Abstract:
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.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Khansa I,Hall C,Madhoun LL,Splaingard M,Baylis A,Kirschner RE,Pearson GDdoi
10.1097/PRS.0000000000003167subject
Has Abstractpub_date
2017-04-01 00:00:00pages
975e-983eissue
4eissn
0032-1052issn
1529-4242pii
00006534-201704000-00039journal_volume
139pub_type
杂志文章abstract::Despite the existence of basic clinical standards in plastic surgery, specific guidelines for body contour photography have not been detailed previously. In this report we propose standard and supplemental views for positioning of the subject for suction-assisted lipectomy and body contour surgery. Also demonstrated a...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199707000-00034
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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doi:10.1097/PRS.0b013e3181a07625
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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doi:10.1097/00006534-199505000-00010
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000260636.43385.90
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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更新日期:1998-07-01 00:00:00
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journal_title:Plastic and reconstructive surgery
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更新日期:2012-09-01 00:00:00