Subperiosteal release of the floor of the mouth in Pierre Robin sequence: experience with 12 cases.
Between 1983 and 1995, 12 children with Pierre Robin sequence were treated with a subperiosteal release of the floor of the mouth (SRFM) to correct severe upper-airway obstruction (group 1: n = 10) and prolonged feeding difficulties (group 2: n = 2). Eight children had isolated Pierre Robin sequence, while four had associated anomalies. The age at surgery was 2 to 13 weeks (mean, 5.2 wk) in group 1, and 8.5 months to 5 years in group 2. Postoperative endotracheal intubation was maintained for 1 to 14 days, and nasopharyngeal intubation for 3 to 13 days. One child with a tracheostomy prior to SRFM was decanulated 11 weeks postoperatively. Postoperative course was uneventful and control polysomnograms (group 1) showed a marked improvement of the obstructive phenomenons and O2 saturation levels. Children were discharged 2 to 6 weeks postoperatively (mean, 4 wk) except for the child with a tracheostomy (19 wk). The only complication was a wound infection treated with systemic antibiotics. Oral feedings were initiated shortly after extubation: six children were discharged with oral feedings only, one child required supplemental gavages for 6 weeks at home, and three children had persistent inadequate oral intake. We have found SRFM to be an effective surgical procedure for the management of infants with Pierre Robin sequence.
Caouette-Laberge
L
L
Division of Plastic Surgery, Hôpital Sainte-Justine, Université de Montreal, Quebec, Canada.
Plamondon
C
C
Larocque
Y
Y
D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery*; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009060:Mouth Floor / Q000601:surgery*; D009334:Neck Muscles / Q000601:surgery*; D010855:Pierre Robin Syndrome / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D012891:Sleep Apnea Syndromes / Q000209:etiology / Q000601:surgery; D014059:Tongue / Q000503:physiopathology* / Q000601:surgery