Abstract
Distraction osteogenesis (DO) has been one of the most innovative concepts in craniomaxillofacial syndromology and surgery through the last 25 years. After more than a quarter of century of extensive use DO has today specific indications for congenital craniofacial and cleft deformities. Technology has evolved from the first application of external devices to intraoral and hybrid or semi-buried techniques. In congenital craniomaxillofacial anomalies distraction is indicated during growth. Mandibular distraction osteogenesis can be safely and effectively used to avoid or remove tracheostomy in neonates with severe airway obstruction caused by micrognathia in Pierre Robin Sequence. For selected newborns, mandibular DO will allow for avoidance of a tracheostomy and improved oral feeding. A careful evaluation of the patient's airway and feeding must be performed and evaluated by a multidisciplinary Team approach. In syndromic micrognathia early mandibular distraction seems to be an appropriate indication. Benefits are functional, morphological and aesthetic with consistent psychological and familiar positive effects. An increased incidence in TMJ complication during distraction osteogenesis in neonates has been recently reported, especially in syndromic patients.
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