Three-Dimensional Airway Changes in Children With Congenital Micrognathia and Obstructive Sleep Apnea Following Mandibular Distraction Osteogenesis

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was applied to all patients and involved the intravenous injection of the bone targeting radiopharmaceutical 99mTc MDP (7.4 MBq/kg, maximum of 518 MBq). 3-D regions-of-interest (ROIs) were applied to the condyles and maximum counts of both condyles. Methods of Data Analysis: Data from each condyle was standardized to an external source and a ratio of R/L condylar uptake was calculated and compared to agematched normal values. The uptake ratio was determined to be high, normal, or low. Each patient was then categorized as normal or abnormal, symmetric or asymmetric based on blinded evaluation of the SPECT scan results. Patient records were then obtained and results of the SPECT scans were compared to the clinical assessment and follow up data. Results of Investigation: Eleven patients (n 11, 0 male, 11 female, ages 12-44 years, mean 19) were referred for a SPECT Tc99 scan of the condyles. Five of the scans showed normal and symmetric activity bilaterally. All of these patients had quiescent or end-stage growth abnormalities and the SPECT results correlated with their clinical diagnosis. Two of these scans exhibited abnormal R/L ratios and this correlated with the clinical diagnosis of condylar hyperplasia on the side with increased uptake. Four scans demonstrated bilateral symmetric uptake with higher-than-normal activity. Two of the 4 exhibited continued symmetric growth clinically and the other two had active bilateral idiopathic condylar resorption. Conclusion: The results of this preliminary study indicate that age-matched normative data is useful in evaluating asymmetric and symmetric abnormalities in mandibular growth. The application of established agematched normal ranges of condylar activity using SPECT Tc99 is useful in guiding the management of patients with suspected condylar hyperplasia, condylar hypoplasia, and idiopathic condylar resorption and may be useful in assessment of activity of inflammatory joint disease.