Pierre Robin Sequence: airway management via mandibular distraction. Case report.

  • Hernán Arango Fernández Servicio de Cirugía Oral y Maxilofacial, Fundación Hospital Universitario Metropolitano. Barranquilla, Colombia.
  • Martha Rebolledo Cobos Departamento de Cirugía Oral, Universidad Metropolitana. Laboratorio de Genética Molecular, Universidad Simón Bolívar. Barranquilla, Colombia.
  • Saulo Pineda Ovalle Servicio de Cirugía Oral y Maxilofacial, Fundación Hospital Universitario Metropolitano. Barranquilla, Colombia.
  • Jonathan Harris Ricardo Departamento de Medicina Oral, Clínica Odontológica de la Corporación Universitaria Rafael Núñez. Cartagena, Colombia.

Abstract

Pierre Robin sequence is a set of congenital conditions characterized by the presence of micrognathia, glossoptosis, cleft palate and obstruction of the airways. The latter can lead to many other complications such as respiratory difficulties, apnea, weight loss and even death. Currently, mandibular distraction, or the lengthening of the mandibular bone, is the most common surgical procedure used to correct a retracted tongue and the airway obstruction it produces in patients with mandibular hypoplasia. The present paper reports the case of a 26-day-old male patient, who presented obstruction on the upper respiratory tract, mandibular retromicrognathia, and retracted tongue and cleft palate, all conditions characteristic to Pierre Robin sequence. The patient also had a medical record of orotracheal intubation due to respiratory difficulties. The subject underwent mandibular distraction surgery with a horizontal vector, which resulted in a satisfactorily cleared airway. 

References

1. Insalaco LF, Scott AR. Peripartum Management of Neonatal Pierre Robin Sequence.Clin Perinatol. 2018;45(4):717-35.
2. Côté A, Fanous A, Almajed A, Lacroix Y. Pierre Robin sequence: review of diagnostic and treatment challenges. Int J Pediatr Otorhinolaryngol. 2015;79(4):451-64.
3. Bütow KW, Morkel JA, Naidoo S, Zwahlen RA. Pierre Robin sequence: Subdivision, data, theories, and treatment - Part 2: Syndromic and nonsyndromic Pierre Robin sequence. Ann Maxillofac Surg. 2016;6(1):35-7.
4. Daniel M, Bailey S, Walker K, Hensley R, Kol-Castro C, Badawi N, Cheng A, Waters K. Airway, feeding and growth in infants with Robin sequence and sleep apnoea. Int J Pediatr Otorhinolaryngol. 2013;77(4):499-503.
5. Greathouse ST, Costa M, Ferrera A, Tahiri Y, Tholpady SS, Havlik RJ, Flores RL. The Surgical Treatment of Robin Sequence. Ann Plast Surg. 2016;77(4):413-9.
6. Martín-Masota R, Osorio-Cámara JM, Martínez-Plaza A, Ocete-Hita E. Distracción mandibular ósea: resultados del postoperatorio inmediato. Rev Esp Cir Oral Maxilofac. 2018;40(1):1-6.
7. Ching JA, Daggett JD, Alvarez SA, Conley CL, Ruas EJ. A Simple Mandibular Distraction Protocol to Avoid Tracheostomy in Patients With Pierre Robin Sequence. Cleft Palate Craniofac J. 2017;54(2):210-5.
8. Couce ML, Baña A, Pérez-Muñuzuri A, Albertos-Castro J, García-Rielo JM, Fraga JM. [Usefulness of mandibular distraction in the Pierre Robin sequence in neonates]. An Pediatr. 2014;80(2):e42-3.
9. Lee JC, Bradley JP. Surgical considerations in pierre robin sequence. Clin Plast Surg. 2014;41(2):211-7.
10. Li WY, Poon A, Courtemanche D, Verchere C, Robertson S, Bucevska M, Malic C, Arneja JS. Airway Management in Pierre Robin Sequence: The Vancouver Classification. Plast Surg. 2017 Feb;25(1):14-20.
11. Resnick CM. Precise osteotomies for mandibular distraction in infants with Robin sequence using virtual surgical planning. Int J Oral Maxillofac Surg. 2018;47(1):35-43.
12. Hong P, Kearns D. Airway characteristics of infants with Pierre Robin sequence who undergo mandibular distraction osteogenesis. Ear Nose Throat J. 2015;94(8):E25-9.
13. Breik O, Tivey D, Umapathysivam K, Anderson P. Mandibular distraction osteogenesis for the management of upper airway obstruction in children with micrognathia: a systematic review. Int J Oral Maxillofac Surg. 2016;45(6):769-82.
14. Sesenna E, Magri AS, Magnani C, Brevi BC, Anghinoni ML. Mandibular distraction in neonates: indications, technique, results. Ital J Pediatr. 2012;38:7.
15. Martínez-Plaza A, Fernández-Valadés R, España-López A, García-Medina B, Capitán Cañadas LM, Monsalve-Iglesias F. Cambios en la dimensión de la vía aérea en pacientes con secuencia de Pierre-Robin asociada a síndromes malformativos tras distracción mandibular: planificación del vector de distracción. Rev Esp Cirug Oral y Maxilofac. 2015, 37(2):71-9.
Published
2019-06-30
How to Cite
ARANGO FERNÁNDEZ, Hernán et al. Pierre Robin Sequence: airway management via mandibular distraction. Case report.. Journal of Oral Research, [S.l.], v. 8, n. 3, p. 244-248, june 2019. ISSN 0719-2479. Available at: <https://www.joralres.com/index.php/JOralRes/article/view/joralres.2019.036>. Date accessed: 24 apr. 2024. doi: https://doi.org/10.17126/joralres.2019.036.
Section
Cases