8.3 Summary and Conclusions
The development of the accurate techniques for cephalometric roentgenography of infants has made possible a longitudinal study of the growth of the micrognathic mandible. As a result of these studies, useful diagnostic and prognostic information has been obtained to provide a rationale for the management of individual cases.
The lateral cephalometric roentgenogram is a valuable diagnostic aid in assessing the severity of the glossoptosis and its obstruction of the airway. A definite correlation exists between the degree of constriction of the airway and the severity of the clinical state. On the basis of these findings, it is possible to recommend either conservative management or tracheotomy in extreme situations, or distraction osteogenesis. Three cases, out of a larger series of similar cases,were presented to indicate the spectrum of variations to be encountered.
In all instances, it was found that where an adequate metabolic situation was provided and the infant gained weight, mandibular growth during the first few months was sufficient to provide for a natural resolution of the symptoms attending the glossoptosis.
Longitudinal records have indicated that mandibular growth is proportionally adequate to reduce the retrognathic profile and provide an esthetically harmonious facial appearance.
Based on investigations performed during the tenure of Special Research Fellowship from the National Institute of Dental Research Institutes of Health (Dr. Pruzansky, Senior Assistant Dental Surgeon [R], United States Public Health Service, National Institute of Dental Research, Department of Health, Education and Welfare).
KeywordsCleft Palate Hyoid Bone Distraction Osteogenesis Facial Appearance Cranial Vault
Unable to display preview. Download preview PDF.
- 1.Pruzansky S, Richmond JB. Growth of mandible in infants with micrognathia. Am J Dis Child 1954; 88:29–42.Google Scholar
- 2.Robin, P. La glossoptose: un grave danger pour nos enfants. Paris: Gaston Doin; 1929.Google Scholar
- 3.Robin, P. Glossoptosis due to atresia and hypoplasia of the mandible. Am J Dis Child 1934; 48:541–547.Google Scholar
- 4.Eley RC, Farber S. Hypoplasia of the mandible (micrognathy) as a cause of cyanotic attack in newly born infant: Report of 4 cases. Am J Dis Child 1930; 39:1167–1175.Google Scholar
- 5.Davis AD, Dunn R. Micrognathis: a surgical treatment for correction in early infancy. Am J Dis Child 1933; 45:799–806.Google Scholar
- 6.Callister AC. Hypoplasia of the mandible (micrognathy) with cleft palate: treatment in early infancy with skeletal traction. Am J Dis Child 1937; 53:1057–1064.Google Scholar
- 7.Lleweyllyn JS, Biggs AD. Hypoplasia of the mandible: report of case, with resume of literature and suggestions for modified form treatment. Am J Dis Child 1943; 65:440.Google Scholar
- 8.Douglas B. The treatment of micrognathia associated with obstruction by plastic procedure. Plast Reconstruct Surg 1946; 1:300.Google Scholar
- 11.May H, Chun LT. Congenial ankyloglossia (tongue-tie) associated with glossoptosis ( retruded mandible) and palatum fissum (clift palate). Pediatrics 1948; 2:685–687.Google Scholar
- 15.Sjolin S. Hypoplasia of the mandible as a cause of respiratory difficulties in the infant. Acta Paediat 1950; 39:255–261.Google Scholar
- 16.Berkowitz S. Cleft lip and palate-perspectives in management. 1st ed. Little, Brown; 1996.Google Scholar