Our Summary

This research paper discusses different types of surgeries used to fix severe jaw deformities in children. The timing and type of surgery depend on how serious the child’s condition is. The paper specifically looks at a procedure called “mandibular distraction,” which is used to correct issues with the jaw. While this procedure is helpful, it does not prevent the need for a secondary surgery when the child is fully grown. However, it does improve the child’s ability to function, their appearance, and their social and emotional well-being in the short term. Another procedure, called “costochondral rib grafting,” can also produce good results, especially when combined with the mandibular distraction. A second surgery, which involves adjusting the jaw and chin when the child reaches skeletal maturity, can be more successful if the child had a previous mandibular distraction. The paper is relevant to conditions like Craniofacial microsomia, Goldenhar syndrome, and Hemifacial microsomia, which all affect the development of the face and jaw.

FAQs

  1. What are the potential benefits of early mandibular distraction in children without respiratory and feeding difficulties?
  2. How does costochondral rib grafting in combination with mandibular distraction improve results in Pruzansky type IIB and III mandibles?
  3. What are the benefits of secondary 2-jaw orthognathic surgery plus genioplasty at skeletal maturity following prior mandibular distraction?

Doctor’s Tip

A doctor may advise a patient undergoing jaw surgery to follow post-operative instructions carefully, including maintaining a soft diet, avoiding strenuous activities, and attending follow-up appointments to monitor healing and progress. They may also recommend physical therapy or speech therapy as needed to aid in recovery and achieve optimal functional and aesthetic outcomes. Additionally, the doctor may emphasize the importance of good oral hygiene to prevent infections and complications during the healing process.

Suitable For

Patients who may be recommended for jaw surgery include those with craniofacial microsomia, Goldenhar syndrome, hemifacial microsomia, and other congenital conditions affecting the jaw and facial structures. Patients with severe facial asymmetry, malocclusion, obstructive sleep apnea, or difficulty with breathing, chewing, and speaking may also be candidates for jaw surgery. Additionally, patients with skeletal discrepancies that cannot be corrected with orthodontics alone may benefit from orthognathic surgery. Treatment recommendations will depend on the individual patient’s specific needs and goals for functional and aesthetic improvement.

Timeline

Before jaw surgery:

  1. Initial consultation with an oral and maxillofacial surgeon or orthodontist to discuss concerns and treatment options.
  2. Orthodontic treatment to align teeth and correct bite issues in preparation for surgery.
  3. Pre-surgical planning including imaging studies such as X-rays and CT scans to assess the jaw structure.
  4. Pre-operative appointments with the surgical team to discuss the procedure, expectations, and potential risks.

After jaw surgery:

  1. Immediate post-operative care in the hospital or surgical center, including pain management and monitoring for complications.
  2. Recovery period at home with restrictions on activities such as eating solid foods and participating in strenuous exercise.
  3. Follow-up appointments with the surgical team to monitor healing progress and adjust treatment as needed.
  4. Continued orthodontic treatment to fine-tune the bite and alignment of the teeth.
  5. Long-term follow-up care to monitor the stability of the surgical results and address any potential issues that may arise.

What to Ask Your Doctor

  1. What specific type of jaw surgery do you recommend for my condition?

  2. What are the potential risks and complications associated with this surgery?

  3. What is the expected recovery time and post-operative care for this surgery?

  4. How will this surgery impact my jaw function, aesthetics, and overall quality of life?

  5. Will I need any additional surgeries or procedures in the future after this jaw surgery?

  6. How long do the results of this jaw surgery typically last?

  7. Are there any alternative treatment options to jaw surgery that I should consider?

  8. What is the success rate of this type of jaw surgery for patients with similar conditions to mine?

  9. Are there any specific lifestyle changes or precautions I should take before or after the surgery?

  10. What is the cost of the jaw surgery and will my insurance cover it?

Reference

Authors: Shakir S, Bartlett SP. Journal: Clin Plast Surg. 2021 Jul;48(3):375-389. doi: 10.1016/j.cps.2021.02.001. Epub 2021 May 8. PMID: 34051892