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[Distraction osteogenesis in a newborn infant with Pierre-Robin sequence]
S Villani1, B Brevi, E Sesenna
1Dienst für Zahn-, Mund- und Kieferheilkunde, Krankenhaus Bruneck, 39031 Bruneck BZ, Italien. sandro.villani@as-brunico.it
Insights
A new extraoral distractor for Pierre Robin sequence in newborns offers a promising solution. This innovative device reduces scarring and complications, improving outcomes for infants with this condition.
Area of Science:
- Craniofacial surgery
- Pediatric surgery
- Biomedical engineering
Background:
- Pierre Robin sequence (PRS) prognosis is often linked to asphyxia and cerebral damage.
- Traditional PRS treatments present challenges and require long-term care.
- Distraction osteogenesis is a promising PRS treatment, especially for newborns.
Observation:
- A novel extraoral distractor was developed for newborns up to 3 months old.
- Two infants, aged 2 and 3 months, were treated with this new device.
- The distractor was specifically designed by the department for neonatal application.
Findings:
- Successful airway management was achieved in both cases, with extubation on postoperative days 7 and 20.
- Significant mandibular length gain was observed: 20 mm in the first case and 15 mm in the second.
- The new distractor minimized pin-related complications and scarring.
Implications:
- This novel extraoral distractor offers a safer and more effective treatment for PRS in newborns.
- Reduced scarring and fewer complications can lead to improved long-term aesthetics and function.
- The device's design addresses limitations of traditional distraction osteogenesis in infants.
Background:
The prognosis for Pierre Robin sequence is often closely correlated with direct postnatal asphyxia (ARDS) and permanent cerebral damage. Unfortunately, all of the well-known treatments entail many problems, which often lead to medical care of the patient for many years. Distraction osteogenesis was recently introduced as a very promising procedure. We revised this concept for newborn children aged up to 3 months.
Materials And Methods:
The first patient was operated with an extraoral distractor at an age of approx. 3 months. The second patient was operated at an age of approx. 2 months. A new distractor was used, conceived specifically by our department for newborn children.
Results:
Distraction osteogenesis was successful in both cases. After 20 days the first patient was able to breathe without the tracheotomy cannula. In the second case, we removed the nasopharyngeal tube successfully on the 7th postoperative day. The bilateral length gain amounted to 20 mm in the first case and 15 mm in the second.
Discussion:
The usual jaw distraction osteogenesis has many disadvantages in babies: scar formation in the places depressed by pins and early pin loss. For the above-mentioned reasons, we developed a new type of extraoral distractor, which solves these problems. Less required space and the absence of pins resulting in fewer disfiguring scars are the clinical advantages of this new distractor.