Airway obstruction in children with congenital hypoplasia of the mandible.

The aim of this study is to establish the relation between congenital mandibular hypoplasia and upper airway obstruction using a prospective cohort and cross-sectional study design. Furthermore, we aim to analyse the craniofacial growth pattern, feeding problems and mandibular distraction outcome in children with congenital mandibular hypoplasia. Also we will determine the reliablity of ultrasonography compared to 3D-CT scans in measurement of the mandible.

Children with congenital mandibular hypoplasia are at risk for development of airway obstruction.

Exams in both study population 1a / control population 1 b / control population 2 will take place at the age of 3 months, 6 months, 9 months, 1 year, 2 years, 3 years, 4 years and 6 years old.



Exams in study population 1b / control population 1b are cross-sectional and will consist of one study visit.



Exams in study population 2 are cross-sectional and will take place directly after the 3D-CT scan.

This will be an invasive observational study in which patients in both study population 1a and control population 1a / 2 will undergo a number of exams and tests to address objectives 1a / 1b / 2a / 2b. The test and exams are:

1. Polysomnography (for the detecting of OSA, two clinical PSG's in the first year, and thereafter an ambulant PSG once a year);

2. Endoscopy (to assess the type and severity of airway obstruction, in the first year);

3. Lateral skull X-ray (to assess the skull morphometrics, when the child is > 6 year on an annual basis);

4. Ultrasonography (to assess mandibular growth, annually);

5. Jaw-index (to assess mandibular growth, annually);

6. OSA-18/OSA-12 (to assess presence of OSA and QOL, annually).



For the reliabity and validity study of ultrasonography all children in study population 2 (who undergo a 3D-CT scan as part of regular patient care) will get an ultrasound exam of the mandible.