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Video

Pediatric Otolaryngology

(A945) Respiratory Support and Feeding Outcomes for Pediatric Patients Undergoing Mandibular Distraction Osteogenesis for Airway Obstruction

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • LM

    Logan F. McColl, MD, MBA

    Chief Resident Physician
    Department of Otolaryngology—Head and Neck Surgery, The Ohio State University Wexner Medical Center, Department of Otolaryngology—Head and Neck Surgery, Nationwide Children’s Hospital
    Columbus, Ohio, United States

    • Co-Author(s)

  • Zialesi W. Adissem, BS

    College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
    Department of Pediatric Otolaryngology—Head and Neck Surgery, Nationwide Children’s Hospital
    Columbus, Ohio, United States

  • MA

    Monirah Albathi, MBBS

    Assistant Professor
    Princess Nourah Bint Abdulrahman University College of Medicine
    Riyadh, Ar Riyad, Saudi Arabia

    • Senior Author(s)

  • Jonathan Grischkan, MD, MS, FAAP, FACS

    Professor
    Department of Otolaryngology—Head and Neck Surgery, The Ohio State University Wexner Medical Center, Department of Otolaryngology—Head and Neck Surgery, Nationwide Children’s Hospital,
    Bexley, Ohio, United States

Disclosure(s):
Logan F. McColl, MD, MBA: No relevant relationships to disclose.
Zialesi W. Adissem, BS: No relevant relationships to disclose.
Monirah Albathi, MBBS: No relevant relationships to disclose.
Jonathan Grischkan, MD, MS, FAAP, FACS: No relevant relationships to disclose.


Introduction: The purpose of this study is to evaluate the respiratory and feeding outcomes of infants with micrognathia who undergo mandibular distraction osteogenesis (MDO) as primary treatment for tongue-base airway obstruction (TBAO).

Methods: Retrospective chart review of infants with micrognathia who underwent MDO for TBAO under the care of a multidisciplinary craniofacial team at a quaternary care center was performed. Neonatal course, clinical characteristics, perioperative respiratory status, polysomnography findings, and feeding outcomes were recorded and evaluated. Patients who had preoperative tongue-lip adhesion (TLA) or tracheostomy were excluded. Twenty-six patients who underwent MDO between 12/2015 and 10/2023 were identified. The average length of follow-up was 1090 days.

Results: The mean age at time of MDO was 35 days. Twenty-five patients had a cleft palate. A pathogenic genetic mutation was found in 34% of patients; most commonly the COLA21 gene (Stickler Syndrome). Nineteen percent of patients were preterm and 70% required resuscitation at birth. At the time of MDO surgery, 38% were on room air while two were still intubated. Eighty-eight percent were a grade 3 view or greater on the Cormack-Lehane grading system (CLGS) pre-operatively and post-operatively improved to grade 1 in all but 2 patients who improved to grade 2. Twenty-five patients were extubated on the first attempt; average duration of intubation post-operatively was 9 days. Mean apnea-hypopnea index (AHI) improved from 37.9 to 2.2 after surgery. Average weight at the time of surgery was 3.9 kg and 17 patients (65%) were on enteral feeding pre-operatively. The majority of patients resumed exclusive oral feeding within 3 weeks post-operatively.

Conclusions: MDO resolved TBAO in infants with PRS and significant improvements in AHI and CLGS were seen in all patients. Within three weeks postoperatively, most patients required no respiratory support and were fed exclusively by mouth.