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Mandibular Distraction Osteogenesis (MDO) is a useful procedure that we use to lengthen the lower jaw (mandible) in growing children. It harnesses the power of distraction osteogenesis. MDO can be performed on a patient at any age, but in North Austin we are careful to select the most effective time to use MDO so that we do not have to repeat the surgery multiple times.
A patient with craniofacial microsomia (left) before MDO, (center left) after activation, (center right) during healing, and (right) after healing.
- In MDO, the surgeon makes a cut on the side of the lower jaw (mandible) that they want to lengthen.
- They then apply a distraction device across the cut.
- In some cases, the surgeon places these devices under the skin and attaches them with small screws against the surface of the bone (internal distractors).
An example of mandibular distraction using an internal device, before and during distraction
- In severe cases where there is less bone to attach the device, the surgeon will place small pins into the bone through the skin and the device will be outside the skin (external distractors).
An external mandible distraction device. The pins with white caps go through the skin and are attached to the bone.
- Approximately five days after surgery, we teach you how to turn the device, which slowly separates the cut ends of the bone away from each other.
- In older children, we will ask you to turn the device at a rate of 1mm a day. In infants, we often increase the rate to 2 mm a day.
- This slow turning creates the phenomenon of distraction osteogenesis that will create new bone in the gap once the turning stops.
- Conditions we see that may benefit from MDO include Pierre-Robin Sequence, Craniofacial microsomia, and Treacher Collins syndrome.
- We also can use MDO to treat severe cases of obstructive sleep apnea in children.
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