Micrognathia, also known as mandibular hypoplasia, is a condition where the lower jaw is smaller than the upper jaw and the rest of the mouth. While the severity of micrognathia will vary from person to person, most cases will result in a noticeable difference between the upper and lower jaws. This size differential can then lead to eating, sleeping, swallowing, and breathing difficulties because the jaw puts pressure on the tongue and prevents it from functioning normally.
In all cases, micrognathia is present at birth and is often due to genetic mutations inherited from the mother or father. In rare cases, micrognathia can happen because of complications during birth or pregnancy. Regardless of why it happens, however, it is important to have micrognathia diagnosed and treated promptly to prevent potential complications.
In some cases, no treatment is needed to correct micrognathia. Mild cases of the condition will auto correct as the child ages, and the lower jaw will grow to a completely normal size. However, monitoring and self-correction only work in very mild cases, so it is important to remain vigilant in the event that further treatment is necessary. While every situation is different, if the jaw does not improve before 18 months of age, corrective surgery is necessary.
In most cases, micrognathia will require reconstructive surgery to make the lower jaw the same size as the upper jaw. There are several basic types of surgery that can be done depending on how shrunken the jaw is and the visibility of the overall damage to the face.
To temporarily ensure that your child’s tongue does not block their airway, your doctor may perform a tongue-lip adhesion. During this procedure, the tongue is attached to the lower lip.
A mandibular distraction osteogenesis surgery is the most common procedure to correct serious cases of micrognathia. During this procedure, the lower jaw is lengthened and enlarged to match the size of the upper jaw. This form of plastic surgery will help your child’s face have a normal appearance.
In serious cases where your child’s airway is severely blocked, and there is no way around it, they may need a tracheostomy. Tracheostomies are procedures where your doctor essentially creates a new airway to bypass an obstruction. While this will not repair the lower jaw, it sometimes accompanies a mandibular distraction osteogenesis.
While nonsurgical treatments cannot necessarily correct the size and shape of the lower jaw, they can help prevent potential complications. This is important because most children do not qualify for corrective surgery until they are at least 18 months old. In the meantime, they may experience eating, sleeping, and swallowing difficulties that can only be helped with nonsurgical treatments.
By positioning your baby as they sleep, you can help prevent sleep apnoea and other sleep-time breathing difficulties.
If sleep positioning is not enough to keep your infant breathing as they sleep, they may need a CPAP machine. CPAP machines keep a constant flow of air flowing into your child’s lungs.
A nasopharyngeal tube is a special tube that gets inserted through one or both nostrils to keep the airways open.
While micrognathia is a frightening condition, especially for parents, it is a very treatable one. If the lower jaw does not correct itself within the first 18 months of your child’s life, they will require one or more corrective surgeries to help them breathe and to make it so their lower jaw matches their upper jaw. They may also need nonsurgical treatments to ensure they are breathing, eating, and sleeping properly and safely.