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Utility of the Ultrasonic Scalpel in Mandibular Distraction Osteogenesis

Chung, Cyndi Uy MS*†; Yu, Jason W. DMD, MD; Bastidas, Nicholas MD*†; Bartlett, Scott P. MD*†; Taylor, Jesse Adam MD*†

Journal of Craniofacial Surgery:
doi: 10.1097/SCS.0b013e31825196b4
Original Articles
Abstract

Abstract: The purpose of this study was to describe our technique of bilateral mandibular distraction for micrognathia and to highlight the ultrasonic scalpel as an alternative to conventional saws in performing osteotomies for mandibular distraction osteogenesis. To do so, we retrospectively reviewed all patients who underwent mandibular distraction with an ultrasonic scalpel for tongue-based upper airway obstruction due to micrognathia between 2010 and 2011.

Study outcome measures include operative blood loss, length of surgery, postoperative complications, and avoidance of a tracheostomy. Excel (Microsoft) was used to calculate averages, P values (2-tailed Student t test), and SDs for operative data, sleep studies, and cephalometric analysis.

Nine patients—7 females and 2 males—were distracted for a mean distance of 17 ± 6 mm. Mean blood loss was 15 ± 7 mL, and the average length of surgery was 111 ± 27 minutes. One patient returned to the operating room for debridement/washout of a wound infection, but distraction was continued without sequelae. There were no other postoperative complications. Resolution of airway obstruction was evidenced by clinical examination and avoidance of a tracheostomy in all cases.

Based on these data, we feel that mandibular distraction with univector, internal distractors, and ultrasonic osteotomies at the mandibular angle is safe and efficacious at relieving tongue-based upper airway obstruction and avoiding a tracheostomy.

Author Information

From the *Division of Plastic Surgery, Children’s Hospital of Philadelphia;†University of Pennsylvania Perelman School of Medicine; and ‡Department of Oral and Maxillofacial Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Received December 29, 2011.

Accepted for publication February 21, 2012.

Address correspondence and reprint requests to Jesse A. Taylor, MD, 3400 Spruce St, 10 Penn Tower, Philadelphia, PA 19104; E-mail: taylorj5@email.chop.edu

The authors report no conflicts of interest.

© 2012 Mutaz B. Habal, MD