Nakao Takako, Katayama Misato, Fujimori Yasushi, Kawai Shuichi, Nuri Takashi, Ueda Koichi
Department of Plastic and Reconstructive Surgery, Osaka Medical College, Takatsuki City 569-8686; Kawai Orthodontic Dental Clinic, Takatsuki City 569-0804.
Plast Reconstr Surg Glob Open. 2020 Feb 6;8(2):e2651. doi: 10.1097/GOX.0000000000002651. eCollection 2020 Feb.
Robin sequence is a congenital anomaly, first described by Pierre Robin as a triad of micrognathia, upper airway obstruction and glossoptosis. The most significant airway management technique is the use of distraction osteogenesis to advance the mandible. On the other hand, late complications such as permanent dentition loss and malformation of the damaged teeth have been reported. Therefore, long-term follow-up after mandibular distraction is important. In our case report, we describe 17 years of follow-up after mandibular distraction performed in a 4-month-old male infant with Robin sequence. The patient was a male with a cleft palate. The tracheotomy and tongue-lip adhesion was performed 1 month after birth, because the percutaneous oxygen saturation decreased to 70% during feeding and crying. However, postoperative X-ray examination revealed that he could not obtain sufficient airway after the operation. For the purpose of closing the tracheotomy early, we performed bilateral mandibular distraction at the age of 4 months. The bilateral corticotomy was performed on the mandibular body and an internal traction device was placed. The mandible was bilaterally lengthened by 17.5 mm, and expansion of the airway was confirmed by X-ray. A cleft palate operation was performed at the age of 17 months. At the age of 3 years, the tracheostomy orifice closed and speech/language training and orthodontics were begun. Dental panoramic radiographs showed favorable mandibular growth. No additional operation has been performed. Finally, his orthodontic treatment was completed without any complications at age 17.
罗宾序列征是一种先天性异常，最初由皮埃尔·罗宾描述为小下颌、上呼吸道梗阻和舌后坠三联征。最重要的气道管理技术是使用牵引成骨术来推进下颌骨。另一方面，已报告有诸如恒牙缺失和受损牙齿畸形等晚期并发症。因此，下颌骨牵引后的长期随访很重要。在我们的病例报告中，我们描述了一名患有罗宾序列征的4个月大男婴接受下颌骨牵引后17年的随访情况。该患者为男性，患有腭裂。出生后1个月进行了气管切开术和舌唇粘连术，因为喂养和哭闹时经皮血氧饱和度降至70%。然而，术后X线检查显示术后气道仍未充分建立。为了尽早关闭气管切开术，我们在4个月大时进行了双侧下颌骨牵引。在下颌骨体部进行双侧皮质切开术并放置内部牵引装置。双侧下颌骨延长了17.5毫米，X线证实气道得到了扩张。17个月大时进行了腭裂手术。3岁时，气管造瘘口闭合，开始进行言语/语言训练和正畸治疗。牙科全景X线片显示下颌骨生长良好。未进行其他手术。最后，他在17岁时完成了正畸治疗，未出现任何并发症。
