Pierre Robin/Micrognathia

Jaw Distraction Surgery

Pierre Robin sequence only requires treatment at a young age if the windpipe is obstructed, causing difficulty breathing. The cause of the breathing obstruction may be multifactorial. Mild cases of breathing obstruction from Pierre Robin may be treated with side or face-down positioning and close monitoring. This allows the tongue to fall forward and out of the windpipe. A nasopharyngeal airway, a small tube inserted in the nose, can also increase airflow. Surgical interventions are considered if the above conservative measures fail or if the Pierre Robin is severe. There are two surgical approaches to managing Pierre Robin: tongue-lip adhesion and mandibular distraction. A tongue-lip adhesion involves a surgical fusion of the tongue undersurface to the lower lip. This technique is designed to pull the tongue forward and out of the windpipe. A second procedure is required later to release the tongue from the lip when the infant has grown enough. Mandibular distraction (also known as distraction osteogenesis) involves precise cuts being made in the lower jaw bone. A device is applied to bridge the cut part of the jaw. On a daily basis, the device is designed to slowly separate the cut jaw. This allows for new bone to form in the cut area while lengthening the lower jaw. As the jaw moves forward, it pulls the tongue with it out of the windpipe.