Mandibular volumetric increase following distraction osteogenesis

Abstract

Mandibular distraction osteogenesis (MDO) for the treatment of Pierre Robin sequence (PRS) enables mandibular lengthening and improves airway and feeding function. It remains unknown how the post-distracted mandibular volume compares to a normal control population. The aim of this study was to analyze mandibular volume and symmetry following bilateral MDO and compare post-distraction measurements to a non-distracted, normal age- and sex-matched control cohort. Demographic information and three dimensional-computed tomographic (CT) images were obtained from normal control and distracted PRS patients. Mandibular volume and symmetry indices were calculated and results statistically analyzed. P values ≤0.05 were considered statistically significant. 24 CT scans and 48 hemimandibles were analyzed (8 control patients: mean age=5.6 months, 3 females; 8 distracted patients: mean age pre-distraction=1.8 months, mean age post-distraction=5.3 months, 3 females). No complications were encountered in the distracted group. The mean pre- and post-distraction volume in the MDO group measured 7238.1mm(3) and 15,360.6mm(3), respectively (P=0.0003) and the mean percent increase inmandibular volume following distraction was 113.3%. The mean symmetry index increasedafter distraction from 0.91 to 0.95 (P=0.31). Matched normal control mandibles measured 13,488.6mm(3) versus post-distraction mandibles at 15,360.6mm(3) (P=0.40). Normal control and post-distraction symmetry indices were 0.99 and 0.95, respectively (P=0.68). Distraction resulted in a significantly increased mandibular volume and an observed preservation in mandibular symmetry. Post-distraction volume was increased compared to normal controls but remained less symmetrical.