Lapidot A, Rezvani F, Terrefe D, Ben-Hur N
Laryngoscope. 1976 Jul;86(7):979-83. doi: 10.1288/00005537-197607000-00011.
A functional and simple surgical method for treating the respiratory distress of the neonate affected by Pierre Robin syndrome is described. The base of the tongue is placed in an anterior position via a buried wire suture tied around the body of the hyoid. The method proposed in this paper fulfills the following: 1. It is physiologic since the infant is able to suckle and maintain its nutrition by preserving the function of the mobile portion of the tongue for deglutition. 2. Maintenance of the "pushing" action of the tongue stimulates growth of the mandible. 3. The anchoring wire is not exposed in the oral cavity and the risk of tissue breakdown and infection is eliminated. 4. This technique utilizes the stronger fibrous portion of the mid-tongue rather than muscle which "gives" more readily under pressure. 5. The shortest distance from the base of the tongue to the mid-hyoid provides the best mechanical advantage. 6. The suture, if need be, may be tightened at subsequent periods of time. Under Ketamin (Ketalan) anesthesia the tip of the tongue was held in the forward position. An 18 gauge stainless steel wire was inserted via a large curved needle through the midline of the posterior-most portion at the base of the tongue. The needle was directed anteriorly and inferiorly to emerge below the mid point of the inferior border of the hyoid bone. The opposite end of the wire was then tunneled submucosally to the anterior portion of the base of the tongue at foramen caecum, and directed inferiorly to emerge above the superior border of the mid-portion of the hyoid bone. Through a small skin incision opposite the body of the hyoid bone, both free ends of the wire were tied under tension around the body of the hyoid while pulling the base of the tongue forward. The skin incision was closed with a single nylon suture. A prosthetic obturator was used to close the cleft palate. The outcome was satisfactory with no morbidity.
描述了一种用于治疗患有皮埃尔·罗宾综合征的新生儿呼吸窘迫的实用且简单的手术方法。通过在舌骨体周围系上埋线缝合线，将舌根置于前方位置。本文提出的方法具有以下优点：1. 该方法具有生理性，因为婴儿能够通过保留舌活动部分的吞咽功能进行吸吮并维持营养。2. 维持舌头的“推动”作用可刺激下颌骨生长。3. 固定线未暴露在口腔中，消除了组织破损和感染的风险。4. 该技术利用了舌中部较强的纤维部分，而非在压力下更易变形的肌肉。5. 从舌根到舌骨中部的最短距离提供了最佳的机械优势。6. 如果需要，缝线可在后续时间收紧。在氯胺酮（凯他敏）麻醉下，将舌尖保持在向前位置。通过一根大弯针将一根18号不锈钢丝经舌根最后部的中线插入。针向前下方引导，从舌骨下缘中点下方穿出。然后将钢丝的另一端经黏膜下隧道引至盲孔处舌根的前部，并向下引导，从舌骨中部上缘上方穿出。在舌骨体相对处做一个小皮肤切口，在向前牵拉舌根的同时，将钢丝的两个游离端在张力下系在舌骨体周围。皮肤切口用一根尼龙缝线缝合。使用假体阻塞器关闭腭裂。结果令人满意，无并发症发生。
