The Radiographic “Air Sign” in Neonatal Mandibular Distraction Osteogenesis
- 12 October 2021
- journal article
- research article
- Published by SAGE Publications in Plastic Surgery
- Vol. 31 (1), 98-100
- https://doi.org/10.1177/22925503211048529
Abstract
Timing of extubation on post-mandibular distraction osteogenesis (MDO) surgery is critical, given that at baseline these infants have difficult airways and failed extubation requires either re-intubation of an already complex airway with a fragile, recently osteotomized mandible, or adjunctive airway measures such as CPAP that may apply unwanted pressure to the surgical site. Thus, the goal is to plan extubation when the risk of failure is minimal. Currently, there is a void in the literature addressing the timing of extubation post-MDO and no objective sign of extubation readiness has been elucidated. This study describes a simple clinical pearl to assist in the evaluation of extubation readiness in these patients. Postoperatively, we obtain weekly radiographs to assess distractor stability and advancement, and to assess for the “Air Sign”. The Air Sign describes a radiolucent space (air) visualized in the oropharynx on lateral radiographs, likely indicating that the tongue based airway obstruction has been relieved by mandibular advancement.Keywords
This publication has 4 references indexed in Scilit:
- Morphologic and Aerodynamic Changes of Upper Airway in Pediatric Hemifacial Microsomia Patients Undergoing Distraction OsteogenesisThe Journal of Craniofacial Surgery, 2020
- Optimal duration of mechanical ventilation and influencing factors following mandibular distraction osteogenesis in infants with Pierre Robin sequenceMedicine, 2019
- A Simple Mandibular Distraction Protocol to Avoid Tracheostomy in Patients with Pierre Robin SequenceThe Cleft Palate Craniofacial Journal, 2017
- The Effectiveness of Mandibular Distraction in Improving Airway Obstruction in the Pediatric PopulationPlastic and Reconstructive Surgery, 2014