COMBINATION THERAPY USING GLOSSOPEXY AND RADIOFREQUENCY THERAPY IN PIERRE ROBIN SEQUENCE

Pierre Robin sequence (PRS) describes the clinical triad of micro- and/or retrognathia, glossoptosis and cleft soft palate. Glossopexy has been demonstrated to be an effective treatment in selected cases of obstruction caused by glossoptosis (generally 6 to 10 months of glossopexy period). If radiofrequency therapy (RF) can reduce tongue volume in PRS, it will be helpful in early releasing of the glossopexy. Two-dayold patient showed a PRS triad. Intermittent cyanosis, respiratory difficulty and feeding problems were also observed. The respiration was not improved and prolonged intubation increased the possibility of respiratory complications like pneumonia. The surgical intervention- glossopexy and RF was done 20 days after birth. We applied RF combined with conventional glossopexy and could get successful results while reducing the overall treatment time to 6 weeks. The follow-up until 12 months after birth was uneventful. Considering that early recovery is highly beneficial to PRS patients by reducing risks associated with glossopexy and low energy RF application is very simple and low risk to patient, our combination therapy should be considered for the treatment of airway problem related to PRS.

[1]  K. Takeda,et al.  Complications after lung radiofrequency ablation: risk factors for lung inflammation. , 2008, The British journal of radiology.

[2]  F. Cozzi,et al.  The effect of glossopexy on weight velocity in infants with Pierre Robin syndrome. , 2008, Journal of pediatric surgery.

[3]  Arthur Partikian,et al.  Iatrogenic Botulism in a Child With Spastic Quadriparesis , 2007, Journal of child neurology.

[4]  H. Rotaru,et al.  Treatment of post-traumatic open bite by radiofrequency. , 2007, The British journal of oral & maxillofacial surgery.

[5]  K. Hörmann,et al.  Radiofrequency surgery of the tongue base in the treatment of snoring—a pilot study , 2007, Sleep and Breathing.

[6]  K. Oh,et al.  Radiofrequency Volume Reduction of Gastrocnemius Muscle Hypertrophy for Cosmetic Purposes , 2007, Aesthetic Plastic Surgery.

[7]  Haruyasu Yamada,et al.  Complications of percutaneous radiofrequency ablation for hepato-cellular carcinoma: imaging spectrum and management. , 2005, Radiographics : a review publication of the Radiological Society of North America, Inc.

[8]  A. Denny Distraction osteogenesis in Pierre Robin neonates with airway obstruction. , 2004, Clinics in plastic surgery.

[9]  J. P. Willging,et al.  Airway Management in Pierre Robin Sequence , 1998, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[10]  S. Chevret,et al.  Influence of Long-Term Oro- or Nasotracheal Intubation on Nosocomial Maxillary Sinusitis and Pneumonia: Results of a Prospective, Randomized, Clinical Trial , 1994 .

[11]  A. Sher,et al.  Mechanisms of airway obstruction in Robin sequence: implications for treatment. , 1992, The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association.

[12]  K. Golding-Kushner,et al.  Effect of glossopexy on speech sound production in Robin sequence. , 1992, The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association.

[13]  R. Argamaso Glossopexy for upper airway obstruction in Robin sequence. , 1992, The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association.

[14]  E. Campbell Mechanisms of Airway Obstruction in Emphysema and Asthma , 1958, Proceedings of the Royal Society of Medicine.

[15]  P. Robin GLOSSOPTOSIS DUE TO ATRESIA AND HYPOTROPHY OF THE MANDIBLE , 1934 .