The effect of glossopexy on weight velocity in infants with Pierre Robin syndrome.
OBJECTIVE
In infants with Pierre Robin syndrome (PRS), mandibular distraction may be more advantageous than glossopexy as it not only relieves oropharyngeal airway obstruction but also reverses body growth retardation. Because no data are available on body weight velocity after glossopexy, we assessed longitudinally the body weight velocity in a cohort of children undergoing glossopexy.


METHODS
The records of 48 infants with PRS undergoing glossopexy after unsuccessful nonoperative treatment between 1981 and 2005 were reviewed. Weight measurements were analyzed at 4 time-points: at birth, on admission for glossopexy, on admission for lysis of lip-tongue adhesion (TLA), and at follow-up. Weight velocity was assessed using Tanner's tables.


RESULTS
Adhesion dehiscence occurred in 9 patients (18.7%). Lip-tongue adhesion resolved airway compromise in 36 infants (75%). Release of TLA was accomplished in 34 patients. Data on weight velocity from birth to follow-up (mean, 5.57 +/- 0.59 years) were available for 31 patients. After glossopexy, mean body weight increased from the 9.7 +/- 2.6th to the 17.5 +/- 4.6th percentile (P > .05), whereas mean weight velocity increased from the 19.1 +/- 4.9th to the 74.2 +/- 4.7th percentile (P < .001). No temporal correlation was found between glossopexy and oropharyngeal dysphagia.


CONCLUSIONS
In infants with PRS, glossopexy is a valid alternative to mandibular distraction because it does not cause decline in body growth.
Cozzi
Francesco
F
Pediatric Surgery Unit, University of Rome "La Sapienza," 00161 Rome, Italy. francesco.cozzi@uniroma1.it
Totonelli
Giorgia
G
Frediani
Simone
S
Zani
Augusto
A
Spagnol
Lorna
L
Cozzi
Denis A
DA
D002657:Child Development / Q000502:physiology*; D015331:Cohort Studies; D003680:Deglutition Disorders / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D019647:Oral Surgical Procedures / Q000379:methods*; D010855:Pierre Robin Syndrome / Q000175:diagnosis / Q000601:surgery*; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D014059:Tongue / Q000002:abnormalities / Q000601:surgery*; D016896:Treatment Outcome; D015430:Weight Gain