“…Although overtreating may sound like a safer option to potentially avoid deaths and life-threating complications, surgeries come with complications as well. In particular, MDO, despite having a high success rate, is associated with postoperative complications including infection, inferior alveolar and marginal mandibular nerve damage, mandibular growth disturbances, tooth bud damage, relapse of distracted bone, temporomandibular joint ankyloses, and death; hence, a narrower threshold is needed for surgical intervention based on physiologic effects of airway obstruction (Allen, 2005; da Silva Freitas et al, 2008; Tibesar et al, 2010; Paes et al, 2013; Lam et al, 2014; Murage et al, 2014; Tsang et al, 2015; Verlinden et al, 2015; Paes et al, 2016). We currently advocate for definitive airway placement if the patient is in severe respiratory distress requiring endotracheal intubation.…”