변형된 Tongue-lip Adhesion 방법을 이용한 Pierre-Robin Sequence의 치료: 증례보고

Modified Tongue-lip Adhesion for Pierre-Robin Sequence: A Case Report

Pierre Robin sequence (PRS) is defined by micrognathia, glossoptosis, and upper airway obstruction. Tongue–lip adhesion (TLA) involves surgically moving the tongue forward to the lower lip and is a technique to relieve airway obstruction; however, the conventional technique with an external chin button may lead to local infection or abscess. We report a modified TLA without the external button while achieving stable airway improvement. A male new-born baby presented glossoptosis, micrognathia, airway obstruction, and cleft palate. Despite nasopharyngeal tube placement and prone positioning, recurrent desaturation and obstruction occurred due to secretion-related tube blockage. At 26 days of age, modified TLA was performed. Opposite-based mucosal flaps were elevated on the ventral tongue and lower lip. A resin button was fixed to the tongue base using 2-0 PDS, and suspension sutures were passed through the tongue base and anterior mandibular alveolus using 2-0 Vicryl without applying an external chin button. Mucosal flaps were approximated with 5-0 Vicryl. Postoperatively, the airway remained stable even in the supine position, with no recurrence or complications during 5 months of follow-up. This modified TLA may be a practical alternative to reduce chin-site complications while maintaining effective airway control in PRS infants.