![]() ![]() ![]() Therefore, this combination of findings became referred to as Pierre Robin (pronounced Roban) Sequence. Internal mandibular microdistraction devices represent a substantial advance in airway obstruction management in infants with micrognathia. What is Pierre Robin Sequence In 1923, a French physician named Pierre Robin described a child with a small jaw, tongue that is displaced back towards the throat and cleft palate. As the distal mandibular segment is distracted, the hyoid moves anteriorly, with minor increase in geniohyoid relationship. Hypopharyngeal airway volume increases substantially, with an even greater increase in distance between tongue base and posterior pharyngeal wall. Unidirectional internal microdistractors can achieve good mandibulo-maxillary arch harmony. After distraction, total mandibular length was increased by 26.2% hypopharyngeal airway volume, 192% posterior distance from pharyngeal wall to tongue base, 198.9% and geniohyoid distance, 14.1%. Mandibular ramus was lengthened by 19.5% the body, 43.4%. The breathing problems start either from or shortly after. Clinical examination showed good arch harmony without open-bite or cross-bite deformities. Pierre Robin ( Pee-air Roe-bahn) sequence, also called Pierre Robin syndrome, or PRS, is a condition where babies are born with a small lower jaw, have difficulties breathing (airway obstruction) and often (but not always) have a cleft of the palate (an opening in the roof of the mouth). Mandibulo-maxillary alveolar ridge distances were corrected to 0.5 mm after distraction. Computed tomography data were extracted and analyzed with medical image analysis software for mandibulo-maxillary arch harmony, symmetry, hypopharyngeal airway volume, geniohyoid distance, distraction osteogenesis bone volume, and mandibular length. Standardized serial computed tomography (CT) scans were obtained according to established protocol. ![]() The infants underwent mandibular lengthening with the same internal, unidirectional distraction osteogenesis device. We reviewed a series of infants with PRS and severe upper airway obstruction who underwent mandibular distraction. Prospective analysis of a cohort of three patients with PRS. Little evidence in the medical literature quantitatively demonstrates the changes in skeletal, soft tissue, and hypopharyngeal spaces with mandibular distraction. Pierre Robin sequence (PRS) consists of the following three essential components (see the images below): Micrognathia or retrognathia. One of our craniofacial and pediatric maxillofacial surgeons will perform this operation and will determine the best time for this operation depending on your child’s condition.Early mandibular lengthening by distraction osteogenesis provides an alternative to traditional methods of airway management in infants with Pierre Robin sequence (PRS). This operation is usually performed around one year of age, but may be safely delayed if your child if there is concern about your child’s breathing. Repair of a cleft palate is important for infants to develop normal speech. Patients who are not candidates for distraction osteogenesis may benefit from the placement of a tracheostomy or feeding tube. The surgeons and medical team of Florida Craniofacial Institute will help determine if your child is a candidate for this procedure. Distraction osteogenesis (DO) is a surgical procedure that stretches the bone of the lower jaw to pull the tongue forward and improve airway obstruction. The majority of patients with PRS also have a cleft of the secondary palate. In more significant cases surgery may be required. Pierre Robin sequence (PRS) which is named after the French dental surgeon Pierre Robin is a triad of micrognathia, glossoptosis, and upper airway obstruction (Robin 1923, 1934 ). In less severe cases, special positioning during feedings and sleep will improve the position of the tongue and allow an infant to breathe well until they outgrow the problem. Many cases of Pierre Robin Sequence can be managed but typically requires surgery. ![]()
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