Zenha Horácio, Azevedo Luis, Rios Leonor, Pereira Alberto, Pinto Armindo, Barroso Maria Luz, Costa Horácio
Plastic, Reconstructive & Craniomaxillofacial Surgery Unit, Centro Hospitalar Vila Nova Gaia/Espinho, Gaia, Portugal ; Plastic Surgery and Burns Unit, Hospitais da Universidade de Coimbra, Coimbra, Portugal.
Craniomaxillofac Trauma Reconstr. 2012 Mar;5(1):25-30. doi: 10.1055/s-0031-1300960.
Children with craniofacial abnormalities associated with retromicrognathia and glossoptosis often have compromised upper airway flow. In severe cases, emergency intubation is necessary immediately after birth, and tracheostomy is advocated to manage the airway in the neonatal period and to allow for feeding. Early intervention with bilateral mandibular osteogenesis avoids the need for tracheostomy, along with its complications, and it targets the primary etiologic factor of the problem-the anomalous anatomy of the mandible. We report two neonates with severe Pierre Robin sequence managed with bilateral mandibular distraction osteogenesis on day 9 and day 11 of life. The surgical techniques and distraction and consolidation periods were similar apart from the distraction devices used. The procedures were successful with early extubation (day 5 and day 7), oral feeding tolerance (day 11 and day 13) and hospital discharge (day 19 and day 18). Total mandibular distraction was 19 mm and 23.45 mm, respectively. No major complications were reported. Medium to long-term results were good. Bilateral mandibular distraction osteogenesis in the neonate is a safe and accurate procedure and is the primary option in cases of selected severe Pierre Robin sequence.
患有与小下颌后缩和舌后坠相关的颅面畸形的儿童，其上呼吸道气流通常会受到影响。在严重的情况下，出生后需立即进行紧急插管，并且提倡在新生儿期进行气管切开术以管理气道并便于喂养。早期进行双侧下颌骨成骨术可避免气管切开术及其并发症，并且针对问题的主要病因——下颌骨的异常解剖结构。我们报告了两名患有严重皮埃尔·罗宾序列征的新生儿，分别在出生后第9天和第11天接受了双侧下颌骨牵张成骨术。除了使用的牵张装置外，手术技术以及牵张和巩固期相似。手术成功，患儿分别在第5天和第7天拔管，在第11天和第13天耐受经口喂养，并在第19天和第18天出院。下颌骨总的牵张长度分别为19毫米和23.45毫米。未报告重大并发症。中长期结果良好。新生儿双侧下颌骨牵张成骨术是一种安全且精确的手术，是某些严重皮埃尔·罗宾序列征病例的主要选择。
