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[Palatophanyngeal mechanism of Gastroesophageal reflux in Pierre-Robin sequence]
Z Dudkiewicz1, E Sekula, W Piwowar
1Klinika Chirurgii Dzieci i Mlodziezy, Instytut Matki i Dziecka, Kasprzaka 17a, 01-211, Warszawa, Poland.
Insights
Surgical repair of Pierre-Robin sequence effectively treated gastroesophageal reflux (GER) in children. Early intervention improved symptoms, reducing the need for further surgeries.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Craniofacial Anomalies
Context:
- Pierre-Robin sequence is associated with gastroesophageal reflux (GER).
- GER management is crucial for affected children.
- Surgical interventions for Pierre-Robin sequence may impact GER.
Purpose:
- To investigate the prevalence of GER in children with Pierre-Robin sequence.
- To evaluate the efficacy of surgical treatment on GER symptoms.
- To explore the
- palatal mechanism
- of GER in this population.
Summary:
- Thirty-one children with Pierre-Robin sequence underwent surgical treatment between 1993-1998.
- Gastroesophageal reflux (GER) was confirmed in 28 cases prior to surgery.
- Surgical repair (palatoplasty, subperiosteal release of the floor of the mouth, palato-pharyngeal ring repair) led to rapid clinical improvement and early discharge.
- Post-operative follow-up revealed no GER symptoms.
Impact:
- Surgical correction of the palato-pharyngeal ring may resolve the "palatal mechanism" causing GER in Pierre-Robin sequence.
- Early surgical intervention can potentially reduce the need for procedures like glossopexy, gastrostomy, tracheostomy, and Nissen fundoplication.
- This study highlights a link between craniofacial repair and improved GER management in pediatric patients.
Abstract:
During the period between 1993 and 1998 thirty-one children with symptoms of Pierre-Robin sequence were treated. Since gastroesophageal reflux (GER) is known to occur in patients with Pierre - Robin sequence, each child before surgery was checked for GER. In 28 cases GER was confirmed. We obtained rapid clinical improvement and possibility of early discharge from hospital after surgical treatment (palatoplasty, SRFM - subperiosteal release of the floor of the mouth, repair of the palato-pharyngeal ring). Follow up investigations few months after surgery showed no clinical symptoms of GER. The authors find evidence of " palatal mechanism" of GER in Pierre-Robin sequence and in their opinion early closure of the impaired palto-pharyngeal ring and elimination of mechanism causing posterior rotation of the tonque can reduce indications for such surgical procedures as glossopexy, gastrostomy, tracheostomy and Nissen fundoplication.