Weight Gain in Infants With Pierre Robin Sequence: A Comparison of Nonsurgical Orthodontic Airway Plate Versus Surgical Mandibular Distraction Osteogenesis

Objective To compare weight gain in infants with PRS treated with nonsurgical orthodontic airway plate (OAP) or surgical mandibular distraction osteogenesis (MDO). Design Retrospective cohort study. Setting Single tertiary-care pediatric center. Patients Neonates and infants with PRS at a single institution from 2016 to 2023. Interventions Nonsurgical OAP or surgical MDO, with or without gastrostomy tube (GT) placement. Main Outcome Measures Weight, weight-for-age (WFA) percentile, and WFA Z-score were analyzed at four timepoints: at birth (T0), start of treatment (T1), end of treatment (T2), and end of observation (T3, approximately 12 months of age). Fisher’s exact, two-tailed paired t -test, and mixed effect models were used to compare groups. Results Twenty OAP-treated and sixteen MDO-treated infants with two MDO-Subgroups based on oral feeds status at T3. There were no differences in comorbidities between groups. GT was inserted in no infants in OAP and nine infants in MDO. The hospital stay and total treatment duration were 13.1 days (± 4.8) and 4.3 months (± 0.98) in OAP and 20.8 days (± 11.2) and 4.6 months (± 0.99) in MDO, respectively. There was no difference in weight parameters between OAP and MDO at any time point. All infants in OAP achieved full oral feeds significantly earlier than MDO ( p < . 001). Conclusions Weight gain in infants with PRS treated with either OAP alone or MDO ± GT at a single institution was similar during the first year of life.