Distraction osteogenesis in the pediatric population

Objectives: Distraction osteogenesis has been described routinely in the mandible for the advancement of bony segments. Complications, though infrequent, may include postoperative infection, implant extrusion, nonunion of the bony segments, device malfunction, cranial nerve paresis, and premature consolidation. Methods: Seventy-eight distractions of the mandible were performed over 10 years. The technique in placement of these internal microdistraction devices involves making intraoral and extraoral incisions and beginning distraction after a latency period of 3 days. Following this latency period, distraction occurs at 1 mm/day. Results: In this series of patients, distraction was accomplished successfully. There was a 2.6% rate of wound infection in this series; 2.6% also had bony nonunion; 3.8% had premature bony consolidation; and 3.8% had facial nerve complications. In the three patients with facial nerve paresis, we followed the facial nerve clinically and each paresis resolved within 6 months. Conclusions: Distraction of the mandible may be accomplished in the pediatric population. As with any intervention, inherent perioperative complications may still arise. (C) 2007 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.