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Results for “Micrognathism”

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At least 55 records · Page 3Linked to original sources
PubMed1994

[Ilizarov bone lengthening for treatment of mandibular micrognathism in childhood].

Uni- or bilateral mandibular micrognathia could be congenital or acquired. In case of missing early correction of the lower jaw the midface will become malformed adaptively. Previous therapeutic strategies based on orthodontic measures and/or the use of costochondral grafts. However, especially the surgical treatment is often impossible in little children. In this report three cases of mandibular bone lengthening are presented. This less invasive but most effective surgical technique, which bases on Ilizarov's method originally, is an encouraging alternative procedure.

Adolescent↗
PubMed1996

[A modified method for the surgical treatment of patients with maxillary retro- and micrognathism].

A method of surgical treatment of patients with upper retro- and micrognathia is proposed, consisting in improving the fixation of osteotomied maxillary complex. Implantation of carbonic ceramics behind the maxillary tubercles and osteosynthesis of bone fragments with titanium miniplates helps do without prolonged intermaxillary fixation and permits exercise in the early postoperative period, thus cutting down the invalidity period. Analysis of the results attained in 14 patients showed no relapses of maxillary deformation and a stable functional and esthetic effect.

Abnormalities, Multiple↗
PubMed1996

[Mandibular micrognathism as a sequela of early childhood capitulum fractures and their treatment using distraction osteogenesis].

We report about our experience in five patients who suffered from a mandibular micrognathia after ancylosis of the temporomandibular joint. At first the ancylosis was removed using a costochondral graft. About one year later, the mandible was cut by an osteotomy behind the last visible toothbud and a distractor was inserted. The mandible was to a slide overcorrection. This has to be taken into account to compensate a certain relapse. At first we used an unidirectional device, for one and a half years we have used a bidirectional device (Normed from Tuttlingen/Germany) which enables us to correct mandibular hypoplasias more adequately. Up to now our experience shows, that gradual callus-distraction leads to stable normalization of mandibular hypoplasias. Functional problems concerning chewing and speech are solved, the dramatical improvement of the profile of the face may avoid psycho-social problems for these patients.

Adolescent↗
PubMed1977

[Hypersomnia with periodic apnea in a patient with acquired micrognathism].

A case presenting association of sleep apnea with daytime hypersomnolence and retrognathia is described. Sleep laboratory evaluation showed severe discontinuous hypoxemia and a mean of 250 upper airway obstructions. The patient was treated successfully by surgical correction of the retrognathia.

Airway Obstruction↗
PubMed2000

Neonatal micrognathia is associated with small upper airways on radiographic measurement.

In order to determine if infants with clinical micrognathia identified in the newborn period have smaller upper airways than do normal infants, and if their airway size is related to risk of later apnoea, respiration-timed upper airway radiographic measurements were performed in 21 asymptomatic neonates with clinical micrognathia. Their radiographic measurements were compared with those of a previously reported cohort of 35 normal infants. The micrognathic infants and a control group of 27 infants referred for parental anxiety were followed for 6 mo on home apnoea monitors. Sleep apnoea at home requiring stimulation by the parents occurred in 6 of 7 infants with micrognathia associated with craniofacial anomalies, 9 of 14 (64%) infants with isolated micrognathia, but only 1 of the 27 control infants (p < 0.001). Upper airway measurements at term of the infants with isolated micrognathia who later experienced apnoea were significantly smaller than either those of normal infants (p < 0.01) or of micrognathic infants who did not have apnoea requiring stimulation (p < 0.05). In conclusion, upper airway measurements on timed lateral radiographs in asymptomatic micrognathic infants at term (corrected age) revealed them to be smaller than those of normal infants. Narrower upper airways were associated with increased risk of subsequent apnoea requiring stimulation.

Apnea↗
PubMed2005

[Orthognathic surgery and distraction osteogenesis for treatment of obstructive sleep apnea hypopnea syndrome].

OBJECTIVE: To discuss the indication and protocol of surgical therapy when treating mandibular micrognathism accompanying obstructive sleep apnea-hypopnea syndrome (OSAHS) using distraction osteogenesis and orthognathic surgery. METHODS: A total of 17 patients with mandibular micrognathism accompanying moderate to severe OSAHS, aged 11 to 59 years, 15 men and 2 women, were reviewed. Four of them were treated with orthognathic surgery, 5 of them were treated with distraction osteogenesis, and the other 8 patients were treated with an integrated procedure combining distraction osteogenesis with orthognathic surgery. Cephalometric analysis and polysomnography studies were obtained pre- and postoperatively. RESULTS: SNB angle changed from 64.6 degrees to 71.9 degrees, post airway space (PAS) from 5.4mm to 13.2 mm, apnea and hypopnea index (AHI) from 58.4 to 7.6, lowest saturation of oxygen (LSAT) from 66% to 87%. All the differences showed statistical significance (P < 0.001). The average mental horizontal advancement (MHA) was 14.3 mm and its correlation coefficients with deltaSNB, deltaPAS, deltaAHI, and deltaLSAT were 0.36, 0.62, 0.34, and -0.14, respectively. CONCLUSIONS: Both distraction osteogenesis and orthognathic surgery can be effectively used to treat patients with mandibular micrognathism accompanying OSAHS with slightly different indications. A combination of these two operations may be preferred.

Adolescent↗
PubMed2004

Mandibular distraction for micrognathia and severe upper airway obstruction.

OBJECTIVE: To determine whether the use of mandibular distraction osteogenesis (DOG) can help to avoid tracheotomy or achieve decannulation in patients with mandibular hypoplasia and severe upper airway obstruction. DESIGN: Retrospective medical record review (spanning a 27-month period). SETTING: Tertiary care children's hospital. SUBJECTS: Group A (n=8) was composed of infants with Pierre Robin sequence and no tracheotomy (mean age, 2.5 months); group B (n=6), older nontracheotomized micrognathic children with obstructive sleep apnea (OSA) (mean age, 69 months); and group C (n=12), tracheotomized children with complex congenital syndromes (mean age, 33 months). INTERVENTION: Bilateral mandibular DOG with endoscopic (n=24) and/or radiographic (n=17) airway evaluation (mean follow-up, 16 months [range, 2-42 months]). OUTCOME MEASURES: Group A, tracheotomy avoidance; group B, resolution of OSA (clinically or on polysomnography); and group C, decannulation. RESULTS: Group A, 7 patients (88%) successfully avoided tracheotomy; group B, 5 patients (83%) had resolution of OSA; and group C, 2 patients (17%) underwent decannulation. CONCLUSIONS: Mandibular DOG (1) allows tracheotomy avoidance in infants with isolated Pierre Robin sequence and (2) relieves OSA in older micrognathic children without tracheotomy. However, mandibular DOG does not frequently lead to decannulation in tracheotomized patients with complex congenital syndromes.

Case-Control Studies↗
PubMed2002

The fetal mandible: a 2D and 3D sonographic approach to the diagnosis of retrognathia and micrognathia.

OBJECTIVE: To define parameters that enable the objective diagnosis of anomalies of the position and/or size of the fetal mandible in utero. DESIGN: Fetuses at 18-28 gestational weeks were examined by two- and three-dimensional ultrasound. The study included normal fetuses and fetuses with syndromes associated with known mandible pathology: Pierre Robin sequence or complex (n = 8); hemifacial microsomia (Treacher-Collins syndrome, n = 3); postaxial acrofacial dysostosis (n = 1). Fetuses with Down syndrome (n = 8) and cleft lip and palate without Pierre Robin sequence or complex (n = 18) were also studied. Retrognathia was assessed through the measurement of the inferior facial angle, defined on a mid-sagittal view, by the crossing of: 1) the line orthogonal to the vertical part of the forehead at the level of the synostosis of the nasal bones (reference line); 2) the line joining the tip of the mentum and the anterior border of the more protruding lip (profile line). Micrognathia was assessed through the calculation of the mandible width/maxilla width ratio on axial views obtained at the alveolar level. Mandible and maxilla widths were measured 10 mm posteriorly to the anterior osteous border. RESULTS: In normal fetuses, the inferior facial angle was constant over the time span studied. The mean (standard deviation) value of the inferior facial angle was 65.5 (8.13) degree. Consequently, an inferior facial angle value below 49.2 degree (mean - 2 standard deviations) defined retrognathism. All the fetuses with syndromes associated with mandible pathology had inferior facial angle values below the cut-off value. Using 49.2 degree or the rounded-up value of 50 degree as a cut-off point, the inferior facial angle had a sensitivity of 1.0, a specificity of 0.989, a positive predictive value of 0.750 and a negative predictive value of 1.0 to predict retrognathia. In normal fetuses, the mandible width/maxilla width ratio was constant over the time interval studied. The mean (standard deviation) value was 1.017 (0.116). Consequently, a mandible width/maxilla width ratio < 0.785 defined micrognathism. Mandible width/maxilla width ratio values were below this cut-off point in eight and in the normal range in four fetuses with syndromes associated with mandible pathology. CONCLUSIONS: Retrognathia and micrognathia are conditions that can be separately assessed. The use of inferior facial angle and mandible width/maxilla width ratio should help sonographic recognition and characterization of fetal retrognathic and micrognathic mandibles in utero.

Cephalometry↗