Surgery of Micrognathia from the Neonate to Early Childhood

Non-syndromal and syndromal branchial arch diseases (Treacher Collins syndrome, Goldenhar syndrome, and Pierre Robin syndrome) present commonly with unilateral or bilateral under-development of the facial skeleton (maxilla and mandibula, zygoma, and temporal bones), the ears, and surrounding soft tissue. The phenotypic expression is variable from mild to severe involving different tissues such as bone, nerve, muscular tissue, and soft tissue to various extents. Micrognathia is one prominent clinical feature, leading often to the necessity of early surgical interventions. In the past, severe neonatal upper airway obstruction secondary to micrognathia was managed with a tracheostomy. Although effective, tracheostomy can cause many short-term and long-term complications. More recently, mandibular distraction osteogenesis (MDO) has become a well-accepted surgical option in treating micrognathia in newborns and infants. In this chapter, we give insight into the surgery of micrognathia patients in infancy and childhood.