Surgical Management of Pierre Robin Sequence: Using Mandibular Distraction Osteogenesis to Address Hypoventilation and Failure to Thrive in Infancy.
Mandibular hypoplasia may present in isolation or in the context of glossoptosis and a U-shaped, incomplete cleft palate. This latter triad is referred to as Pierre Robin sequence. Deleterious effects of micrognathia that may present during infancy are due primarily to glossoptosis or posterior displacement of the tongue. This tongue base prolapse may cause varying degrees of upper airway obstruction. A surgical option for management of tongue base airway obstruction secondary to mandibular hypoplasia is neonatal mandibular distraction osteogenesis. Herein, the author seeks to outline the benefits and limitations of early mandibular distraction osteogenesis as a way of managing airway obstruction and feeding difficulty in newborns with micrognathia. A description of the author's operative technique as well as potential complications and pitfalls will also be discussed.
Department of Otolaryngology and Pediatrics, Tufts University School of Medicine, Cleft Lip and Palate Clinic, Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts.
Andrew R
AR
Scott
D005183:Failure to Thrive / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007040:Hypoventilation / Q000209:etiology / Q000601:surgery*; D007223:Infant; D008334:Mandible / Q000601:surgery*; D019857:Osteogenesis, Distraction / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D010855:Pierre Robin Syndrome / Q000150:complications / Q000601:surgery*; D011182:Postoperative Care; D011300:Preoperative Care