Efficacy and Complications of Mandibular Distraction Osteogenesis for Airway Obstruction in the Robin Sequence Population: A Comprehensive Literature Review.
J Craniofac Surg
; 33(6): 1739-1744, 2022 Sep 01.
Article
en En
| MEDLINE
| ID: mdl-35258012
ABSTRACT
INTRODUCTION:
Mandibular distraction osteogenesis (MDO) is becoming the procedure of choice for patients with Robin Sequence (RS) as it offers superior long-term respiratory outcomes in avoidance of tracheostomy. Lacking, is an analysis of the short- and long-term complications. To that end, we have conducted a comprehensive review focusing on complications of MDO. MATERIALS ANDMETHODS:
A systematic review of primary clinical studies reporting outcomes and complications of MDO in RS patients. Outcomes included tracheostomy avoidance and decannulation rate. Complications included dental trauma, nerve injury, surgical site infection and hardware failure. Complications were stratified according to distractor type (internal versus external) and age (>2 months versus <2months).RESULTS:
A total of 49 studies yielded 1209 patients with a mean follow-up of 43.78 months. The tracheostomy avoidance rate was 94% (n = 817/870) and the mortality rate was 0.99% (n = 12/1209). The complication rate was 28.9% (n = 349/1209) with surgical site infections (10.5%) being most common. Dental and nerve injuries occurred in 7.9% and 3.2% of patients, respectively. Hardware replacement occurred in 1.2% of patients. internal distractors had higher rates of dental injury whereas external distractors had higher technical failure rates. There were no differences in complication rates ( P= 0.200), mortality ( P = 0.94) or tracheostomy avoidance ( P = 0.058) between patients >2months or <2months of age.CONCLUSION:
Mandibular distraction osteogenesis is highly reliable and effective with a low mortality and high tracheostomy avoidance rate. There are important complications including nerve and dental injuries which require long-term follow-up. Neonatal patients do not appear to be at higher risk of complications reinforcing the safety of MDO in this population.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
/
6_ODS3_enfermedades_notrasmisibles
/
7_ODS3_muertes_prevenibles_nacidos_ninos
Problema de salud:
2_muertes_prevenibles
/
6_congenital_chromosomal_anomalies
/
6_other_respiratory_diseases
/
7_neonatal_care_health
/
7_non_communicable_diseases
Asunto principal:
Síndrome de Pierre Robin
/
Osteogénesis por Distracción
/
Obstrucción de las Vías Aéreas
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Systematic_reviews
Límite:
Humans
/
Infant
/
Newborn
Idioma:
En
Revista:
J Craniofac Surg
Asunto de la revista:
ODONTOLOGIA
Año:
2022
Tipo del documento:
Article
País de afiliación:
Canadá