Application of Temporary Tongue-Lip Traction During the Initial Period of Mandibular Distraction in Pierre Robin Sequence.

Nam, Hyun Jae; Lee, Joon Ho; Kim, Yong Ha

Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2008;35(3):349-353.
Published online May 1, 2008.

Application of Temporary Tongue-Lip Traction During the Initial Period of Mandibular Distraction in Pierre Robin Sequence.

Hyun Jae Nam, Joon Ho Lee, Yong Ha Kim

Department of Plastic and Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, Korea. kimyon@yumail.ac.kr

Abstract

PURPOSE
There are 3 well-known surgical procedures to treat Pierre Robin sequence: tongue-lip adhesion, distraction osteogenesis of mandible, and tracheostomy. The classical tongue-lip adhesion is an effective way to keep airway. The tongue, however, becomes quite non-mobile and appears dormant until the patient could control upper airway and the adhesion can be maintained for prolonged period. Most of all, this procedure does not provide the correction of the micrognathia. Distraction osteogenesis is a good technique to correct micrognathia and to prevent tracheostomies in patients with Pierre Robin sequence. But airway keeping procedure is needed during the distraction period. The purpose of this study is to determine the usefulness of temporary tongue-lip traction during the initial period of mandibular distraction in Pierre Robin sequence patients with severe airway problems requiring operative procedure. METHODS: It was a prospective study of 2 Pierre Robin sequence patients aged between 4 months and 6 months requiring surgical procedure to correct recurrent and severe pulmonary complications. Two patients underwent distraction osteogenesis of mandible. During the operation, deep one tension suture was performed to tract the tongue and lip. When the patient gained control of upper airway at the initial period of distraction and micrognathia was corrected, the traction suture was removed.
RESULTS
All patients were followed up. No patients complained severe pulmonary complications and tracheostomy could be avoided. No patients had severe pulmonary complication. The pulmonary condition of patients was good.
CONCLUSION
In severe Pierre Robin sequence case, temporary tongue-lip traction is a good assistant method in distraction osteogenesis because this method can avoid tracheostomy.

Keywords: Pierre Robin sequence; Tongue-lip traction; Distraction osteogenesis