Burstein Fernando D, Williams Joseph K
Center for Craniofacial Disorders, Children's Healthcare of Atlanta, and the Division of Plastic and Reconstructive Surgery, Emory University, Atlanta, Ga, USA.
Plast Reconstr Surg. 2005 Jan;115(1):61-7; discussion 68-9.
Pierre Robin sequence may result in physiologically significant obstructive apnea in the neonatal and infant period. This may be life threatening and is most often treated by tracheostomy. To avoid tracheostomy or allow for early decannulation in severely affected infants and children, the authors have developed a new class of neonatal and infant mandibular bone distraction devices. These devices require a single operative procedure for placement and no operative removal is necessary. Fifteen infants (aged 7 days to 11 months; mean age, 3 months) and five children (aged 2 to 8 years; mean age, 5.5 years), 10 boys and 10 girls, with severe obstructive apnea and Pierre Robin sequence were treated with the mandibular infant devices over a 24-month period. Tracheostomy was avoided in 14 patients, whereas five of six patients who had previous tracheostomy were decannulated after mandibular distraction. The final tracheostomy status in one patient will be determined after surgery for gastroesophageal reflux. There were no major complications and no structural device failures.
皮埃尔·罗宾序列征可能在新生儿期和婴儿期导致具有生理意义的阻塞性呼吸暂停。这可能危及生命，最常通过气管造口术进行治疗。为了避免气管造口术或使严重受影响的婴幼儿能够早期拔管，作者开发了一种新型的新生儿和婴儿下颌骨牵张装置。这些装置只需进行一次手术即可放置，无需手术取出。在24个月的时间里，15名婴儿（年龄7天至11个月；平均年龄3个月）和5名儿童（年龄2至8岁；平均年龄5.5岁），共10名男孩和10名女孩，患有严重阻塞性呼吸暂停和皮埃尔·罗宾序列征，接受了下颌婴儿装置治疗。14例患者避免了气管造口术，而6例先前接受气管造口术的患者中有5例在进行下颌骨牵张后拔管。1例患者的最终气管造口状态将在胃食管反流手术后确定。未发生重大并发症，也没有结构装置故障。
