Background: Pierre Robin sequence is characterized by mandibular retrognathia and glossoptosis resulting in airway obstruction and feeding difficulties. When conservative management fails, mandibular distraction osteogenesis or tongue-lip adhesion may be required to avoid tracheostomy. The authors' goal was to prospectively evaluate the airway and feeding outcomes of their comprehensive approach to Pierre Robin sequence, which includes conservative management, mandibular distraction osteogenesis, and tongue-lip adhesion. Methods: A longitudinal study of newborns with Pierre Robin sequence treated at a pediatric academic medical center between 2010 and 2015 was performed. Baseline feeding and respiratory data were collected. Patients underwent conservative management if they demonstrated sustainable weight gain without tube feeds, and if their airway was stable with positioning alone. Patients who required surgery underwent tongue-lip adhesion or mandibular distraction osteogenesis based on family and surgeon preference. Postoperative airway and feeding data were collected. Results: Twenty-eight patients with Pierre Robin sequence were followed prospectively. Thirty-two percent had a syndrome. Ten underwent mandibular distraction osteogenesis, eight underwent tongue-lip adhesion, and 10 were treated conservatively. There were no differences in days to extubation or discharge, change in weight percentile, requirement for gastrostomy tube, or residual obstructive sleep apnea between the three groups. No patients required tracheostomy. The greatest reduction in apnea-hypopnea index occurred with mandibular distraction osteogenesis, followed by tongue-lip adhesion and conservative management. Conclusions: Careful selection of which patients with Pierre Robin sequence need surgery, and of the most appropriate surgical procedure for each patient, can minimize the need for postprocedure tracheostomy. A comprehensive approach to Pierre Robin sequence that includes conservative management, mandibular distraction osteogenesis, and tongue-lip adhesion can result in excellent airway and feeding outcomes. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
http://ift.tt/2oBvcX4
Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com
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- Impact of anti-tumor necrosis factor-α agents on s...
- Understanding patient and physician perceptions of...
- Motorbike-handlebar hernia - a rare traumatic abdo...
- Binaural Interaction Effects of 30-50 Hz Auditory ...
- Salvage Islet Auto Transplantation After Relaparat...
- Hearing Wellness for Musicians
- 10 Lessons From Our First 10 Years
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- Is Auditory Synaptopathy a Result of Drug-Induced ...
- Marketing in Audiology: Multi-layered strategy nee...
- Trial of an Alternate Hearing Aid Delivery Model
- Symptom: Conductive Hearing Loss
- Why is Hearing Loss a Public Health Concern?
- Help Patients ‘Connect the Dots’
- CDC Research on Non-Occupational NIHL
- Manufacturers News
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- Hyper–immunoglobulin E-like syndrome in a patient ...
- Association between atopic manifestations and eosi...
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- Temporal processing and long‐latency auditory evok...
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