Article Text

EARLY CLEFT REPAIR IN INFANTS WITH ROBIN SEQUENCE
  1. Z Dudkiewicz1,
  2. M Hortis-Dzierzbicka1,
  3. P Fudalej1,
  4. E Radkowska1
  1. 1Center for Craniofacial Disorders, Institute of Mother and Child, Warsaw, Poland

Abstract

Palatal cleft repair in infants with Robin sequence (RS) is usually recommended to be performed between 18–24 months of life.

Objective To present our treatment philosophy and experience with early cleft repair executed concurrently with subperiosteal release of the floor of the mouth (SRFM) in over 100 cases of infants with RS, and to show that our approach is effective in treatment of both feeding difficulties and respiratory distress symptoms.

Methods Surgical procedure presented comprises minimally invasive palatoplasty in combination with subperiosteal release of the floor of the mouth. We perform this routinely in young infants with RS at about the fourth month of life. Success of our approach is rooted in the pre-surgical medical treatment comprising permanent insertion of an NG feeding tube to assure both feeding and patency of the upper airway, until palatal surgery accompanied by SRFM is performed.

Results and Conclusions Our medico-surgical protocol enabled us to eliminate from the management of infants with RS such aggressive procedures like tracheotomy, glossopexy, gastrostomy and Nissen fundoplication. Early primary cleft palate repair is of paramount asset for infants with RS in restoring normal feeding and breathing patterns and influences positively development of undisturbed speech articulation.

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