A Nationwide Analysis of the Impact of Craniofacial Syndromes on Mandibular Distraction Osteogenesis Outcomes

Document Type

Journal Article

Publication Date

3-2-2025

Journal

The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association

DOI

10.1177/10556656251325125

Keywords

complication; craniofacial syndromes; micrognathia; national; postoperative

Abstract

OBJECTIVE: To investigate how craniofacial syndromes influence surgical outcomes of mandibular distraction osteogenesis (MDO), in order to optimize perioperative care. DESIGN: Retrospective cohort. SETTING: Single-center. PATIENTS/PARTICIPANTS: The American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-Pediatric) database was queried for relevant Current Procedural Terminology (CPT) codes from 2012 to 2022. Patients with craniofacial syndromes were identified using ICD-9 and ICD-10 codes. INTERVENTION: Mandibular distraction osteogenesis. MAIN OUTCOME MEASURES: 30-day perioperative adverse events including reoperation, readmission, and complications such as infection, dehiscence, pneumonia, sepsis, stroke, intracranial hemorrhage, nerve injury, and death. RESULTS: A total of 209 patients were identified, with 77 (36.8%) having a craniofacial syndrome. The average age at MDO was significantly younger for patients with craniofacial syndromes (99 days) versus the nonsyndromic group (389 days). Patients with craniofacial syndromes had a higher likelihood of undergoing reoperation within 30 days postoperatively (P = .003) and experienced a 1.5 times longer average length of stay (LOS) (P = .039). Additionally, these patients were less likely to achieve same-day discharge (P = .033). Although the overall complication rate was slightly higher in patients with craniofacial syndromes, these differences were not statistically significant. CONCLUSIONS: This nationwide analysis indicates that while overall complication rates for MDO are similar, those with craniofacial syndromes face greater challenges, including higher reoperation rates, longer LOS, and lower same-day discharge rates, compared to patients without craniofacial syndromes. These results underscore the need for tailored postoperative care strategies to improve outcomes for this unique patient population.

Department

School of Medicine and Health Sciences Student Works

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