Patient Outcomes in Mandibular Distraction Based on Timing of Feeding Initiation.

Abstract

Objective: The aim of this study is to compare the feeding outcomes between patients who underwent mandibular distraction osteogenesis (MDO) surgery; one subset received feeding throughout the distraction period, whereas the other subset was not fed until after distraction completion. The objective is to assess whether initiating feeding during the distraction phase can lead to enhanced postoperative care for patients with airway obstruction secondary to micrognathia or Pierre Robin sequence (PRS).

Study design: Retrospective chart review (2000-2024).

Setting: Single academic institution.

Methods: Data were collected in the REDCap database. Demographics and clinical outcomes were reported with frequency (percent) and mean (standard deviation) for categorical and continuous measures, respectively. Linear regression models were fit to compare groups for continuous outcomes.

Results: Eighty-three patients who underwent MDO for micrognathia at the Children's Hospital of Colorado from 2000 to 2024. For patients who started feeding during distraction, they reached full feeds on average 1.4 days after distraction was complete as compared to 12.8 days for those patients who initiated feeding after distraction was complete (P = .027). In total, 42% of patients who started feeding after distraction was completed achieved full feeds, compared to 72% who started during (P = .01). Patients who were fed after distraction, whether or not they achieved full oral feeds before discharge, had on average a 15-day longer hospital stay than those patients who were fed during distraction (P < .01).

Conclusion: Our findings indicate that initiating feeding while undergoing distraction could result in quicker achievement of full feeds and earlier discharge from the hospital.