J Korean Assoc Oral Maxillofac Surg.  2016 Dec;42(6):388-392. 10.5125/jkaoms.2016.42.6.388.

Management of obstructive sleep apnea in a Treacher Collins syndrome patient using distraction osteogenesis of the mandible

Affiliations
  • 1Private Practice, Faculty of Dentistry, GaziosmanpaÅŸa University, Tokat, Turkey.
  • 2Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, GaziosmanpaÅŸa University, Tokat, Turkey. dt.ahmetaltan@gmail.com
  • 3Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mustafa Kemal University, Hatay, Turkey.

Abstract

In this study, we present the surgical treatment of obstructive sleep apnea in a child with Treacher Collins syndrome. A 10-year-old girl with a past history of Treacher Collins syndrome presented to our clinic with her parents for respiratory distress and insomnia. The patient was referred to a sleep laboratory where she was diagnosed with obstructive sleep apnea, which was a consequence of her Treacher Collins syndrome. The patient underwent mandibular distraction osteogenesis under general anesthesia. The mandible was expanded by 15 mm using internal bilateral distractors. After distraction osteogenesis, the patient's respiratory problems resolved, and she was able to sleep comfortably. Distraction osteogenesis was an effective method of advancing the mandible, increasing the upper airway space and ultimately preventing obstructive sleep apnea syndrome in patients with Treacher Collins syndrome.

Keyword

Distraction osteogenesis; Obstructive sleep apnea; Treacher Collins syndrome; Mandibulofacial dysostosis

MeSH Terms

Anesthesia, General
Child
Female
Humans
Mandible*
Mandibulofacial Dysostosis*
Methods
Osteogenesis, Distraction*
Parents
Sleep Apnea, Obstructive*
Sleep Initiation and Maintenance Disorders

Figure

  • Fig. 1 The patient with Treacher Collins syndrome.

  • Fig. 2 Preoperative three-dimensional computed tomography.

  • Fig. 3 Osteotomy with piezo surgery.

  • Fig. 4 Positioning of distraction.

  • Fig. 5 Three-dimensional computed tomography after distraction osteogenesis.

  • Fig. 6 One year after the end of treatment.


Reference

1. Akre H, Øverland B, Åsten P, Skogedal N, Heimdal K. Obstructive sleep apnea in Treacher Collins syndrome. Eur Arch Otorhinolaryngol. 2012; 269:331–337. PMID: 21626120.
Article
2. Jin SM, Lee HS, Ryu HH, Ryu SH, Shin DY, Kim CH, et al. Retrospective study on the airway obstruction aspects of computed tomography and lateral cephalometry and the correlation of polysomnography in obstructive sleep apnea patients. J Korean Assoc Oral Maxillofac Surg. 2012; 38:295–304.
Article
3. Okşayan R, Sökücü O, Uyar M, Topçuoğlu T. Effects of edentulism in obstructive sleep apnea syndrome. Niger J Clin Pract. 2015; 18:502–505. PMID: 25966722.
Article
4. Hoeve LJ, Pijpers M, Joosten KF. OSAS in craniofacial syndromes: an unsolved problem. Int J Pediatr Otorhinolaryngol. 2003; 67(Suppl 1):S111–S113. PMID: 14662180.
Article
5. Rosen CL, Storfer-Isser A, Taylor HG, Kirchner HL, Emancipator JL, Redline S. Increased behavioral morbidity in school-aged children with sleep-disordered breathing. Pediatrics. 2004; 114:1640–1648. PMID: 15574628.
Article
6. Hoeve HL, Joosten KF, van den Berg S. Management of obstructive sleep apnea syndrome in children with craniofacial malformation. Int J Pediatr Otorhinolaryngol. 1999; 49(Suppl 1):S59–S61. PMID: 10577777.
Article
7. Østertun Geirdal A, Øverland B, Heimdal K, Storhaug K, Asten P, Akre H. Association between obstructive sleep apnea and health-related quality of life in individuals affected with Treacher Collins syndrome. Eur Arch Otorhinolaryngol. 2013; 270:2879–2884. PMID: 23455582.
Article
8. Posnick JC, Ruiz RL. Treacher Collins syndrome: current evaluation, treatment, and future directions. Cleft Palate Craniofac J. 2000; 37:434. PMID: 11034023.
Article
9. Plomp RG, Bredero-Boelhouwer HH, Joosten KF, Wolvius EB, Hoeve HL, Poublon RM, et al. Obstructive sleep apnoea in Treacher Collins syndrome: prevalence, severity and cause. Int J Oral Maxillofac Surg. 2012; 41:696–701. PMID: 22521672.
Article
10. Rachmiel A, Emodi O, Rachmiel D, Aizenbud D. Internal mandibular distraction to relieve airway obstruction in children with severe micrognathia. Int J Oral Maxillofac Surg. 2014; 43:1176–1181. PMID: 25052572.
Article
11. Mohan RP, Verma S, Agarwal N, Singh U. Treacher Collins syndrome: a case report. BMJ Case Rep. 2013; DOI: 10.1136/bcr-2013-009341.
Article
12. Posnick JC. Treacher Collins syndrome: perspectives in evaluation and treatment. J Oral Maxillofac Surg. 1997; 55:1120–1133. PMID: 9331237.
Article
13. Rachmiel A, Emodi O, Aizenbud D. Management of obstructive sleep apnea in pediatric craniofacial anomalies. Ann Maxillofac Surg. 2012; 2:111–115. PMID: 23483041.
Article
14. Morovic CG, Monasterio L. Distraction osteogenesis for obstructive apneas in patients with congenital craniofacial malformations. Plast Reconstr Surg. 2000; 105:2324–2330. PMID: 10845284.
Article
15. Wolford LM, Perez DE. Surgical management of congenital deformities with temporomandibular joint malformation. Oral Maxillofac Surg Clin North Am. 2015; 27:137–154. PMID: 25483449.
Article
16. Diner PA, Kollar E, Martinez H, Vazquez MP. Submerged intraoral device for mandibular lengthening. J Craniomaxillofac Surg. 1997; 25:116–123. PMID: 9234090.
Article
17. Kaban LB, Seldin EB, Kikinis R, Yeshwant K, Padwa BL, Troulis MJ. Clinical application of curvilinear distraction osteogenesis for correction of mandibular deformities. J Oral Maxillofac Surg. 2009; 67:996–1008. PMID: 19375009.
Article
Full Text Links
  • JKAOMS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr