Article
Glossopexy for upper airway obstruction in a patient with Pierre Robin Sequence
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Published: | March 26, 2015 |
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Introduction: Pierre Robin sequence (PRS) is a congenital malformation. One of its typical sign is micrognathia, which often causes retroposition of the tongue with possible significant airway obstruction and feeding difficulties. The symptoms usually disappear around one year of the age, when the lower jaw, the oropharynx, and tongue musculature are more developed. If conservative treatment is not sufficient, a surgical procedure such as a tongue-lip adhesion can be performed.
Material/Methods: The case report of premature twin baby with PRS is presented. The baby was born at 27th gestation week by Caesarean operation with typical signs of PRS included micrognatia. Immediate postnatal adaptation was good. However, at the age of four month repeated episodes of desaturation occurred. Retroposition of the tongue and very narrow retrolingual space was diagnosed using flexible endoscopy. Repeated episodes of desaturation happened again, so that labioglossopexy was performed. Dehiscence of the suture with repeated episodes of desaturation occurred 11th day after surgery. So that a new tongue-lip adhesion was performed. Further course was uneventful. Three month after surgrery is child doing well, without any episodes of desaturation.
Results: Labioglossopexy (tongue-lip adhesion) is an effective procedure of treatment the respiratory obstruction associated with retroposition of the tongue typical for PRS. Surgical technique and its advantages and possible complications are discussed.
Conclusions: Labioglossopexy in patients with PRS should be balanced against the other operations, namely tracheostomy and mandibular distraction. Labioglossopexy is less invasive method then tracheostomy, simplifies nursing care, shortens hospital stay and makes homecare less demanding.
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