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
Summary
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.
- 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.