PMC4334891_01
A 6-week-old female with Pierre Robin sequence.
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The little patient was admitted to our unit with severe airway obstruction and tracheostomy (Fig. 1).
PMC4334891_02
Intraoperative right osteotomy performed with piezosurgery and placement of the distractor device (same on the left).
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The osteotomies were performed externally using a Piezosurgery device manufactured by Mectron Medical Technology (Carasco, Italy) which allows great cutting accuracy and the possibility of use in very restricted areas (Fig. 2).
PMC4334891_03
(A) Pre-op 3D CT showing severe mandibular hypoplasia with retrognathia at 6 weeks old. (B) Post-op 3D CT showing normal mandibular development two years after the distraction procedure.
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Direct visualization with flexible endoscope demonstrated the airway changes (Fig. 3).
The baby at 28 months with normal appearance and function.
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Improvement in feeding was seen following mandibular distraction and removal of he nasogastric tube (Fig. 4).
(A) Airway obstruction with collapsed tongue and epiglottis before distraction; (B) mandibular advancement - tongue and epiglottis are in an advanced form with creation of a new pharyngeal space airway after distraction.
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The last control was performed at the age of 28 months (Fig. 5).