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New technique for airway correction in neonates with severe Pierre Robin sequence
1Department of Plastic Surgery, Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee, WI 53225, USA. adenny@chw.org
The Journal of Pediatrics
|July 20, 2005
Summary
Distraction osteogenesis effectively treats severe Pierre Robin sequence in neonates by elongating the mandible, improving airway and feeding, and avoiding tracheostomy. This surgical technique offers a safe and effective alternative for affected infants.
Area of Science:
- Craniofacial Surgery
- Pediatric Surgery
- Neonatal Care
Background:
- Severe Pierre Robin sequence presents challenges in neonates, including micrognathia and glossoptosis, often necessitating tracheostomy.
- Airway obstruction and feeding difficulties are significant concerns in affected infants.
Purpose of the Study:
- To evaluate the efficacy of mandibular distraction osteogenesis as an alternative to tracheostomy in neonates with severe Pierre Robin sequence.
- To assess the impact of mandibular lengthening on airway patency, feeding ability, and long-term outcomes.
Main Methods:
- Mandibular distraction osteogenesis was performed on 11 neonates with severe Pierre Robin sequence.
- Patients were monitored for extubation, feeding progression, sleep study results, and growth parameters.
- A 5-year clinical follow-up assessed mandibular shape and dental development.
Main Results:
- All 11 patients were extubated within 3 to 6 days post-distraction.
- Oral feeding was achieved by 54.5% at 1 month and 100% by 1 year.
- Sleep studies normalized within 1 month post-operation for 7 patients.
- Long-term follow-up showed normal mandibular shape and undisturbed tooth eruption.
Conclusions:
- Mandibular distraction osteogenesis is an effective alternative to tracheostomy for selected neonates with severe Pierre Robin sequence.
- The procedure successfully addresses micrognathia, improves airway, and facilitates oral feeding.
- Distraction osteogenesis promotes normal craniofacial growth and dental development in the long term.