Barr Rebecca M, Khan Sabina A, Shah Manish N, Roy Soham, Teichgraeber John F, Greives Matthew R
*Division of Pediatric Plastic Surgery, Department of Pediatric Surgery †Division of Pediatric Anesthesiology, Department of Anesthesia ‡Departments of Neurosurgery and Pediatric Surgery §Department of Pediatric Otolaryngology, McGovern School of Medicine, University of Texas Health Science Center, Houston and Children's Memorial Hermann Hospital, Houston, TX.
J Craniofac Surg. 2016 Oct;27(7):1674-1676. doi: 10.1097/SCS.0000000000002903.
Many patients with Pierre Robin sequence (PRS) have associated birth defects, most commonly in association with abnormalities in bone or cartilage formation. Depending on severity, treatment of PRS ranges from nonoperative management with prone positioning to surgical intervention such as distraction osteogenesis. Generally, if a surgical approach is needed, these patients undergo nasal endoscopy or direct laryngoscopy with their intubation, which puts the cervical spine in a position of extreme extension. The authors present a patient with syndromic PRS secondary to Sticklers syndrome, with a cervical abnormality diagnosed with three-dimensional computed tomography and further evaluated with dynamic lateral plain x-rays to assess cervical instability. The goal of this report is to highlight the need to include cervical spine evaluation in the preoperation workup of patients with PRS, especially those with suspected abnormalities in bone or collagen formation.
许多患有皮埃尔·罗宾序列征（PRS）的患者伴有先天性缺陷，最常见的是与骨骼或软骨形成异常有关。根据严重程度，PRS的治疗方法从采用俯卧位的非手术治疗到诸如牵张成骨术等手术干预。一般来说，如果需要手术治疗，这些患者在插管时要接受鼻内镜检查或直接喉镜检查，这会使颈椎处于极度伸展的位置。作者介绍了一名继发于斯蒂克勒综合征的综合征性PRS患者，通过三维计算机断层扫描诊断出颈椎异常，并通过动态侧位X线平片进一步评估颈椎稳定性。本报告的目的是强调在PRS患者的术前检查中需要包括颈椎评估，尤其是那些怀疑有骨骼或胶原蛋白形成异常的患者。
