“Orthoglossopelveplasty” and the algorithm for its use in the Pierre Robin sequence

Introduction: Several patients with the Pierre Robin sequence (micrognathia, glossoptosis, and airway obstruction) have an altered, shortened, and retractable genioglossus muscle that prevents protraction of the tongue and keeps the anterior part of the tongue vertical and its volume posteriorly dis...

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Main Authors: Vera Lúcia Nocchi Cardim, Jullyana Heinen Peixoto, Alessandra dos Santos Silva
Format: Article
Language:English
Published: Sociedade Brasileira de Cirurgia Plástica 2019-06-01
Series:Revista Brasileira de Cirurgia Plástica
Subjects:
Online Access:http://www.rbcp.org.br/export-pdf/2531/en_v34n2a08.pdf
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author Vera Lúcia Nocchi Cardim
Jullyana Heinen Peixoto
Alessandra dos Santos Silva
author_facet Vera Lúcia Nocchi Cardim
Jullyana Heinen Peixoto
Alessandra dos Santos Silva
author_sort Vera Lúcia Nocchi Cardim
collection DOAJ
description Introduction: Several patients with the Pierre Robin sequence (micrognathia, glossoptosis, and airway obstruction) have an altered, shortened, and retractable genioglossus muscle that prevents protraction of the tongue and keeps the anterior part of the tongue vertical and its volume posteriorly displaced. This can contribute to supraglottic obstruction, feeding difficulty, and inversion of the growth stimulation forces of the mandibular body. Methods: A retrospective study of patients with the Pierre Robin sequence treated between 2012 and 2017 with "orthoglossopelveplasty," which includes modification of glossopexy, releasing the anomalous genioglossus of its insertion and releasing the tongue to raise its anterior third and advance the volume of its base using a traction suture of the tongue base to the mandible symphysis. We present a treatment algorithm that prioritizes the need for surgery associated, or not, with mandibular distraction in accordance with respiratory and/or feeding difficulty severity. Results: Twelve cases of oropharyngeal obstruction treated from 2012 to 2017 are presented, their priorities and orthoglossopleoplasty are discussed, and the proposed algorithm is applied. Conclusion: Anatomical reorganization of the musculature in a correct anterior position provides protraction and functionality to the tongue, clears the airway in the oropharynx, and improves the feeding function and mandibular development, with low surgical morbidity rates and few complications.
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spelling doaj.art-36eef96384474e24a65c0436970eb45c2023-12-03T09:45:50ZengSociedade Brasileira de Cirurgia PlásticaRevista Brasileira de Cirurgia Plástica1983-51752177-12352019-06-01340222823610.5935/2177-1235.2019RBCP0138“Orthoglossopelveplasty” and the algorithm for its use in the Pierre Robin sequenceVera Lúcia Nocchi Cardim0Jullyana Heinen Peixoto1Alessandra dos Santos Silva2Hospital Beneficiência Portuguesa de São Paulo, Núcleo de Cirurgia Plástica Avançada, São Paulo, SP, BrazilHospital Beneficiência Portuguesa de São Paulo, Núcleo de Cirurgia Plástica Avançada, São Paulo, SP, BrazilHospital Beneficiência Portuguesa de São Paulo, Núcleo de Cirurgia Plástica Avançada, São Paulo, SP, BrazilIntroduction: Several patients with the Pierre Robin sequence (micrognathia, glossoptosis, and airway obstruction) have an altered, shortened, and retractable genioglossus muscle that prevents protraction of the tongue and keeps the anterior part of the tongue vertical and its volume posteriorly displaced. This can contribute to supraglottic obstruction, feeding difficulty, and inversion of the growth stimulation forces of the mandibular body. Methods: A retrospective study of patients with the Pierre Robin sequence treated between 2012 and 2017 with "orthoglossopelveplasty," which includes modification of glossopexy, releasing the anomalous genioglossus of its insertion and releasing the tongue to raise its anterior third and advance the volume of its base using a traction suture of the tongue base to the mandible symphysis. We present a treatment algorithm that prioritizes the need for surgery associated, or not, with mandibular distraction in accordance with respiratory and/or feeding difficulty severity. Results: Twelve cases of oropharyngeal obstruction treated from 2012 to 2017 are presented, their priorities and orthoglossopleoplasty are discussed, and the proposed algorithm is applied. Conclusion: Anatomical reorganization of the musculature in a correct anterior position provides protraction and functionality to the tongue, clears the airway in the oropharynx, and improves the feeding function and mandibular development, with low surgical morbidity rates and few complications.http://www.rbcp.org.br/export-pdf/2531/en_v34n2a08.pdfglossoptosispierre robin sequencemicrognathiaairway obstructionfloor of the mouthdistraction osteogenesis
spellingShingle Vera Lúcia Nocchi Cardim
Jullyana Heinen Peixoto
Alessandra dos Santos Silva
“Orthoglossopelveplasty” and the algorithm for its use in the Pierre Robin sequence
Revista Brasileira de Cirurgia Plástica
glossoptosis
pierre robin sequence
micrognathia
airway obstruction
floor of the mouth
distraction osteogenesis
title “Orthoglossopelveplasty” and the algorithm for its use in the Pierre Robin sequence
title_full “Orthoglossopelveplasty” and the algorithm for its use in the Pierre Robin sequence
title_fullStr “Orthoglossopelveplasty” and the algorithm for its use in the Pierre Robin sequence
title_full_unstemmed “Orthoglossopelveplasty” and the algorithm for its use in the Pierre Robin sequence
title_short “Orthoglossopelveplasty” and the algorithm for its use in the Pierre Robin sequence
title_sort orthoglossopelveplasty and the algorithm for its use in the pierre robin sequence
topic glossoptosis
pierre robin sequence
micrognathia
airway obstruction
floor of the mouth
distraction osteogenesis
url http://www.rbcp.org.br/export-pdf/2531/en_v34n2a08.pdf
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