Hsieh Sun T, Woo Albert S
Department of Plastic Surgery, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, 2 Dudley Street, Suite 500, Providence, RI 02905, USA.
Pediatric Plastic Surgery, Craniofacial Program, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, 2 Dudley Street, Suite 180, Providence, RI 02905, USA.
Clin Plast Surg. 2019 Apr;46(2):249-259. doi: 10.1016/j.cps.2018.11.010. Epub 2019 Feb 8.
Pierre Robin sequence consists of clinical triad of micrognathia, glossoptosis, and airway compromise with variable inclusion of cleft palate. Evaluation of airway obstruction includes physical examination, polysomnography for obstruction events, and a combination of nasoendoscopy and bronchoscopy to search for synchronous obstructive lesions. A multidisciplinary approach is required given the high rate of syndromic disease. Management of airway obstruction and feeding starts with nonsurgical maneuvers, such as prone and lateral positioning, nasopharyngeal stenting, and continuous positive airway pressure. Surgical management includes mandibular distraction and tongue-lip adhesion. Subglottic obstruction and central sleep apnea may best be treated with tracheostomy.
皮埃尔·罗宾序列征由小颌畸形、舌后坠和气道受压三联征组成,腭裂的纳入情况各不相同。气道梗阻的评估包括体格检查、用于阻塞事件的多导睡眠监测,以及鼻内镜检查和支气管镜检查相结合以寻找同步阻塞性病变。鉴于综合征性疾病的高发病率,需要多学科方法。气道梗阻和喂养问题的管理首先采用非手术措施,如俯卧位和侧卧位、鼻咽支架置入和持续气道正压通气。手术管理包括下颌骨牵张和舌唇粘连。声门下梗阻和中枢性睡眠呼吸暂停可能最好通过气管切开术治疗。