Obstructive sleep apnea (OSA) OSA is a condition where there are repeated episodes of complete/partial blockage of the airway during sleep. It is characterized by repetitive pauses in breathing and loud snoring and occurs when the base of the tongue crowds the normal airflow into the trachea, due to the small size of the lower jaw. The syndrome can affect children between two and six years of age. Mandibular distraction is found to be an effective treatment for sleep apnea. Jaw distraction involves surgery to lengthen a small or recessed jaw, which opens up the airway and allows the child to breathe properly.
Causes of Obstructive Sleep Apnea in Children
Enlarged tonsils and adenoids can block the airway and make the breathing process more difficult. Children born with a small or recessed jaw experience breathing and feeding problems as the tongue moves back into the throat when breathing in, which blocks the airway partially or completely. Symptoms of OSA in children include
– Bed wetting
– Mouth breathing
– Difficulty awakening
– Excessive daytime sleepiness
– Hyperactivity/behavior problems
– Restlessness during sleep
– Behavior problems or sleepiness
– Frequent infections
– Sleeping in odd positions
Non-surgical interventions can resolve the condition in most cases. Jaw distraction may be recommended if severe or persistent upper airway obstruction occurs.
How Mandibular Distraction Treatment Resolves Breathing Issues
An incision is made through the skin under the jaw line. The mandible or lower jaw bone is cut on each side to allow a distraction device to be connected to either side of this separation in the bone. The distractor is adjusted over a period of time to stretch the space and allow the bone to grow to fill the space. The distraction device supports the bone and allows it to gain strength over a period of time about six to eight weeks after surgery. When the bone is strong enough, the distraction device is removed. In children with Treacher Collins syndrome or facial clefting syndromes the distraction procedure may have to be repeated, as the jaw may not grow as expected.
Improved breathing and feeding are the major advantages of mandibular distraction. The process increases the oxygen level of the blood and improves sleep-disordered breathing and brain function and also addresses behavioral problems.
If your child is diagnosed with sleep apnea, consult a plastic surgeon with expertise in reconstructive and craniofacial surgery. A reliable surgeon will with work with a multidisciplinary team of medical and surgical staff to determine if jaw distraction is the appropriate solution to treat the condition.