Some children are born with an abnormally small mandible or jawbone, a condition called micrognathia. A small jaw can cause eating and breathing difficulties due to the jaw pushing the tongue into the throat when the child breathes in. The first line of action would be to try non-surgical methods to improve the airway obstruction. However, if these are not successful, surgical treatment would be recommended. Mandibular distraction or distraction osteogenesis is a highly predictable and reliable surgical procedure to correct micrognathia. The procedure widens an excessively narrow mandible, opens the airway, and improves the childs ability to breathe and eat. It also restores facial symmetry by aligning the lower and upper jaws.
What Distraction Osteogenesis Involves
Corrective jaw surgery is performed by plastic surgeons specialized in craniofacial surgery and reconstructive procedures. The physical examination would include X-rays and a CT scan to confirm the childs candidate for mandibular distraction. The surgeon will communicate with an orthodontist to develop a proper treatment plan. The procedure involves surgical insertion of a distraction (lengthening) device into the jaw by making incisions on either side of the jaw bone. The device is stabilized with pins fitted in the bones to prevent the jaw from collapsing. The device is adjusted gradually to pull the soft tissues and bones apart till the required projection is achieved. When the jaw bone is lengthened, the airway opens up, allowing the child to breathe properly. The distraction device is removed once the bone is strong enough. The entire process may take up to 6 weeks. Once the surgery is successfully completed, the operated jaw will grow in proportion with the rest of the face. Repeated distraction procedures may be needed for infants with Treacher Collins syndrome or facial clefting syndromes.
Jaw distraction has been useful to avoid the need for tracheostomy, the surgical procedure which creates an opening through the neck into the windpipe. It also decreases the need for bone grafting for large mandibular advancements.
Distraction osteogenesis is also a treatment option for conditions such as obstructive sleep apnea [OSA], continuity defects of the mandible, reconstruction after a resection, alveolar crest augmentation, midface retrusion, cranial synostosis and temporomandibular joint ankylosis.
Choose the Right Surgeon for Optimal Results
To ensure safe and effective treatment for your childs jaw disorder, make sure that you find a plastic surgeon with expertise in reconstructive procedures for young children and that the surgery is performed in an AAAASF (The American Association for Accreditation of Ambulatory Surgery Facilities) accredited plastic surgery center.