Paradigm Shift in Airway Management for Pierre Robin Sequence: Tongue Base Suspension

Safri, Shabbir; Wickemeyer, Johanna; Valika, Taher

doi:10.1097/scs.0000000000007198

Cited by 5 publications

(11 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…TBS has not been previously described in the treatment of children with PRS. They show that TBS can be a potential method for treating airway obstruction in neonates with PRS 11 . We also advocate that the role of TBS may be more important in TLA by assessing the effectiveness of TBS using intraoral endoscopy.…”

Section: Discussionmentioning

confidence: 92%

“…Safri et al 11 reported the first use of TBS for this purpose. TBS may be considered an alternative in future surgical algorithms for managing the PRS, as it directly addresses the site of upper airway obstruction.…”

Section: Discussionmentioning

confidence: 99%

“…In case TLA is not as effective as anticipated, TBS is an additional or alternative surgical method. In previous studies, 1,11 TLA and TBS were often grouped as one procedure, collectively described as TLA, with TBS characterized as an auxiliary procedure. However, we describe them separately because each requires emphasis.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Transoral Endoscopy-Assisted Tongue-Lip Adhesion With Modified Tongue Base Suspension in a Pierre-Robin Sequence: A Safe and Effective Technique

Kim,

Ryu,

Jung

et al. 2023

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

Life-threatening airway obstruction is a major concern in patients with Pierre-Robin sequence. Tongue-lip adhesion (TLA) has been used to manage airway obstruction. The authors present the case of a female neonate with Pierre-Robin sequence who presented with airway obstruction and a cleft palate. She underwent a TLA procedure with modified tongue base suspension (TBS). Endoscopy was used to check and control the traction of the tongue base to enable unobstructed self-ventilation. Positive outcomes including improved O2 saturation and weight gain were noted. The effectiveness of TLA was enhanced by using TBS with real-time endoscopy to evaluate the oropharyngeal airway space required to alleviate airway obstruction. The use of endoscopy enabled us to check and determine how much the tongue base should be tracted by manipulating the tongue anteriorly and posteriorly. The authors report transoral endoscopy-assisted TLA and modified TBS.

show abstract

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Transoral Endoscopy-Assisted Tongue-Lip Adhesion With Modified Tongue Base Suspension in a Pierre-Robin Sequence: A Safe and Effective Technique

Kim,

Ryu,

Jung

et al. 2023

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

show abstract

“…[12,13] In addition, it is worth noting that due to airway dysfunction, children need to further strengthen the oxygen support for before and after mandibular traction. [14,15] At present, in clinical practice, after the child is weaned from the ventilator, a nasal cannula is usually used for additional oxygen support to meet the oxygen demand. Safe and effective oxygen support is very important for the prognosis of children with Pierre-Robin syndrome.…”

Section: The Authors Have No Funding and Conflicts Of Interest To Dis...mentioning

confidence: 99%

Humidified versus nonhumidified low-flow oxygen therapy in children with Pierre-Robin syndrome: A randomized controlled trial

et al. 2022

View full text Add to dashboard Cite

Background: Humidification is an important process in clinical oxygen therapy. We aimed to evaluate the effects and safety of humidified versus nonhumidified low-flow oxygen therapy in children with Pierre-Robin syndrome.Methods: This study was an open-label, single-centered randomized controlled trial (RCT) with a parallel group design. The study protocol has been registered in Chinese Clinical Trial Registry (ChiCTR1900021584). The children were randomized to the humidified versus nonhumidified groups. Average arterial oxygen partial pressure (PaO 2 ) and carbon dioxide partial pressure (PaCO 2 ), incidence of ventilator-associated pneumonia (VAP), nasal cavity dryness, nasal mucosal bleeding and bacterial contamination of the humidified bottle, the cost of nasal oxygen therapy and duration of intensive care unit (ICU) stay were analyzed.Results: A total of 213 children with Pierre-Robin syndrome were included. There were no significant differences in the gender, age, weight, prematurity, duration of anesthesia and surgery duration of mandibular traction between humidified group and nonhumidified group (all P > .05). No significant differences in the average arterial PaO 2 and PaCO 2 level on the postoperative day 1, 2, and ICU discharge between humidified group and nonhumidified group were found (all P > .05). There were no significant differences in the incidence of nasal cavity dryness, nasal mucosal bleeding, bacterial contamination and VAP, the duration of ICU stay between humidified group and nonhumidified group (all P > .05). The cost of nasal oxygen therapy in the humidified group was significantly less than that of nonhumidified group (P = .013).Conclusions: Humidifying the oxygen with cold sterile water in the low-flow oxygen therapy in children may be not necessary. Future RCTs with lager sample size and rigorous design are warranted to further elucidate the effects and safety of humidified versus nonhumidified low-flow oxygen therapy.Abbreviations: ICU = intensive care unit, PaCO 2 = carbon dioxide partial pressure, PaO 2 = arterial oxygen partial pressure, RCT = randomized controlled trial, SICU = surgical intensive care unit, VAP = ventilator-associated pneumonia.

show abstract

“…To the Editor: We read with great enthusiasm the recent publication by Safri et al (2020) proposing an innovative alternative surgical approach, tongue base suspension (TBS), for management of airway obstruction secondary to retrognathia, micrognathia, and glossoptosis in the patients with Pierre Robin sequence (PRS) 1 . Although we congratulate the authors for their successful management of the presented case of a 5-week-old full term male patient with PRS, we do not agree that presenting a single case should be considered as an example for a “paradigm shift” in the current status of airway management for PRS patients.…”

mentioning

confidence: 99%

Comments on Paradigm Shift in Airway Management for Pierre Robin Sequence: Tongue Base Suspension

Jahromi¹,

Stoehr

Konofaos³

et al. 2021

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

Paradigm Shift in Airway Management for Pierre Robin Sequence: Tongue Base Suspension

Abstract: Surgical management of the airway in children with Pierre Robin Sequence (PRS) includes tongue lip adhesion and mandibular distraction. Herein, the authors report the first case of an alternative surgical approach, the tongue base suspension (TBS).

Cited by 5 publications

References 10 publications

Transoral Endoscopy-Assisted Tongue-Lip Adhesion With Modified Tongue Base Suspension in a Pierre-Robin Sequence: A Safe and Effective Technique

Transoral Endoscopy-Assisted Tongue-Lip Adhesion With Modified Tongue Base Suspension in a Pierre-Robin Sequence: A Safe and Effective Technique

Humidified versus nonhumidified low-flow oxygen therapy in children with Pierre-Robin syndrome: A randomized controlled trial

Comments on Paradigm Shift in Airway Management for Pierre Robin Sequence: Tongue Base Suspension

Contact Info

Product

Resources

About