Changes in airway dimensions after mandibular distraction in patients with Pierre-Robin sequence associated with malformation syndromes

Introduction

The Pierre Robin syndrome, or sequence, is a triad characterised by micrognathia, glossoptosis and upper respiratory obstruction, with or without cleft palate. Most patients respond to postural treatment, although tracheotomy is necessary on extreme occasions. Mandibular distraction is currently an effective therapeutic alternative that elongates the jaw and resolves the respiratory obstruction. The choice of vector for distraction is essential for modifying the dimensions of the airways.

Patients and methods

The objective of this study is to evaluate the changes produced in the dimensions of the upper airways in eight children with Pierre Robin sequence, treated with mandibular distraction, depending on the vector of distraction planned. To this end, a lateral cranial X-ray was performed pre- and post-distraction, tracing a line from the mandibular plane to the base of the tongue and as far as the posterior pharyngeal wall, measuring the millimetres of separation between the two structures.

Results and conclusions

The results showed that the horizontal distraction vector, in the first place, and the oblique vector in the second place, would be the procedures of choice in view of their positive effects on the airways.