Journal of the Korean Association of Oral and Maxillofacial Surgeons

  • 제34권4호
  • /
  • Pages.460-467
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  • 2008
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  • 2234-7550(pISSN)
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  • 2234-5930(eISSN)
대한구강악안면외과학회 (The Korean Association of Oral and Maxillofacial Surgeons)
권호 표지

Pierre Robin sequence 환아에서 하악골신장술

MANDIBULAR DISTRACTION OSTEOGENESIS IN AN INFANT WITH PIERRE ROBIN SEQUENCE: REPORT OF A CASE

  • 유선열 (전남대학교 치의학전문대학원 구강악안면외과학교실, 전남대학교 치의학연구소) ;
  • 권준경 (전남대학교 치의학전문대학원 구강악안면외과학교실, 전남대학교 치의학연구소) ;
  • 김선국 (전남대학교 치의학전문대학원 구강악안면외과학교실, 전남대학교 치의학연구소)
  • Ryu, Sun-Youl (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • Kwon, Jun-Kyong (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • Kim, Sun-Kook (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University)
  • 발행 : 2008.08.29
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초록

Pierre Robin sequence as a symptom triad of micrognathia, glossoptosis, and cleft palate results in upper airway obstruction and feeding problems. If mild, it is often managed in the prone position. When positional treatment fails, however, surgical intervention such as tongue-lip adhesion, tracheostomy, and mandibular distraction osteogenesis is mandatory to relieve airway obstruction. There has been growing interest in the application of distraction osteogenesis for the management of craniofacial abnormalities. The mandibular distraction osteogenesis to newborns may prevent the airway obstruction, decrease the potential tracheostomy, and reduce the likehood of orthognathic surgery after growth. We experienced an infant with Pierre Robin sequence who showed mandibular hypoplasia, glossoptosis, incomplete cleft palate, intermittent cyanos is, depression of the chest, and respiratory difficulty associated with airway obstruction. We treated the airway obstruction by tongue-lip adhesion at 2 weeks of age, and treated the mandibular retrognathism and depression of the chest byusing internal mandibular distraction osteogenesis at 7 month of age. The mandible moved forwardly, the upper airway space was enlarged, and the antero-posterior distance of the mandible was elongated after the mandibular distraction. Mandibular distraction osteogenesis may be a promising technique to avoid the need of tracheostomy and orthognathic surgery, and to correct airway obstruction in infants with congenital craniofacial malformation.

키워드

참고문헌

  1. 유선열, 이용욱, 서일영: Pierre Robin sequence 환자에서 기도 폐색의 외과적 치료. 대한구강악안면외과학회지 2004;30(3):237-245
  2. Caouette-Laberge L, Bayet B, Larocque Y: The Pierre Robin sequence: review of 125 cases and evolution of treatment modalities. Plast Reconstr Surg 1994;93(5):934-942 https://doi.org/10.1097/00006534-199404001-00006
  3. Smith JD: Treatment of airway obstruction in Pierre Robin syndrome. A modified lip-tongue adhesion. Arch Otolaryngol 1981;107(7):419-421 https://doi.org/10.1001/archotol.1981.00790430021005
  4. Tomaski SM, Zalzal GH, Saal HM: Airway obstruction in the Pierre Robin sequence. Laryngoscope 1995;105(2):111-114 https://doi.org/10.1288/00005537-199502000-00001
  5. Perkins JA, Sie KC, Milczuk H, Richardson MA: Airway management in children with craniofacial anomalies. Cleft Palate Craniofac J 1997;34(2):135-140 https://doi.org/10.1597/1545-1569(1997)034<0135:AMICWC>2.3.CO;2
  6. Marcus CL, Ward SL, Mallory GB, Rosen CL, Beckerman RC, Weese-Mayer DE, et al.: Use of nasal continuous positive airway pressure as treatment of childhood obstructive sleep apnea. J Pediatr 1995;127(1):88-94 https://doi.org/10.1016/S0022-3476(95)70262-8
  7. McCarthy JG: The role of distraction osteogenesis in the reconstruction of the mandible in unilateral craniofacial microsomia. Clin Plast Surg 1994;21:625-631
  8. Cohen SR, Simms C, Burstein FD: Mandibular distraction osteogenesis in the treatment of upper airway obstruction in children with craniofacial deformities. Plast Reconstr Surg 1998;101(2):312-318 https://doi.org/10.1097/00006534-199802000-00008
  9. Moore MH, Guzman-Stein G, Proudman TW, Abbott AH, Netherway DJ, David DJ: Mandibular lengthening by distraction for airway obstruction in Treacher-Collins syndrome. J Craniofac Surg 1994;5(1):22-25 https://doi.org/10.1097/00001665-199402000-00006
  10. Morovic CG, Monasterio L: Distraction osteogenesis for obstructive apneas in patients with congenital craniofacial malformations. Plast Reconstr Surg 2000;105(7):2324-2330 https://doi.org/10.1097/00006534-200006000-00003
  11. Sidman JD, Sampson D, Templeton B: Distraction osteogenesis of the mandible for airway obstruction in children. Laryngoscope 2001;111(7):1137-1146 https://doi.org/10.1097/00005537-200107000-00004
  12. Denny AD, Talisman R, Hanson PR, Recinos RF: Mandibular distraction osteogenesis in very young patients to correct airway obstruction. Plast Reconstr Surg 2001;108(2):302-311 https://doi.org/10.1097/00006534-200108000-00004
  13. Izadi K, Yellon R, Mandell DL, Smith M, Song SY, Bidic S, et al. : Correction of upper airway obstruction in the newborn with internal mandibular distraction osteogenesis. J Craniofac Surg 2003;14(4):493-499 https://doi.org/10.1097/00001665-200307000-00019
  14. Chigurupati R, Massie J, Dargaville P, Heggie A: Internal mandibular distraction to relieve airway obstruction in infants and young children with micrognathia. Pediatr Pulmonol 2004;37(3):230-235 https://doi.org/10.1002/ppul.10426
  15. Douglas B: The treatment of micrognathia associated with obstruction by a plastic procedure. Plast Reconstr Surg 1946;1:300-308 https://doi.org/10.1097/00006534-194611000-00007
  16. Delorme RP, Larocque Y, Caouette-Laberge L: Innovative surgical approach for the Pierre Robin anomalad: Subperiosteal release of the floor of the mouth musculature. Plast Reconstr Surg 1989;83:960-966 https://doi.org/10.1097/00006534-198906000-00004
  17. Conway WA, Victor LD, Magilligan DJ, Jr., Fujita S, Zorick FJ, Roth T: Adverse effects of tracheostomy for sleep apnea. JAMA 1981;246(4):347-350 https://doi.org/10.1001/jama.246.4.347
  18. McCarthy JG, Schreiber J, Karp N, Thorne CH, Grayson BH: Lengthening the human mandible by gradual distraction. Plast Reconstr Surg 1992;89(1):1-10 https://doi.org/10.1097/00006534-199289010-00001
  19. Ilizarov GA: The tension-stress effect on the genesis and growth of tissues: part I, the influence of stability of fixation and soft-tissue preservation. Clin Orthop 1989:238-249
  20. Ilizarov GA: The tension-stress effect on the genesis and growth of tissues: part II. The influence of the rate and frequency of distraction. Clin Orthop 1989:239-263