Mandibular Distraction Osteogenesis for Upper Airway Obstruction in Infants and Neonates: Airway Outcomes, Hospitalization Burden and Procedure Application in the Polish Population
4 affiliations
- 1Department of Maxillofacial and Reconstructive Surgery for Children and Adolescents, Regional Specialized Children’s Hospital, 18a Zolnierska Str., 10-561 Olsztyn, Poland
- 2Department of Conservative Dentistry, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdansk, Poland
- 3Department of Maxillofacial Surgery, Faculty Hospital F. D. Roosevelt, Slovak Medical University, 975 17 Banská Bystrica, Slovakia
- 4Head and Neck Surgery Clinic for Children and Young Adults, Department of Clinical Pediatrics, University of Warmia and Mazury in Olsztyn, Regional Specialized Children’s Hospital, 18a Zolnierska Str., 10-561 Olsztyn, Poland
Abstract
Objectives: This study retrospectively evaluated the respiratory outcomes and hospitalization burden of infants and neonates diagnosed with upper airway obstruction who underwent bilateral mandibular distraction osteogenesis in the Polish population. Methods: The study analyzed 40 patients aged 0–12 months who underwent bilateral MDO for respiratory insufficiency associated with mandibular hypoplasia between 2013 and 2025. Successful airway management was defined as tracheostomy avoidance, without the need for further respiratory support in non-tracheostomized patients, or successful decannulation, with no requirement for additional respiratory support in patients with pre-existing tracheostomy. Duration of hospitalization and intensive care unit stay were also evaluated. Results: Twenty three patients had iPRS and 17 had sPRS. An overall successful airway outcome was achieved in 30/40 patients (75.0%), with a significantly higher success rate in iPRS than sPRS (95.7% vs. 47.1%, p < 0.001). MDO prevented tracheostomy in 28/30 (93.3%) patients, including all 20 patients with iPRS. In contrast, only 2/10 (20.0%) previously tracheostomized patients were successfully decannulated, both with iPRS. Patients with successful airway outcomes were younger at MDO (median 54 vs. 138 days, p = 0.015). The multivariable analysis indicated sPRS as an independent predictor of respiratory failure after adjustment for age. Conclusions: Bilateral MDO provided effective airway management, particularly in patients with iPRS, and was highly effective in avoiding a new tracheostomy. Syndromic diagnosis and pre-existing tracheostomy characterized patients with substantially less favorable airway outcomes, highlighting clinically important differences within this heterogeneous population.
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BibTeX
@article{kolodziejski2026mandibular,
title = {{Mandibular Distraction Osteogenesis for Upper Airway Obstruction in Infants and Neonates: Airway Outcomes, Hospitalization Burden and Procedure Application in the Polish Population}},
author = {Patryk Kołodziejski and Aleksandra Kołodziejska and Sebastian Radziak and Anna Krzykowska and Barbora Hocková and Krzysztof Dowgierd},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208109},
url = {https://www.mdpi.com/2077-0383/15/20/8109},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Mandibular Distraction Osteogenesis for Upper Airway Obstruction in Infants and Neonates: Airway Outcomes, Hospitalization Burden and Procedure Application in the Polish Population
AU - Patryk Kołodziejski
AU - Aleksandra Kołodziejska
AU - Sebastian Radziak
AU - Anna Krzykowska
AU - Barbora Hocková
AU - Krzysztof Dowgierd
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208109
UR - https://www.mdpi.com/2077-0383/15/20/8109
AB - Objectives: This study retrospectively evaluated the respiratory outcomes and hospitalization burden of infants and neonates diagnosed with upper airway obstruction who underwent bilateral mandibular distraction osteogenesis in the Polish population. Methods: The study analyzed 40 patients aged 0–12 months who underwent bilateral MDO for respiratory insufficiency associated with mandibular hypoplasia between 2013 and 2025. Successful airway management was defined as tracheostomy avoidance, without the need for further respiratory support in non-tracheostomized patients, or successful decannulation, with no requirement for additional respiratory support in patients with pre-existing tracheostomy. Duration of hospitalization and intensive care unit stay were also evaluated. Results: Twenty three patients had iPRS and 17 had sPRS. An overall successful airway outcome was achieved in 30/40 patients (75.0%), with a significantly higher success rate in iPRS than sPRS (95.7% vs. 47.1%, p < 0.001). MDO prevented tracheostomy in 28/30 (93.3%) patients, including all 20 patients with iPRS. In contrast, only 2/10 (20.0%) previously tracheostomized patients were successfully decannulated, both with iPRS. Patients with successful airway outcomes were younger at MDO (median 54 vs. 138 days, p = 0.015). The multivariable analysis indicated sPRS as an independent predictor of respiratory failure after adjustment for age. Conclusions: Bilateral MDO provided effective airway management, particularly in patients with iPRS, and was highly effective in avoiding a new tracheostomy. Syndromic diagnosis and pre-existing tracheostomy characterized patients with substantially less favorable airway outcomes, highlighting clinically important differences within this heterogeneous population.
SN - 2077-0383
ER -