title: A novel technique for performing a tongue-lip adhesion-the tongue suspension technique.
abstract: BACKGROUND
  The tongue-lip adhesion has undergone several modifications in an attempt to reduce surgical complications and failure rates. Current techniques rely on the use of a button at the tongue base for suspension, which raises concerns about possible aspiration and interference with oral motor function and bottle-feeding. A new technique for tongue-lip adhesion is proposed that adds a tongue suspension to the standard surgical adhesion.
  
  
  METHODS
  A total of 22 patients with Pierre Robin sequence who received a tongue-lip adhesion via a tongue suspension technique were reviewed. The surgical technique differs from the standard surgical approach by the use of a suture weave across the base of the tongue instead of a standard button to suspend the tongue anteriorly.
  
  
  RESULTS
  Average age at the time of tongue-lip adhesion was 13.9 days, with a mean operative time of 88.8 minutes. A marked improvement in postoperative oxygenation was seen in the majority of patients. One dehiscence occurred secondary to a traumatic postoperative extubation, eventually requiring a tracheostomy for subglottic stenosis.
  
  
  CONCLUSIONS
  A technical innovation for performing a tongue-lip adhesion using a tongue suspension in conjunction with a standard transverse adhesion of the lip is described. The advantage of the tongue-lip adhesion with suspension includes immediate postoperative extubation, as well as removal of concerns regarding button aspiration and possible interference in early developmental oral motor function and bottle-feeding. This technique is reproducible, expanding the craniofacial surgeon's armamentarium for the management of difficult airways in Pierre Robin sequence.
authors.affiliation: Grand Rapids Medical Education and Research Center/Michigan State University, Grand Rapids, Michigan, USA. robert.mann@devoschildrens.org
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Mann
authors.forename: Keith C
authors.initials: KC
authors.lastname: Neaman
authors.forename: Brian
authors.initials: B
authors.lastname: Hill
authors.forename: Robert
authors.initials: R
authors.lastname: Bajnrauh
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Martin
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008046:Lip / Q000601:surgery*; D008297:Male; D061646:Operative Time; D019647:Oral Surgical Procedures; D010855:Pierre Robin Syndrome / Q000601:surgery*; D014059:Tongue / Q000601:surgery*; D016896:Treatment Outcome