Tongue-lip adhesion in Pierre-Robin sequence: Role redefined

Area of Science:

• Craniofacial Surgery
• Pediatric Airway Management
• Neonatal Care

Background:

• Robin sequence presents a triad of retrognathia, glossoptosis, and airway obstruction, often complicated by mandibular hypoplasia affecting feeding, swallowing, and growth.
• While nonsurgical methods manage most cases, selected neonates require surgical intervention for survival.
• Conventional surgical options include tracheostomy, with a shift towards mandibular distraction procedures and, less frequently, tongue-lip adhesion (TLA).

Observation:

• This case highlights a neonate managed successfully with a simple U-stitch tongue-lip adhesion (TLA), a basic principle of TLA procedures.
• The U-stitch technique retracts the tongue forward, directly addressing airway obstruction.

Findings:

• Tongue-lip adhesion (TLA) can be a life-saving intervention for neonatal airway compromise in Robin sequence.
• The procedure effectively alleviates upper airway obstruction, providing a critical window for mandibular and associated structure development.

Implications:

• TLA serves as a valuable, potentially less invasive surgical alternative for securing the airway in neonates with Robin sequence.
• Further research is needed to clarify the comparative efficacy of TLA versus other surgical interventions like mandibular distraction.
• The choice of surgical procedure should consider available resources and surgeon expertise while prioritizing patient survival and optimal development.