Neonatal mandibular distraction osteogenesis

Mandibular distraction osteogenesis is a surgical technique used in the management of tongue base obstruction in patients with micrognathia. Judicious and early application of this procedure has been shown to negate the need for tracheostomy and gastrostomy tube placement in select neonates with micrognathia and glossoptosis with and without cleft palate (Pierre Robin sequence). This article describes the operative technique using an external distraction system, with an emphasis on the importance of preoperative assessment and patient selection, as well as the expected postoperative course. Current data on short- and long-term outcomes and new technologies within this growing field are also highlighted.