Distraction osteogenesis - a panacea for infant micrognathia with upper airway obstruction?

Mandibular distraction osteogenesis (MDO) has been described as an effective method of treating upper airway obstruction (UAO) in micrognathic infants with a low morbidity and few short-term complications. This technique has almost eliminated the need for tracheostomy in non-syndromic patients at The Royal Children's Hospital (RCH) in Melbourne. However, there are few studies describing the longer-term effects on feeding, growth and the developing mandible. This study describes the experience at the RCH in managing infants with micrognathia over the past twelve years, with particular emphasis on airway, feeding and growth. By international standards, this study comprises one of the larger cohorts of children under five years who have had MDO (n=73). This retrospective review shows that the procedure is effective in alleviating the need for airway assistance and supplemental feeding without adversely affecting the growth of these children. This study makes a significant contribution to the evidence base underpinning MDO as the preferred surgical intervention for infants with micrognathia and UAO.