If your child has a very small jawbone, your doctor may recommend surgery to make it larger. This helps with breathing and chewing.
The options include subcranial rotation distraction and a bone graft. The team will talk with you about the best choice for your child.
Subcranial rotation distraction
For children who have had a breathing tube inserted into their windpipe (tracheostomy), we recommend subcranial rotation distraction. Usually it is done when your child is 6 to 10 years old.
Seattle Children’s Craniofacial Center is the first to use subcranial rotation distraction to improve the airway and jaw position in children with Treacher Collins syndrome. The goal is to allow a child to breathe without a tube in their windpipe. Surgeons around the world are adopting our approach.
Subcranial rotation distraction gets better results than the traditional treatment because it combines 2 separate procedures: mandible distraction and Le Fort II nasomaxillary advancement.
Performing both procedures at the same time makes a bigger correction in the backwards jaw rotation caused by this syndrome. The combined surgery helps open your child’s airway and improve their breathing.
Read more about subcranial rotation distraction.
A bone graft is used instead of distraction if the joint that connects your child’s jawbone to their skull (temporomandibular joint) is not stable.
- Surgeons use a piece of bone from your child’s rib to lengthen the jawbone or make a new jaw joint.
- Surgeons take the bone graft from a single rib through a small incision on your child’s chest.
- After surgery, the new bone in the jaw will become hard and strong. The bone that was taken from the rib will often grow back.
- Doctors first consider this option when your child is 4 to 7 years old.