Pierre Robin Sequence is a developmental abnormality that results in micrognathia, glossoptosis, and airway obstruction. Patients can have respiratory symptoms shortly after birth from airway obstruction. Traditionally tracheostomy has been the treatment of choice. Early mandibular distraction osteogenesis is an effective treatment and can obviate the need for tracheostomy in many cases and improve aesthetic position of the chin. The procedure involves placing two distractors on the lower border of the mandible just anterior to the angle. They are left in place for two days and distraction is begun at a rate of 1mm/day until the mandible has gained adequate projection. The bone is left to consolidate over 6-8 weeks and the distractors are removed. The case presented highlights the work-up and surgical management of a neonate with Pierre Robin Sequence and symptomatic micrognathia.
Intended Audience:
This educational activity is intended for plastic surgery practitioners, residents, and other healthcare professionals interested in translating expanded knowledge into practice for the improvement of patient outcomes in plastic and reconstructive surgery.
Learning Objectives:
By the end of this activity, participants will be able to:
- Identify and evaluate clinical features of Pierre Robin Sequence and severe neonatal micrognathia.
- Analyze surgical and non-surgical management options for neonatal airway obstruction
- Apply decision-making strategies in the management of neonatal airway compromise