ABSTRACT
The author presents the results of management of newborns and infants with Robin sequence (Rs) according to a new programme elaborated in the National Research Institute of Mother and Child. The management according to these principles allows early palatbe reconstruction in young infants and has a significant influence on their health status.
Subject(s)
Pierre Robin Syndrome/diagnosis , Pierre Robin Syndrome/therapy , Humans , Infant , Infant, NewbornABSTRACT
During the period between 1993 and 1998 thirty-one children with symptoms of Pierre-Robin sequence were treated. Since gastroesophageal reflux (GER) is known to occur in patients with Pierre - Robin sequence, each child before surgery was checked for GER. In 28 cases GER was confirmed. We obtained rapid clinical improvement and possibility of early discharge from hospital after surgical treatment (palatoplasty, SRFM - subperiosteal release of the floor of the mouth, repair of the palato-pharyngeal ring). Follow up investigations few months after surgery showed no clinical symptoms of GER. The authors find evidence of " palatal mechanism" of GER in Pierre-Robin sequence and in their opinion early closure of the impaired palto-pharyngeal ring and elimination of mechanism causing posterior rotation of the tonque can reduce indications for such surgical procedures as glossopexy, gastrostomy, tracheostomy and Nissen fundoplication.
Subject(s)
Gastroesophageal Reflux/diagnosis , Gastroesophageal Reflux/surgery , Pierre Robin Syndrome/complications , Child , Child, Preschool , Female , Gastroesophageal Reflux/etiology , Humans , Infant , Male , Palate/surgery , Pharynx/surgeryABSTRACT
OBJECTIVE: To assess the prevalence of gastroesophageal reflux (GER) in patients with Pierre Robin sequence and to assess whether early palatoplasty with subperiosteal release of the floor of the mouth eliminates upper respiratory tract infections and gastroesophageal reflux. METHODS: In the period from 1993 to 1997, 24 children with Pierre Robin sequence were treated. Because GER is known to occur in patients with this syndrome, we screened for GER in each child for whom an early palatoplasty was to be performed at 3 months of age. In 21 cases, the presence of GER was confirmed. Within the past 2 years, palatoplasty has been combined with subperiosteal release of the floor of the mouth (SRFM). Prompt clinical improvement and shortened hospital stays have resulted. RESULTS AND CONCLUSIONS: Follow-up studies performed several months after the surgery showed no evidence of GER. The authors conclude that an early closure of the impaired palatopharyngeal ring and the elimination of the mechanism that causes the posterior rotation of the tongue can reduce the need for such surgical procedures as glossopexy, gastrostomy, tracheostomy, and Nissen's fundoplication.
