Abstract:

BACKGROUND: Distraction osteogenesis can effectively improve airway obstruction in children with Pierre Robin syndrome. The growth inhibition of postoperative children can be significantly improved, especially in the growth of children’s body weight. However, there is no data to evaluate early distraction can benefit in body weight growth in children with post-osteogenesis.
OBJECTIVE: To record changes in body weight percentile at different stages of the Pierre Robin syndrome and compare with those with cleft palate and undistracted osteogenesis column to evaluate the effect of early distraction osteogenesis on growth and development of child patients.
METHODS: The clinical data of 56 cases of severe Pierre Robin syndrome in Guangzhou Women and Children’s Medical Center from 2015 to 2018 were collected, including 41 cases of mandibular distraction osteogenesis. The weight at 5 time points (birth, initial visit, before mandibular distraction osteogenesis, removal of distractor and cleft palate surgery) were recorded. The body weight of the child was converted into body weight percentile, and the growth rate curve of the child was made using statistical software. According to the age of the distraction osteogenesis, patients were divided into three groups (< 1 month; 1-3 months; 4-7 months). Simultaneously, body weight percentile of 21 cases of cleft palate (cleft palate group) and 15 cases of undistracted osteogenesis Pierre Robin syndrome (undistracted osteogenesis group) were collected and compared among groups. All the guardians of the children signed informed consent. This study was approved by the Hospital Ethics Committee.
RESULTS AND CONCLUSION: (1) The mean body weight percentile decreased from 34.4 ± 23.0 at birth to 13.1 ± 15.3 before the mandibular distraction osteogenesis in the distraction osteogenesis group (P < 0.001). The body weight percentile increased to 28.2 ± 24.1 when the distractor was removed, showing significant difference as compared with that before mandibular distraction osteogenesis (P < 0.05). At follow-up, the body weight percentile increased to 42.4 ± 14.1 as compared with that after removal of the distractor (P < 0.001). (2) At 10.6 ± 2.6 months follow-up, the body weight percentile was significantly greater in the distraction osteogenesis group than in the undistracted osteogenesis group (P < 0.001). There was no significant difference between the cleft palate group and the distraction osteogenesis group (P > 0.05). (3) At the first visit, the body weight percentile in the group (1-3 months) and (4-7 months) was significantly lower than in the group (< 1 month) (P < 0.05). (4) It is indicated that distraction osteogenesis is effective to reduce the growth inhibition of the child's weight percentile in server Pierre Robin syndrome. The earlier the surgery, the better the growth of the child’s body weight is.

Key words: mandible, distraction osteogenesis, Pierre Robin syndrome, growth and development, body mass percentile, distractor removal, cleft palate surgery