SUBPERIOSTEAL RELEASE OF THE FLOOR OF THE MOUTH IN PIERRE ROBIN-SEQUENCE - EXPERIENCE WITH 12 CASES

Between 1983 and 1995, 12 children with Pierre Robin sequence were tre ated with a subperiosteal release of the floor of the mouth (SRFM) to correct severe upper-airway obstruction (group 1: n = 10) and prolonge d feeding difficulties (group 2: n = 2), Eight children had isolated P ierre Robin sequence, while four had associated anomalies, The age at surgery was 2 to 13 weeks (mean, 5.2 wk) in group 1, and 8.5 months to 5 years in group 2, Postoperative endotracheal intubation was maintai ned for 1 to 14 days, and nasopharyngeal intubation for 3 to 13 days. One child with a tracheostomy prior to SRFM was decanulated 11 weeks p ostoperatively, Postoperative course was uneventful and control polyso mnograms (group 1) showed a marked improvement of the obstructive phen omenons and O-2 saturation levels, Children were discharged 2 to 6 wee ks postoperatively (mean, 4 wk) except for the child with a tracheosto my (19 wk), The only complication was a wound infection treated with s ystemic antibiotics. Oral feedings were initiated shortly after extuba tion: six children were discharged with oral feedings only, one child required supplemental gavages for 6 weeks at home, and three children had persistent inadequate oral intake, We have found SRFM to be an eff ective surgical procedure for the management of infants with Pierre Ro bin sequence.