Neonatal Jaw (Mandibular) Distraction

Before jaw distraction Neonatal jaw (mandibular) distraction is used to treat tongue-based obstructive sleep apnea for infants with a small jaw (micrognathia).

The goal of distraction is to increase the size of the lower jaw, moving the oral soft tissues and the tongue forward off the airway. This helps to resolve obstructive sleep apnea and potentially avoid tracheostomy.

Infants are put to sleep for the procedure and then monitored in our Newborn Intensive Care Unit (NICU). They may require narcotics for a few days and then are routinely treated with acetaminophen or ibuprofen.

Before the distraction procedure, patients will have a polysomnogram (sleep study) and 3-D CT scan. Parents or caregivers must follow the routine pre-surgery instructions for the safety of the infant.

The procedure takes place in the operating room. Your surgeon may elect to place an internal or external distractor. Through two small incisions in the mouth, the lower jaw (mandible) is cut on each side and a device is placed on either side of the face attached to pins. The placement of internal devices requires an incision on both sides of the child’s neck by which the jaw is lengthened and the device is placed beneath the skin. Doctors turn the distractor pins using a type of wrench. During surgery, the patient is asleep, and vital signs are monitored closely.

Distractor pins. Some patients stay in the hospital (in the NICU) during the entire process of pin-turning. By frequent turning of the pins (at the hospital or home), the bones gradually separate with increased tension and new bone is formed in this space.

During the distraction process, babies often had a difficult time eating orally. Special feeding techniques are implemented to keep the infants well nourished.

If patients go home during distraction, parents learn how to perform pin care, turning distraction pins and special feeding techniques before leaving the hospital.

  • There is redness at the pin sites
  • You have trouble turning the distraction pins

Last Updated 05/2015