The surgical correction of pierre robin sequence

Mandibular distraction osteogenesis versus tongue-lip adhesion

Roberto L. Flores, Sunil S. Tholpady, Shawkat Sati, Grant Fairbanks, Juan Socas, Matthew Choi, Robert J. Havlik

Research output: Contribution to journalArticle

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Abstract

Background:: The authors present an outcomes analysis of mandibular distraction osteogenesis versus tongue-lip adhesion in the surgical treatment of Pierre Robin sequence. Methods:: A retrospective, 15-year, single-surgeon review was undertaken of all nonsyndromic neonates with Pierre Robin sequence treated with mandibular distraction osteogenesis (2004 to 2009; n = 24) or tongue-lip adhesion (1994 to 2004; n = 15). Outcomes included time of extubation, length of intensive care unit stay, incidence of tracheostomy, and surgical complications. Polysomnography data were collected 1 month and 1 year postoperatively. Sleep study data included changes in oxygen saturation and apnea-hypopnea index. Results:: There were no postprocedure tracheostomies in the mandibular distraction osteogenesis group and four tracheostomies in the tongue-lip adhesion group. The preoperative oxygen saturations were significantly lower in the mandibular distraction osteogenesis group compared with tongue-lip adhesion (76.5 percent versus 82 percent; p <0.05). Preoperative apnea-hypopnea index was significantly higher in the mandibular distraction osteogenesis group compared with the tongue-lip adhesion group (47 versus 37.6; p <0.05). Despite these preoperative differences, patients undergoing mandibular distraction osteogenesis demonstrated significantly higher oxygen saturation levels at 1 month (98.3 percent versus 87.5 percent; p <0.05) and 1 year postoperatively (98.5 percent versus 89.2 percent; p <0.05) and lower apnea-hypopnea index at 1 month (10.9 versus 21.6; p <0.05) and 1 year postoperatively (2.5 versus 22.1; p <0.05) compared with tongue-lip adhesion. Surgical complications were comparable between the two groups. Conclusions:: In nonsyndromic patients with Pierre Robin sequence, mandibular distraction osteogenesis demonstrates superior outcome measures regarding oxygen saturation, apnea-hypopnea index, and incidence of tracheostomy compared with tongue-lip adhesion.

Original languageEnglish (US)
Pages (from-to)1433-1439
Number of pages7
JournalPlastic and Reconstructive Surgery
Volume133
Issue number6
DOIs
StatePublished - 2014
Externally publishedYes

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Pierre Robin Syndrome
Distraction Osteogenesis
Lip
Tongue
Tracheostomy
Apnea
Oxygen
Tissue Adhesions
Polysomnography
Incidence
Intensive Care Units
Sleep
Outcome Assessment (Health Care)
Newborn Infant

ASJC Scopus subject areas

  • Surgery

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The surgical correction of pierre robin sequence : Mandibular distraction osteogenesis versus tongue-lip adhesion. / Flores, Roberto L.; Tholpady, Sunil S.; Sati, Shawkat; Fairbanks, Grant; Socas, Juan; Choi, Matthew; Havlik, Robert J.

In: Plastic and Reconstructive Surgery, Vol. 133, No. 6, 2014, p. 1433-1439.

Research output: Contribution to journalArticle

Flores, Roberto L. ; Tholpady, Sunil S. ; Sati, Shawkat ; Fairbanks, Grant ; Socas, Juan ; Choi, Matthew ; Havlik, Robert J. / The surgical correction of pierre robin sequence : Mandibular distraction osteogenesis versus tongue-lip adhesion. In: Plastic and Reconstructive Surgery. 2014 ; Vol. 133, No. 6. pp. 1433-1439.
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