Airway Changes Following LeFort III Distraction Osteogenesis for Syndromic Craniosynostosis: A Clinical and Cephalometric Study

摘要

LeFort III distraction osteogenesis (DO) improves midface form and dental relationships, but its effect on the superior airspace remains undocumented. This study assesses the upper airway effects of LeFort III DO in patients with syndromic Craniosynostosis. Retrospective single-institution review of all patients undergoing LeFort III DO from 2000 to 2006 (n=20). All study patients had at least one year follow-up and a diagnostic quality lateral cephalogram preoperatively and one year postoperatively. Patients with preoperative evidence of obstructive sleep apnea (OSA) were evaluated by a pediatric otolaryngologist and sleep studies were obtained as needed. Changes in velar angle, and the nasopharyngeal, velopharyngeal, oropharyngeal and hypopharyngeal spaces were measured cephalometrically. Patients with moderate to severe OSA or trache-ostomy were designated as having significant airway compromise. Cephalometric differences in the superior airspace were compared between patients with and without significant airway compromise.