Breathe Free — Surgery Saves a Baby's Airway
A special procedure relieves the respiratory problems that threaten an infant.
Most of us take breathing for granted, but for infant Jordan Dolansky, born on May 13, it was a struggle. He was born with Goldenhar syndrome, where the lower jaw is underdeveloped.
"His chin had pushed his tongue and epiglottis back into his airway," explains his mother, Felicia Dolansky of Clinton Corners in Dutchess County. "He could breathe, but it was difficult for him."
"Jordan had no respiratory reserve," explains Gerald Geldzahler, DDS, Chief of Oral and Maxillofacial Surgery at Westchester Medical Center. "A cold could have made him lose his airway."
Doctors feared that, to protect the baby's breathing, a tracheostomy would be needed. That would have meant breathing through his neck, possibly for years. But Dr. Geldzahler had a better solution. On July 19, he performed a procedure called distraction osteogenesis, in which the lower jaw was surgically cut and slightly pulled apart—"distracted"—in tiny increments.
The operation causes a soft callus to develop around the break. Before it can harden, it is stretched further. By turning tiny screws called actuators three times daily for eight days after the operation, Jordan's parents extended his jaw by 15 millimeters.
Westchester is helping to pioneer this procedure for breathing problems, Dr. Geldzahler says. It can sometimes be used to relieve severe cases of obstructive sleep apnea, in which a temporary airway blockage causes many brief nighttime breathing interruptions. He has made presentations on the topic at national and international meetings of specialists. "Very few centers are doing this," he says.
