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Outcomes after tongue-lip adhesion or mandibular distraction osteogenesis in infants with Pierre Robin sequence and

P Papoff1, G Guelfi, R Cicchetti

  • 1Pediatric Emergency and Intensive Care, Sapienza University of Rome, Umberto I Policlinico, Rome, Italy.

International Journal of Oral and Maxillofacial Surgery
|August 28, 2013
PubMed

Insights

Tongue-lip adhesion (TLA) and mandibular distraction osteogenesis (MDO) both help infants with Pierre Robin sequence (PRS) breathing issues. MDO offers faster oral feeding and better airway stability, despite a longer hospital stay.

Area of Science:

  • Craniofacial Surgery
  • Pediatric Airway Management
  • Congenital Anomalies

Background:

  • Pierre Robin sequence (PRS) is a congenital condition characterized by micrognathia, glossoptosis, and airway obstruction.
  • Severe breathing difficulties in infants with PRS often necessitate surgical intervention when conservative treatments fail.

Purpose of the Study:

  • To compare the outcomes of tongue-lip adhesion (TLA) and mandibular distraction osteogenesis (MDO) in infants with severe PRS-related breathing difficulties.
  • To evaluate the efficacy of TLA versus MDO in terms of respiratory support weaning and oral feeding resumption.

Main Methods:

  • A retrospective, single-centre study (2002-2012) included 18 infants with severe PRS-related airway obstruction.
  • Patients underwent either TLA (n=9) or MDO (n=9) for airway management.
  • Primary outcomes included successful weaning from respiratory support and achievement of full oral feeding.

Main Results:

  • Both TLA and MDO resulted in successful weaning from respiratory support for most infants (8/9 MDO, 9/9 TLA).
  • Residual respiratory distress post-discharge was more frequent after TLA (6/9) compared to MDO (1/9).
  • Infants undergoing MDO resumed full oral feeding significantly sooner (44±24 days) than those treated with TLA (217±134 days).

Conclusions:

  • Both TLA and MDO are safe and effective surgical options for infants with severe PRS-related airway obstruction.
  • While MDO may lead to a longer hospital stay, it provides more efficient airway stabilization and faster oral feeding resumption compared to TLA.

Keywords:
Airway obstructionMandibular distractionPierre Robin sequenceTongue–lip adhesion

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