What is mandibular distraction?
Mandibular distraction is a method used to increase the length of the jaw bone. It requires a surgical procedure to attach the distractors, on each side of the jaw bone. The process of distraction occurs after surgery and usually takes between 10 and 14 days.
Why would a child need mandibular distraction?
Some children are born with an abnormally small jaw bone (mandible is another name for the lower jaw.) This condition is called micrognathia [my-kroh-NATH-ee-ah] and can be associated with a number of problems. Infants with a small jaw can have trouble eating and breathing. This is because the small jaw pushes the baby’s tongue into the back of the throat causing blockage of breathing and swallowing. The idea of mandibular distraction can seem complex and may be difficult to grasp.
How does mandibular distraction work?
Are there any instructions I need to follow before surgery?
Most children who undergo mandibular distraction are still in the hospital when the procedure is performed. If your child is at home before having surgery your child must have a physical examination by his or her pediatrician or family doctor within 7 days before surgery to make sure he or she is in good health. The doctor you see needs to complete the History and Physical form provided by our office. You must bring the completed form with you the day of surgery.
For your child’s safety, it is very important that they have an empty stomach when anesthesia is given. Please follow our preoperative eating and drinking guidelines. If you do not follow these guidelines, your child’s surgery will be cancelled.
What can I expect after surgery?
The procedure usually takes between 2 and 4 hours. Your child will be taken to the pediatric intensive care unit (PICU) following surgery. It is common for your child to remain on a ventilator after surgery. The amount of time your child will need to stay on the ventilator depends on how much trouble your child had breathing before surgery. Your child will transition off the ventilator as breathing improves.
The distraction process will begin 3 days after surgery. It is important to wait a few days before starting the distraction process. On post-operative day 3, your surgeon will begin moving the jaw forward by turning a screw on the front of each distractor.
The nurses will learn how to continue the distraction process. You may also learn how to perform the distractions yourself if your child will be discharged from the hospital before the distraction is complete. Some children do not need to stay in the hospital during the distraction process. The distraction technique is straightforward and families are supported throughout the process.
Does it hurt?
Your child will have pain and discomfort for a few days after surgery. This will be controlled with pain medication. After a few days, the pain typically subsides, and only mild pain medication such as Tylenol® may be needed from time to time.
Some parents and nurses are concerned that the process of distracting the jaw is painful. During distraction, the jaw bones are separated less than 1 millimeter each time the screws are turned. This amount is less than the thickness of a United States quarter.
Distraction is generally well tolerated. Many older children who have undergone this procedure report no significant pain during the daily distractions.
Expert care for mandibular distraction
Mandibular distraction is a highly specialized surgical treatment for infants and children with complex conditions. It is not a routine part of most surgeons’ practice.
Our ENT and facial plastic surgery have specialized knowledge and experience caring for children who may need mandibular distraction. Our team has performed more of these procedures than any other surgeons in the region, and possibly the country. More importantly, we carefully evaluate when this procedure is appropriate and when it is not recommended.
Every child is unique, and mandibular distraction is a major surgical procedure with potential risks. Your doctor will take the time needed to discuss your child’s specific condition and whether mandibular distraction is an option worth considering.
Questions?
This information is not specific to your child and provides general information. If you have any questions, please call your nearest Children’s Minensota ENT and facial plastic surgery clinic.
