Maxillofacial Department, Hospital del Salvador, Children's Hospital Exequiel González Cortés, Santiago, Chile.
Int J Oral Maxillofac Surg. 2011 May;40(5):471-4. doi: 10.1016/j.ijom.2011.01.003. Epub 2011 Feb 16.
Pierre Robin sequence is a pathology derived from alteration in the first and second branchial arch. Patients have breathing problems due to micrognathia and glossoptosis, causing severe upper airway obstruction. One surgical treatment is distraction osteogenesis. Three patients with Pierre Robin sequence (case 1, 3 months old; cases 2 and 3, 1 month old) with severe upper airway obstruction requiring mechanical ventilator assistance, underwent mandibular distraction osteogenesis prematurely with a new anchoring system, thus avoiding tracheostomy and its consequences. An intraoral approach was used to avoid scarring. A new anchoring device with transfixing Kirschner wire in the proximal (mandibular ramus) and distal segment (chin zone) was used. This diminishes the risk of distractor device displacement, guaranteeing optimal stability. A more anterior installation reduces the risk of damaging tooth buds in the mandibular body and the inferior alveolar nerve. The more anterior the fixation, the more horizontal the distraction vector becomes. The position and stability of the device are crucial. In these three patients the placement of two transfixing Kirschner wires using an intraoral approach showed good results and stability during the period of distraction and consolidation, with optimal results on the upper airway, avoiding tracheostomy.
Pierre Robin 序列是一种源自第一和第二鳃弓改变的病理学。患者由于小下颌和舌下垂而存在呼吸问题，导致严重的上气道阻塞。一种手术治疗是牵引成骨术。三名患有 Pierre Robin 序列（病例 1，3 个月大；病例 2 和 3，1 个月大）的患者，上气道严重阻塞，需要机械通气辅助，使用新的锚固系统提前进行下颌骨牵引成骨术，从而避免气管切开术及其后果。采用口腔内入路避免了疤痕形成。使用近端（下颌支）和远端（颏部区域）带有贯穿克氏针的新型锚固装置。这降低了牵引器装置移位的风险，保证了最佳的稳定性。更靠前的安装降低了损伤下颌体和下牙槽神经中牙胚的风险。固定装置越靠前，牵引矢量变得越水平。装置的位置和稳定性至关重要。在这三个患者中，使用口腔内入路放置两根贯穿克氏针的方法显示出良好的效果和在牵引和巩固期间的稳定性，对上气道有最佳的效果，避免了气管切开术。
