Mandibular Distraction Osteogenesis (MDO) for Neonatal Airway Obstruction-Advances, Challenges, and Future Direction
Keywords:
Pierre Robin Sequence, Micrognathia, Mandibular Distraction Osteogenesis, Airway Obstruction, Tracheostomy Prevention, Feeding ImprovementAbstract
Background: Infants with micrognathia, glossoptosis, and often cleft palate have feeding problems and upper airway obstruction resulting from the Pierre Robin Sequence (PRS). Mandibular distraction osteogenesis (MDO) is a surgical technique designed to prevent tracheostomy and to improve the functional results.
Objectives: This systematic review aims to assess MDO's clinical effectiveness, safety profile, and clinical outcome, as well as the long-term implication of treating babies with PRS with airway blockage.
Methods: Searches were made in major medical databases using PRISMA guidelines. The analysis was carried on 49 studies and 1,209 neonatal PRS who had MDO. Data extraction was focused on the main topics of patient demographics, surgical methods, feeding outcomes & airway improvements, complication rates, and technical factors.
Results: MDO allowed 94% of patients to avoid tracheostomies, while more than 67% experienced an impressive improvement in their postoperative eating. Complications that occurred include infections, oral injuries, and nerve palsies in 28.9% of patients. MDO now has support as a long-lasting intervention, although there is a lack of long-term data. Conclusion: The use of MDO is a safe and efficient option to tracheostomy in newborns with PRS selected carefully. Multicenter research, ongoing standardizations of treatments, and maximizing of results are essential to standardizing treatment and maximizing results.
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