Respiratory distress in Pierre Robin sequence: an experience with mandible traction by wires

• Published in: International journal of oral and maxillofacial surgery Vol. 40; no. 5; pp. 464 - 470
• Main Authors: Baciliero, U, Spanio di Spilimbergo, S, Riga, M, Padula, E
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.05.2011; Elsevier
• Subjects: Airway Obstruction - etiology; Airway Obstruction - surgery; Biological and medical sciences; Bone Wires; Cleft Palate - therapy; Consumer Behavior; Dentistry; Female; Follow-Up Studies; glossoptosis; Humans; Infant; Infant, Newborn; Intubation; Intubation, Gastrointestinal; Male; Mandible - surgery; mandibular traction; Medical sciences; Nasopharynx; neonatal respiratory distress; Otorhinolaryngology. Stomatology; Oximetry; Oxygen - blood; Palatal Obturators; Parents - psychology; Pierre Robin sequence; Pierre Robin Syndrome - complications; Pneumology; Prolapse; Prone Position; Respiratory Insufficiency - etiology; Respiratory Insufficiency - surgery; Respiratory system : syndromes and miscellaneous diseases; retrognathia; Retrognathia - etiology; Retrognathia - surgery; Retrospective Studies; Surgery; Tongue Diseases - congenital; Traction - methods; Treatment Outcome; neonatal respiratory distress; glossoptosis; retrognathia; mandibular traction; Pierre Robin sequence; Human; Mandible; Neonatal; Respiratory disease; Stomatology; Pierre Robin syndrome; Wire; Traction; Newborn; Treatment; Surgery; Respiratory distress
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1016/j.ijom.2010.11.014

Abstract Congenital retrognathia and glossoptosis characterize isolated Pierre Robin sequence (iPRS); the small mandible and its retracted position cause retrodisplacement of the tongue and reduction of the oropharyngeal airway. These neonates may be affected by airway obstruction, feeding difficulties, failure to thrive, and chronic hypoxaemia. To solve the respiratory problems secondary to glossoptosis, various treatments have been described including prone positioning, a nasopharyngeal tube, glossopexy, and mandibular distraction. Over the last 28 years, the authors have treated 118 neonates and infants affected by iPRS by carrying out traction of the mandible using two parasymphyseal wires, positioned under local anaesthesia. All the procedures were successful, with no major complication. The patients’ respiratory problems and apnoea disappeared suddenly after beginning traction.