerREPearsonGD. Airway and feeding outcomes of mandibular distraction, tongue-Lip adhesion, and conservative management in pierre robin sequence: a prospective study. Plast Reconstr Surg.2017;139(4):975e-983e.
15.
ZhangRSHoppeICTaylorJABartlettSP. Surgical management and outcomes of pierre robin sequence: a comparison of mandibular distraction osteogenesis and tongue-Lip adhesion. Plast Reconstr Surg.2018;142(2):480-509.
16.
MandellDLYellonRFBradleyJPIzadiKGordonCB. Mandibular distraction for micrognathia and severe upper airway obstruction. Archives of Otolaryngology - Head and Neck Surgery. 2004;130(3):344-348.
17.
RogersGFMurthyASLaBrieRAMullikenJB. The GILLS score: part I. Patient selection for tongue-Lip adhesion in robin sequence. Plast Reconstr Surg.2011;128(1):243-251.
18.
AbramowiczSBacicJDMullikenJBRogersGF. Validation of the GILLS score for tongue-Lip adhesion in robin sequence patients. Journal of Craniofacial Surgery. 2012;23(2):382-386.
19.
HanKDSeruyaMOhAKZalzalGHPreciadoDA. “Natural” decannulation in patients With robin sequence and severe airway obstruction. Annals of Otology, Rhinology, and Laryngology. 2012;121(1):44-50.
20.
Viezel-MathieuASafranTGilardinoMS. A systematic review of the effectiveness of tongue Lip adhesion in improving airway obstruction in children With pierre robin sequence. Journal of Craniofacial Surgery. 2016;27(6):1453-1456.
21.
LogjesRJHMermansJFPaesECMuradinMSMGriotJPDBreugemCC. Assessment of health-related quality of life in robin sequence: a comparison of mandibular distraction osteogenesis and tongue-Lip adhesion. Plast Reconstr Surg.2019;143(5):1456-1465.
22.
PapoffPGuelfiGCicchettiRCarestaECozziDAMorettiCMidullaFMianoSCerasaroCCasconeP. Outcomes after tongue-Lip adhesion or mandibular distraction osteogenesis in infants with pierre robin sequence and severe airway obstruction. International Journal of Oral & Maxillofacial Surgery. 2013;42(11):1418-1423.
23.
SwennenGSchliephakeHDempfRSchierleHMalevezC. Craniofacial distraction osteogenesis: a review of the literature: part 1: clinical studies. Int J Oral Maxillofac Surg.2001;30(2):89-103.
24.
IzadiKYellonRMandellDLSmithMSongSYBidicSBradleyJP. Correction of upper airway obstruction in the newborn with internal mandibular distraction osteogenesis. Journal of Craniofacial Surgery. 2003;14(4):493-499.
DavidsonEHBrownDShetyePROrthMGreigAVHGraysonBHWarrenSMMcCarthyJG. The evolution of mandibular distraction: device selection. Plast Reconstr Surg.2010;126(6):2061-2070.
27.
TibesarRJScottARMcnamaraCSampsonDLanderTASidmanJD. Distraction osteogenesis of the mandible for airway obstruction in children : long-term results. Otolaryngology - Head and Neck Surgery. 2010;143(1):90-96.
MurageKPCostaMAFrielMTHavlikRJTholpadySSFloresRL. Complications associated with neonatal mandibular distraction osteogenesis in the treatment of robin sequence. Journal of Craniofacial Surgery. 2014;25(2):383-387.
30.
DiepGKEisemannBSFloresRL. Neonatal mandibular distraction osteogenesis in infants With pierre robin sequence. Journal of Craniofacial Surgery. 2020;31(4):1137-1141.
31.
American Cleft Palate-Craniofacial Association (ACPA).Home Page. Retrieved September 24, 2021, from https://acpa-cpf.org/; n.d.
32.
The International Society of Craniofacial Surgery (ISCFS). Home Page. Retrieved September 24, 2021, from https://www.iscfs.org/; n.d.
33.
BelcherRHPhillipsJD. Total facial nerve injury during mandibular distraction osteogenesis. Int J Pediatr Otorhinolaryngol.2020;136:110182.
34.
MasterDLHansonPRGosainAK. Complications of mandibular distraction osteogenesis. J Craniofac Surg.2010;21(5):1565-1570.
35.
HammoudehJAFahradyanABradyCTsuhaMAzadgoliBWardSUrataMM. Predictors of failure in infant mandibular distraction osteogenesis. J Oral Maxillofac Surg.2018;76(9):1955-1965.
36.
IgarashiMFilipponeMVAlfordBR. Temporal bone findings in pierre robin syndrome. Laryngoscope. 1976;86(11):1679-1687.
37.
GenecovDGBarcelóCRSteinbergDTroneTSperryE. Clinical experience With The application of distraction osteogenesis for airway obstruction. Journal of Craniofacial Surgery. 2009;20(Supplement 2):1817-1821.
38.
AllamKASaiedSMAAbulezzTAMaherHAliMKawamotoHKBradleyJP. Neonatal mandibular distraction osteogenesis : a technique for treating neonates with micrognathia and risk of respiratory obstruction. Egyptian Journal of Plastic and Reconstructive Surgery. 2011;35(2):191-197.
39.
ScottARTibesarRJLanderTASampsonDESidmanJD. Mandibular distraction osteogenesis in infants younger than 3 months. Arch Facial Plast Surg.2011;13(3):173-179.
40.
FrawleyGEspenellAHowePShandJHeggieA. Anesthetic implications of infants with mandibular hypoplasia treated with mandibular distraction osteogenesis. Paediatr Anaesth.2013;23(4):342-348.
41.
RachmielAEmodiORachmielDAizenbudD. Internal mandibular distraction to relieve airway obstruction in children with severe micrognathia. International Journal of Oral & Maxillofacial Surgery. 2014;43(10):1176-1181.
42.
Nunes da CostaJMatiasJ. Isolated robin sequence in siblings: review of current concepts. J Plast Reconstr Aesthet Surg.2014;67(11):e259-e265.
43.
RachmielAShiloD. The use of distraction osteogenesis in oral and maxillofacial surgery. Ann Maxillofac Surg.2015;5(2):146-147.
44.
KonaşEÇalışMBitikOYiğitŞKorkmazAYurdakökMTunçbilekG. Functional outcomes of mandibular distraction for the relief of severe airway obstruction and feeding difficulties in neonates with pierre robin sequence. Turkish Journal of Pediatrics. 2016;58(2):159-167.
45.
SteinbergJPBradyCMWatersBRSoldanskaMBursteinFDThomasJEWilliamsJK. Mid-term dental and nerve-related complications of infant distraction for robin sequence. Plast Reconstr Surg.2016;138(1):82e-90e.
46.
ZellnerEGMhlabaJMReidRRSteinbacherDM. Does mandibular distraction vector influence airway volumes and outcome?J Oral Maxillofac Surg.2017;75(1):167-177.
47.
MuddPAPerkinsJNHarwoodJEFValdezSAllenGC. Early intervention: distraction osteogenesis of the mandible for severe airway obstruction. Otolaryngology - Head and Neck Surgery. 2012;146(3):467-472.
48.
MaoZZhangNCuiY. Three-Dimensional printing of surgical guides for mandibular distraction osteogenesis in infancy. Medicine (Baltimore)2019;98(10):e14754.
49.
LinSJRoySPatelPK. Distraction osteogenesis in the pediatric population. Otolaryngology - Head and Neck Surgery. 2007;137(2):233-238.
50.
SendersCWKolstadCKTollefsonTTSykesJM. Mandibular distraction osteogenesis used to treat upper airway obstruction. Arch Facial Plast Surg.2010;12(1):11-15.
51.
MohamedAMBishriAAMohamedAH. Distraction osteogenesis as followed by CT scan in pierre robin sequence. J Craniomaxillofac Surg.2011;39(6):412-419.
52.
HammoudehJBindingnaveleVKDavisBDavidson WardSLSanchez-LaraPAKleiberGNazarian MobinSSFrancisCSUrataMM. Neonatal and infant mandibular distraction as an alternative to tracheostomy in severe obstructive sleep apnea. Cleft Palate-Craniofacial Journal. 2012;49(1):32-38.
53.
KapadiaSMGolinkoMSWilliamsJK. Facial nerve paralysis and frey syndrome in an infant following removal of an internal mandibular distraction device. Journal of Craniofacial Surgery. 2013;24(3):961-963.
54.
TahiriYGreathouseSTTholpadySSHavlikRSoodRFloresRL. Mandibular distraction osteogenesis in Low-weight neonates with robin sequence: is it safe?Plast Reconstr Surg.2015;136(5):1037-1044.
55.
VerlindenCRAVijfeijkenSECMVDJansmaEPBeckingAGSwennenG. Complications of mandibular distraction osteogenesis for congenital deformities: a systematic review of the literature and proposal of a New classification for complications. International Journal of Oral & Maxillofacial Surgery. 2015;44(1):37-43.
56.
MofidMMMansonPNRobertsonBCTufaroAPEliasJJVander KolkCA. Craniofacial distraction osteogenesis: a review of 3278 cases. Plast Reconstr Surg.2001;108(5):103-114.
