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Scientific Oral Presentation

Pediatric Otolaryngology

Feasibility of Pediatric Mandibular Distraction Osteogenesis Using Low Profile Plates (2x2) in Neonates

Monday, October 19, 2026
8:12 AM - 8:18 AM PT
Location: 409AB

    Presenting Author(s)

  • Dylan K. Thompson, BS

    Medical Student
    Vanderbilt University School of Medicine
    Nashville, Tennessee, United States

    • Co-Author(s)

  • Kalpnaben R. Patel, MD,CCRP

    Pediatric Otolaryngology Research Coordinator
    Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center
    Franklin, TN, United States

    • Senior Author(s)

  • Ryan H. Belcher, MD, MPH

    Associate Professor
    Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center
    Nashville, Tennessee, United States

Disclosure(s):
Kalpnaben R. Patel, MD,CCRP:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Ryan H. Belcher, MD, MPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Mandibular distraction osteogenesis (MDO) is the preferred intervention in pediatric patients with tongue-base obstruction secondary to micrognathia. While MDO hardware with 3x3 plates are the most commonly used devices, no study has yet reported patient outcomes when a less invasive MDO device, with 2x2 plates and fewer screws, is used.

Methods: A retrospective chart review gathered all micrognathia patients who received MDO using a 2x2 plating system from 2017 to 2025 at our tertiary-care hospital system. Patient demographics and outcomes were extracted from the medical record. Descriptive statistics were generated and compared to existing literature.

Results: Twenty-four pediatric patients who received MDO using 2x2 plates were included. At MDO, respiratory status varied with 41.7% of patients on room-air (ORA) with side-lying or prone positioning, 25.0% intubated, 12.5% on high-flow nasal cannula (NC), 8.3% on NC, 8.3% ORA with nasal trumpet, and 4.2% with prior tracheostomy. 54.2% of patients received feeds by nasogastric or orogastric tube, 20.8% by G-tube, 16.7% per os, and 8.3% by total parenteral nutrition. Device failure and surgical site infection (SSI) occurred in 8.3% and 25.0% of cases, respectively. Following MDO, 57.9% of patients without prior G-tube avoided G-tube placement, and 79.2% of patients without prior tracheostomy avoided tracheostomy creation. Rates of device failure (Fisher’s Exact Test, p = 0.059) and SSI (p = 0.101) were not significantly different than published values. Avoidance of tracheostomy (p = 1.00) and avoidance of additional airway procedure (p = 0.272) were found to be similar to published values.

Conclusions: The use of less invasive 2x2 plating systems for MDO is a feasible method of relieving tongue-base obstruction secondary to micrognathia in our patient population. Our study demonstrated post-surgical tracheostomy and additional airway procedure are prevented at rates similar to that seen in literature. Larger, multi-center, studies are needed to further explore the rates of SSI and device failure in MDO using 2x2 plating systems.