Cozzi Francesco, Totonelli Giorgia, Frediani Simone, Zani Augusto, Spagnol Lorna, Cozzi Denis A
Pediatric Surgery Unit, University of Rome "La Sapienza," 00161 Rome, Italy.
J Pediatr Surg. 2008 Feb;43(2):296-8. doi: 10.1016/j.jpedsurg.2007.10.015.
In infants with Pierre Robin syndrome (PRS), mandibular distraction may be more advantageous than glossopexy as it not only relieves oropharyngeal airway obstruction but also reverses body growth retardation. Because no data are available on body weight velocity after glossopexy, we assessed longitudinally the body weight velocity in a cohort of children undergoing glossopexy.
The records of 48 infants with PRS undergoing glossopexy after unsuccessful nonoperative treatment between 1981 and 2005 were reviewed. Weight measurements were analyzed at 4 time-points: at birth, on admission for glossopexy, on admission for lysis of lip-tongue adhesion (TLA), and at follow-up. Weight velocity was assessed using Tanner's tables.
Adhesion dehiscence occurred in 9 patients (18.7%). Lip-tongue adhesion resolved airway compromise in 36 infants (75%). Release of TLA was accomplished in 34 patients. Data on weight velocity from birth to follow-up (mean, 5.57 +/- 0.59 years) were available for 31 patients. After glossopexy, mean body weight increased from the 9.7 +/- 2.6th to the 17.5 +/- 4.6th percentile (P > .05), whereas mean weight velocity increased from the 19.1 +/- 4.9th to the 74.2 +/- 4.7th percentile (P < .001). No temporal correlation was found between glossopexy and oropharyngeal dysphagia.
In infants with PRS, glossopexy is a valid alternative to mandibular distraction because it does not cause decline in body growth.
在患有皮埃尔·罗宾综合征（PRS）的婴儿中，下颌骨牵张术可能比舌粘连松解术更具优势，因为它不仅能缓解口咽气道梗阻，还能逆转身体生长发育迟缓。由于目前尚无关于舌粘连松解术后体重增长速度的数据，我们对一组接受舌粘连松解术的儿童的体重增长速度进行了纵向评估。
回顾了1981年至2005年间48例非手术治疗失败后接受舌粘连松解术的PRS婴儿的病历。在4个时间点分析体重测量数据：出生时、接受舌粘连松解术入院时、接受唇舌粘连松解术（TLA）入院时以及随访时。使用 Tanner 表格评估体重增长速度。
9例患者（18.7%）发生粘连裂开。舌粘连松解术缓解了36例婴儿（75%）的气道受压情况。34例患者完成了TLA松解。31例患者有从出生到随访（平均5.57±0.59岁）的体重增长速度数据。舌粘连松解术后，平均体重从第9.7±2.6百分位增加到第17.5±4.6百分位（P>.05），而平均体重增长速度从第19.1±4.9百分位增加到第74.2±4.7百分位（P<.001）。未发现舌粘连松解术与口咽吞咽困难之间存在时间相关性。
在患有PRS的婴儿中，舌粘连松解术是下颌骨牵张术的有效替代方法，因为它不会导致身体生长发育下降。
