Innovative surgical approach for the Pierre Robin anomalad: subperiosteal release of the floor of the mouth musculature.

Abstract

The Pierre Robin anomalad presenting with severe respiratory distress is a difficult situation still associated with a significant mortality rate. A surgical approach based on a new idea is described. The concept is that the musculature of the floor of the mouth is under increased tension and pushes the tongue upward and backward with secondary respiratory obstruction. The surgical approach consists of a subperiosteal release of the musculature of the floor of the mouth through a 2-cm submental incision. So far this procedure has been used in four patients with severe obstruction, and marked improvement has occurred postoperatively in all cases. This surgical technique is simple and is associated with little morbidity. It should lessen the need for tracheostomy, which carries a greater morbidity, especially in newborns. We think that this new surgical approach can significantly improve the outcome of the severe form of Pierre Robin anomalad.