Neonatal Jaw (Mandibular) Distraction

Before jaw distraction Neonatal jaw (mandibular) distraction is used to treat obstructive sleep apnea for infants with micrognathia and Pierre Robin sequence. The goal of distraction is to increase the size of the lower jaw and surrounding tissues and pull the tongue forward and off the oral airway. This helps resolve obstructive sleep apnea and feeding difficulties.

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 are given a polysomnogram or sleep study and 3D 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. A small incision (cut) is made in the mouth. This incision is known as an osteotomy. A device is placed externally on either side of the face attached to pins. 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 10/2012