P47. Mandibular Ramus Versus Body Distraction Osteogenesis in the Treatment of Pierre Robin Sequence: Does Osteotomy Location Matter? A Systematic Review and Meta-analysis
Bibliographic record
Abstract
PURPOSE: Mandibular distraction osteogenesis (MDO) is a common surgical intervention for severe upper airway obstruction (UAO) in Pierre Robin Sequence (PRS); however, consensus regarding the location and outcomes of MDO by osteotomy sites is lacking. This study aims to compare outcomes of the two common approaches to MDO - mandibular body (MB) and mandibular ramus (MR) osteotomies - in PRS. METHODS: A systematic review and meta-analysis of studies reporting techniques and outcomes of MDO in PRS over the last 50 years was conducted. Forest plots by osteotomy type were constructed using pooled proportions for the primary outcome of failure to resolve UAO. RESULTS: Sixty articles yielded 1,148 patients with MDO at an average of 10 months old and follow-up of 34.6 months. Proportion of failure of UAO reversal was 0.0035 [0.0000; 0.0309] for MB and 0.0293 [0.0052; 0.0656] for MR, with no statistically significant difference between osteotomy sites (p= 0.9212). Subgroup analyses by age at MDO, distractor type, distraction rates and length also revealed no statistically significant differences. Thirty-eight studies reported at least one complication (54.84% of MB studies; 72.41% MR), however, these findings should be interpreted with caution as differences in thresholds for reporting complications might exist. CONCLUSION: Both MB and MR osteotomies are highly effective forms of MDO in treating UAO in PRS infants; however, they carry risk of complication. Further research is needed to assess the impact of osteotomy site on long-term outcomes and whether the difference in complication rates would persist in a controlled comparison.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.023 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.030 |
| Bibliometrics | 0.004 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".