title: Bilateral mandibular distraction osteogenesis in the neonate with pierre robin sequence and airway obstruction: a primary option.
abstract: Children with craniofacial abnormalities associated with retromicrognathia and glossoptosis often have compromised upper airway flow. In severe cases, emergency intubation is necessary immediately after birth, and tracheostomy is advocated to manage the airway in the neonatal period and to allow for feeding. Early intervention with bilateral mandibular osteogenesis avoids the need for tracheostomy, along with its complications, and it targets the primary etiologic factor of the problem-the anomalous anatomy of the mandible. We report two neonates with severe Pierre Robin sequence managed with bilateral mandibular distraction osteogenesis on day 9 and day 11 of life. The surgical techniques and distraction and consolidation periods were similar apart from the distraction devices used. The procedures were successful with early extubation (day 5 and day 7), oral feeding tolerance (day 11 and day 13) and hospital discharge (day 19 and day 18). Total mandibular distraction was 19 mm and 23.45 mm, respectively. No major complications were reported. Medium to long-term results were good. Bilateral mandibular distraction osteogenesis in the neonate is a safe and accurate procedure and is the primary option in cases of selected severe Pierre Robin sequence.
authors: Plastic, Reconstructive & Craniomaxillofacial Surgery Unit, Centro Hospitalar Vila Nova Gaia/Espinho, Gaia, Portugal ; Plastic Surgery and Burns Unit, Hospitais da Universidade de Coimbra, Coimbra, Portugal.
authors: Horácio
authors: H
authors: Zenha
authors: Luis
authors: L
authors: Azevedo
authors: Leonor
authors: L
authors: Rios
authors: Alberto
authors: A
authors: Pereira
authors: Armindo
authors: A
authors: Pinto
authors: Maria Luz
authors: ML
authors: Barroso
authors: Horácio
authors: H
authors: Costa
keywords: Pierre Robin; distraction osteogenesis; mandibular distraction; micrognathia