Perioperative management of 19 infants undergoing glossopexy (tongue-lip adhesion) procedure: a retrospective study

Area of Science:

• Pediatric Surgery
• Anesthesiology
• Craniofacial Anomalies

Background:

• Glossopexy (tongue-lip adhesion) is a surgical intervention for infants with Pierre Robin sequence experiencing severe upper airway obstruction and feeding difficulties due to glossoptosis.
• These infants often present with challenging airway anatomy, predicting difficult intubation.
• The procedure anchors the tongue to the lower lip and mandible to alleviate airway obstruction.

Purpose of the Study:

• To retrospectively analyze the perioperative management of infants undergoing glossopexy.
• To evaluate airway management strategies before, during, and after the glossopexy procedure.
• To assess the effectiveness of interventions like nasopharyngeal tubes in maintaining airway patency.

Main Methods:

• Retrospective review of 19 infants who underwent glossopexy between 1992 and 2010.
• Analysis of anesthetic techniques, intubation methods, and postoperative airway management.
• Documentation of patient diagnoses, including Pierre Robin sequence, Treacher Collins syndrome, and Stickler syndrome.

Main Results:

• Seventeen of 19 patients had Pierre Robin sequence; others had Treacher Collins or Stickler syndrome.
• Nasopharyngeal tubes were used during anesthesia induction in all patients.
• Post-extubation, 11 of 12 patients required a nasopharyngeal tube for airway maintenance; 2 patients ultimately required tracheostomy.

Conclusions:

• Careful airway management is essential both preoperatively and postoperatively for infants undergoing glossopexy.
• Nasopharyngeal tubes proved effective in maintaining upper airway patency throughout the perioperative period.
• Glossopexy release surgery, often combined with palate repair, did not necessitate fiberoptic intubation in this cohort.