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Related Experiment Videos

Swallowing disorders in Pierre Robin sequence: its correction by distraction.

Fernando Ortíz Monasterio1, Fernando Molina, Fidel Berlanga

  • 1Department of Plastic and Reconstructive Surgery, Hospital General Dr. Manuel Gea González, and Postgraduate Division, Medical School, Universidad Nacional Autónoma de México, Mexico City, Mexico. fortizm@prodigy.net.mx

The Journal of Craniofacial Surgery
|November 18, 2004
PubMed
Summary

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Mandibular distraction surgery significantly improved breathing and swallowing in Pierre Robin sequence patients. This treatment resolved apnea, reflux, and aspiration, enhancing overall respiratory and feeding function.

Area of Science:

  • Craniofacial Surgery
  • Pediatric Otolaryngology
  • Pediatric Pulmonology

Background:

  • Pierre Robin sequence presents with micrognathia, glossoptosis, and feeding issues, often leading to respiratory obstruction, aspiration, and pulmonary infections.
  • Gastroesophageal reflux and sleep-disordered breathing, including apnea, are common complications in patients with Pierre Robin sequence.

Purpose of the Study:

  • To evaluate the efficacy of mandibular distraction osteogenesis in managing swallowing disorders, apnea episodes, and gastroesophageal reflux in patients with Pierre Robin sequence.
  • To assess the impact of mandibular lengthening on respiratory function and pharyngeal transit.

Main Methods:

  • A study involving 18 patients with Pierre Robin sequence undergoing bilateral mandibular distraction osteogenesis.
  • Pre- and post-treatment assessments included polysomnography, barium pharyngoscopy, blood gas analysis, and esophageal pH monitoring.

Related Experiment Videos

  • Mandibular elongation ranged from 7 to 19 mm (mean 12 mm) using external distraction devices.

    • Main Results:

    • Gastroesophageal reflux and apnea episodes resolved in all patients post-distraction.
    • Mean oxygen saturation improved from 72% to 93%, with apnea and hypopnea indices normalizing.
    • Pharyngeal transit time decreased to under 1 second, and abnormal tongue movements and barium stasis were eliminated.

    Conclusions:

    • Mandibular distraction osteogenesis is a highly effective treatment for improving swallowing function, resolving respiratory obstruction, and eliminating gastroesophageal reflux in Pierre Robin sequence.
    • The procedure significantly enhances respiratory parameters and reduces the risk of pulmonary complications associated with this condition.