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Johns Hopkins Pediatric

An Effective Distraction for Neonatal Airway Obstruction

Pediatrician - Special Surgery Edition
October 9, 2015

Redett, Dorafshar, Kumar

3-D models take the guesswork out for craniofacial surgeons Richard Redett, Amir Dorafshar and Anand Kumar.

One of the most exciting technical advances in pediatric craniofacial surgery at Johns Hopkins today is distraction osteogenesis, which eliminates the need for bone grafting and replaces it with bone generation. By moving bones slowly over time, the technique avoids soft-tissue damage and promotes bone formation with no permanent hardware. In treating neonatal airway obstruction, in which an infant’s jaw is so small that the tongue is pushed against the back of the throat, explains pediatric craniofacial surgeon Anand Kumar, surgeons manipulate the jawbone and insert a device to gradually move it forward, bringing the tongue along with it. The device is initially adjusted, followed by a three-month healing period, and then removed to allow the patient to heal hardware-free. Traditional treatments have included the use of breathing and feeding tubes, but distraction can eliminate these. It is also decreases tissue damage, the need for secondary bone grafting procedures, and blood loss during surgery. “The neonatal airway distraction program,” says Kumar, “has really changed many lives.” 

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