Temporary Tongue-Lip Traction during the Initial Period of Mandibular Distraction in Pierre Robin Sequence

Abstract

Distraction osteogenesis is a good technique to correct micrognathia and to prevent tracheostomy in patients with Pierre Robin sequence. However, the airway must be maintained during the distraction period. The purpose of this study was to determine the usefulness of temporary tongue-lip traction during the initial period of mandibular distraction in Pierre Robin sequence patients with severe airway problems requiring operative procedures. Three Pierre Robin sequence patients between 4 months and 3 years of age requiring surgical procedures to correct recurrent and severe pulmonary complications. All patients underwent distraction osteogenesis of the mandible. During surgery, a deep one-tension suture was used to apply traction to the tongue. When the patient gained control of the upper airway during the initial period of distraction and micrognathia was corrected, the traction suture was removed. The patients were followed for a mean of 5.4 years. No patients complained of severe pulmonary complications, and tracheostomy was avoided. The lower face area was increased in all three patients. In severe Pierre Robin sequence cases, temporary tongue-lip traction was a good adjunct to distraction osteogenesis because this method avoided tracheostomy.