Respiratory distress in Pierre Robin sequence: an experience with mandible traction by wires.
Congenital retrognathia and glossoptosis characterize isolated Pierre Robin sequence (iPRS); the small mandible and its retracted position cause retrodisplacement of the tongue and reduction of the oropharyngeal airway. These neonates may be affected by airway obstruction, feeding difficulties, failure to thrive, and chronic hypoxaemia. To solve the respiratory problems secondary to glossoptosis, various treatments have been described including prone positioning, a nasopharyngeal tube, glossopexy, and mandibular distraction. Over the last 28 years, the authors have treated 118 neonates and infants affected by iPRS by carrying out traction of the mandible using two parasymphyseal wires, positioned under local anaesthesia. All the procedures were successful, with no major complication. The patients' respiratory problems and apnoea disappeared suddenly after beginning traction.
Cleft Center and Maxillofacial Unit at the Hospital of Vicenza, San Bortolo Hospital, Via Rodolfi 37, 36100 Vicenza, Italy.
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U
Baciliero
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Spanio di Spilimbergo
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Riga
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Padula
D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery; D001864:Bone Wires; D002972:Cleft Palate / Q000628:therapy; D003258:Consumer Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007440:Intubation; D007441:Intubation, Gastrointestinal; D008297:Male; D008334:Mandible / Q000601:surgery*; D009305:Nasopharynx; D010092:Oximetry; D010100:Oxygen / Q000097:blood; D010158:Palatal Obturators; D010290:Parents / Q000523:psychology; D010855:Pierre Robin Syndrome / Q000150:complications*; D011391:Prolapse; D016684:Prone Position; D012131:Respiratory Insufficiency / Q000209:etiology / Q000601:surgery*; D063173:Retrognathia / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D014060:Tongue Diseases / Q000151:congenital; D014143:Traction / Q000379:methods*; D016896:Treatment Outcome
D010100:Oxygen