Open AccessTongue–lip adhesion in Pierre-Robin sequence: Role redefined
Author(s) -
Veena Singh,
Chandni Sinha,
Nishant Sahay,
Ansarul Haq,
Sarsij Sharma,
Shilpa Payal
Publication year - 2020
Publication title -
national journal of maxillofacial surgery
Language(s) - English
Resource type - Journals
eISSN - 2229-3418
pISSN - 0975-5950
DOI - 10.4103/njms.njms_11_17
Subject(s) - medicine , tongue , airway obstruction , swallowing , airway , craniofacial , adhesion , pharynx , hypoplasia , mandible (arthropod mouthpart) , surgery , orthodontics , dentistry , chemistry , botany , organic chemistry , pathology , psychiatry , biology , genus
The triad of retrognathia, glossoptosis, and airway obstruction characterizes the Robin sequence along with the detrimental effects of mandibular hypoplasia on feeding, swallowing, and growth, which are very well described. Most of the babies are managed successfully on nonsurgical measures, but selected patients require surgical intervention in the neonatal period for survival. Conventionally, tracheostomy was done, which still remains a first-line surgical procedure for some surgeons. However, presently, most of the craniofacial centers have switched over to mandibular distraction procedures at an early stage and only sometimes tongue-lip adhesion (TLA). The literature is unclear as to which surgical procedure for securing the airway is more effective for these patients, and hence, the choice of procedure depends on the resources and surgical expertise. This article tells the tale of a neonate who survived by just placing a simple U-stitch between the tongue and lip, retracting the tongue outside, which is the basic concept of all TLA procedures. It also reemphasizes the importance of TLA in Robin patients to improve the airway obstruction and helps buy the time in which the mandible and associated structures grow.