31. Kết quả phẫu thuật kéo giãn xương hàm dưới điều trị Hội chứng Pierre Robin thể nặng

Abstract

Our study aimed to assess the effectiveness of mandibular distraction osteogenesis (MDO) in treating severe cases of Pierre Robin Syndrome (PRS) at the National Children's Hospital from 2019 to 2023. This method was utilized as an alternative to prior tracheostomy procedures. The study included PRS patients experiencing significant respiratory distress, feeding difficulties, and requiring ventilatory support, with a maxillomandibular discrepancy exceeding 10mm. Conducted as a non-controlled clinical intervention, we evaluated 102 patients aged 2 weeks to 6 months, tracking their progress for 6 to 36 months. Post-MDO, a success rate of 95.1% was observed, with surgeries typically performed at an average age of 59.18 ± 21.73 days. CT scans revealed a fourfold increase in airway size post-operation, and mandibular length saw a rapid increase of 60 - 78% within 3 months without the need for bone grafting. Preoperative maxillomandibular discrepancy, initially at 15.56 ± 1.57mm, reduced to 1.24 ± 0.89mm post-device removal and further to 1.07 ± 0.76mm after 9 months. The success rate for oral feeding after surgery was 82.4%. Mandibular distraction osteogenesis proves to be a safe and effective alternative for severe PRS cases. However, its success hinges on meticulous patient selection, surgical planning, and complication management.