Browse > Article

SURGICAL TREATMENT OF AIRWAY OBSTRUCTION IN INFANTS WITH PIERRE ROBIN SEQUENCE  

Ryu, Sun-Youl (Department of Oral and Maxillofacial Surgery, College of Dentistry, Dental Science Research Institute, Chonnam National University)
Lee, Young-Uk (Department of Oral and Maxillofacial Surgery, College of Dentistry, Dental Science Research Institute, Chonnam National University)
Seo, Il-Young (Department of Oral and Maxillofacial Surgery, College of Dentistry, Dental Science Research Institute, Chonnam National University)
Publication Information
Journal of the Korean Association of Oral and Maxillofacial Surgeons / v.30, no.3, 2004 , pp. 237-245 More about this Journal
Abstract
The deformities of micrognathia and glossoptosis in the newborn are frequently associated with a cleft palate, which is known as Pierre Robin sequence. Upper airway obstruction is the most serious problem in these patients. Treatment of Pierre Robin sequence includes either positional or surgical intervention. Mild cases are often managed in the prone position. However, when the patient fails to thrive due to chronic upper airway obstruction, or severe respiratory distress ensures despite positional treatment, surgical intervention is mandatory to relieve the obstruction. We experienced three infants with Pierre Robin sequence who showed a symptom triad of micrognathia, glossoptosis, and cleft palate. Intermittent cyanosis, depression of the chest, respiratory difficulty and feeding problems were also observed. To relieve severe upper airway obstruction caused by micrognathia and glossoptosis, we simultaneously performed modified tongue lip adhesion (TLA) and a subperiosteal release of the floor of the mouth (SRFM). Respiratory and feeding difficulties were relieved, the tongue positioned anteriorly, body weight increased, and mandibular growth improved. Simultaneous TLA and SRFM may constitute a simple and reliable method for surgical treatment of airway obstruction in patients with Pierre Robin sequence.
Keywords
Pierre Robin sequence; Airway obstruction; Surgical treatment;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Randall P: The Robin sequence: micrognathia and glossoptosis with airway obstruction. In Converse J (ed): Reconstructive Plastic Surgery, 3rd ed. Vol 4, Philadelphia, Saunders, 1999;3123-3134
2 Robin P: Backward lowering of the root of the tongue causing respiratory disturbance. Bull Acad Natl Med 1923;89:37-41
3 Caouette-Laberge L, Bayet B, Larocque Y: The Pierre Robin sequence: review of 125 cases and evolution of treatment modalities. Plast Reconstr Surg 1994;93:934-942   DOI   PUBMED   ScienceOn
4 Delorme R-P, Larocque Y, Caouette-Laberge L : Innovative surgical approach for the Pirre Robin anomalad: Subperiosteal release of the floor of the mouth musculature. Plast Reconst Surg 1989;83:960-966   DOI   ScienceOn
5 Argamaso AE: Glossopexy for upper airway obstruction in Robin sequence. Cleft Palate Craniofac J 1992;29:232-238   DOI   ScienceOn
6 Pruzansky S, Richmond JB: Growth of the mandible in infants with micrognathia. Am J Dis Child 1954;88:29
7 Augarten A, Sagy M, Yahav J, Barzilay Z: Management of upper airway obstruction in the Pierre Robin syndrome. Br J Oral Maxillofac Surg 1990;28:105-108   DOI   ScienceOn
8 Smith JD : Treatment of airway obstruction in Pirre Robin syndrome. Arch Otolaryngol 1981;107:419-421   DOI   PUBMED
9 Douglas B: The treatment of micrognathia associated with obstruction by a plastic procedure. Plast Reconstr Surg 1946;1:300-308   DOI
10 Sher AE : Mechanisms of airway obstruction in Robin sequence: implication for treatment. Cleft Palate-Craniofac J 1992;29:224-23   DOI   ScienceOn
11 Routledge RT: The Pierre Robin syndrome: A surgical emergency in the neonatal period. Br J Plast Surg. 1960;13:204-218   DOI   PUBMED   ScienceOn
12 Cruz MJ, Kerschner JE, Beste DJ, Conley SF: Pierre Robin sequence: secondary respiratory difficulties and intrinsic feeding abnormalities. Laryngoscope 1999;109:1632-1636   DOI   ScienceOn
13 Parsons RW, Smith DJ : A modified tongue-lip adhesion for Pierre-Robin anomalad. Cleft Palate J 1980;17:144-147   PUBMED
14 Farnsworth PB, Pacik PT: Glossoptotic hypoxia and micrognathia: the Pierre Robin syndrome revisited. Clin Pediatr 1971;10:600
15 Pashayan HM, Lewis MB: Clinical experience with the Robin sequence. Cleft Palate J 1984;21:270-276
16 Frohberg U, Lange R: Surgical treatment of Robin sequence and sleep apnea syndrome: case report and review of literature. J Oral Maxillofac Surg 1993;51: 1274-1277   DOI   PUBMED   ScienceOn
17 Myer CM, Reed JM, Cotton RT, Willging JP, Shott SR: Airway management in Pierre Robin sequence. Otolayngol Head Neck Surg 1998;118:630-635   DOI   ScienceOn