Indianapolis, Ind. From the Division of Plastic Surgery, Riley Hospital for Children, Indiana University School of Medicine.
Plast Reconstr Surg. 2013 Aug;132(2):419-421. doi: 10.1097/PRS.0b013e3182958a54.
Mandibular distraction osteogenesis is an established technique used to treat infants with Pierre Robin sequence associated with severe airway obstruction. The authors present a 7-year retrospective review of all patients with Pierre Robin sequence treated with mandibular distraction osteogenesis. Recorded variables included improvements in apnea/hypopnea index and postintervention tracheostomy. Multiple preoperative variables were assessed for association with successful mandibular distraction osteogenesis or tracheostomy. Fifty patients were identified for this study. Four patients (8 percent) required tracheostomy after distraction. A Fisher's exact test demonstrated no statistical association of tracheostomy with prematurity, low birth weight, preoperative intubation, late intervention, genetic syndromes, cardiac abnormalities, pulmonary abnormalities, or gastrostomy tube. The absence of a cleft palate, gastroesophageal reflux disease, and need for Nissen fundoplication were associated with failure of distraction.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
下颌骨牵引成骨术是一种成熟的技术，用于治疗伴有严重气道阻塞的 Pierre Robin 序列的婴儿。作者对所有接受下颌骨牵引成骨术治疗的 Pierre Robin 序列患者进行了 7 年的回顾性研究。记录的变量包括呼吸暂停/低通气指数的改善和术后气管切开术。评估了多个术前变量与下颌骨牵引成骨术或气管切开术成功的相关性。本研究共纳入 50 例患者。4 例患者（8%）在牵引后需要行气管切开术。Fisher 确切检验显示，气管切开术与早产、低出生体重、术前插管、晚期干预、遗传综合征、心脏异常、肺部异常或胃造口管无统计学关联。无腭裂、胃食管反流病和需要行 Nissen 胃底折叠术与牵引失败相关。
临床问题/证据水平：治疗，IV。
