Description of a Novel Technique to Perform Neonatal Mandibular Distraction

INTRODUCTION Ilizarov first described distraction osteogenesis in 1969 to surgically lengthen long bones.1,2 He observed that mechanically induced tensile stress placed on healing bone causes new bone formation. Successful application of this technique to the mandible by McCarthy and others1,3 has provided a way to treat severe retrognathia-induced airway obstruction. Previously, many of these patients underwent a tracheotomy and suffered from its associated morbidity and occasional mortality.4 Descriptions of this procedure cite the use of Kirschner wires (K-wires) to secure the distraction device.5 The K-wires can be difficult to maintain in position because of the softness and thinness of the neonatal mandible. Our early experience with this technique resulted in several devastating complications. The focus of this paper is to describe our evolution in developing an alternative technique that we believe achieves excellent clinical outcome without the potential for severe complications.