This patient was born with a very small lower jaw. This caused her tongue to crowd into the back of her throat, preventing normal breathing. To make breathing possible, an opening was surgically placed through the front of the neck and into the windpipe. This procedure is called a tracheostomy. During this patient’s first six years of life, she managed with her tracheostomy. As the rest of her body grew, her lower jaw did not grow at all. By the time she was 6 years old, her jaw was still the size of a 2-year-old’s and she could not breathe without her tracheostomy.
At age 6, this patient had surgery during which her lower jaw was lengthened by 25 mm (about 1 inch). Conventional jaw surgery would not achieve the needed amount of lengthening. Distraction osteogenesis was used to reconstruct the lower jaw. The surgical techniques and instruments were developed by Beyond Faces’ surgeons. Using this method, special titanium distraction devices were placed onto the jaw bone through the mouth. These devices, when tightened, caused the lower jaw to grow.
After healing from the surgery, this patient was able to breathe normally, the tracheostomy was removed, and the hole in the neck closed. This allowed this patient to lead a normal life, unrestrained from the tracheosotomy and inability to eat regularly. But as is the case with many children who have craniofacial disorders, the underlying growth problem persisted.
Between the ages of 6 and 15, this patient's lower jaw did not grow properly. She developed bite problems that needed additional treatment. The treatment, therefore, did not end with the surgery at 6 years old. We typically follow our patients for their entire childhood and beyond. At this time, this patient is undergoing a second treatment phase involving orthodontics and orthognathic surgery (a special type of facial bone surgery). Since most girls complete jaw growth by age 16, this patient should not need further surgery after orthognathic procedure.