The Effect of Mandibular Distraction Osteogenesis on Weight Velocity in Infants With Severe Pierre Robin Syndrome

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.