Jaw Distraction Surgical Technique for Pierre Robin Sequence

A new, specialized surgical technique for babies born with a craniofacial deformity that blocks the babys airway can fix the problem and alleviate the need for a tracheostomy.

Baby Paul Lucas was born in Oct. 2009. During pregnancy, his parents had no idea that he would be born with Pierre Robin Sequence resulting in a small jaw, cleft palate and big tongue. The critical problem was that when he was laid on his back, his tongue blocked his airway, causing him to turn blue and go into respiratory distress.

Traditionally, a tracheostomy placed in the throat would be required; however, the child would need the tracheostomy for years until about age 7 to 11 years of age. During that time period the child may often have complications like pneumonia or more rarely children have even died. When children have trachs, they cannot eat or speak normally. They may be developmentally delayed and need a feeding tube.

However, Dr. James Bradley, a UCLA pediatric plastic and reconstructive surgeon, is one of just a few surgeons nationwide that offers an alternative to trach—and it can actually fix the problem in a relatively short amount of time. As these children grow older, its practically impossible to know that they ever had a birth deformity.

During surgery, the bone of the jaw is separated and distractors are put in place on both sides. Then, the baby returns to the neonatal intensive care unit for two weeks and the distraction devices are turned twice a day which helps lengthen the jaw. Ideally, the jaw will grow 3 cm by the end of the 2 week period providing enough space for the tongue to lie properly and allow normal airway breathing. The baby goes home with the distractors in place ( but hidden under the cheek) while the bone continues to grow, although no additional turning is required. The baby has outpatient surgery about 3 months later to remove the device.

For parents who had no idea from prenatal scans or tests that their baby would be born with this deformity, most people are not aware of this surgery which can fix the problem and alleviate the need for a trach. For parents this process can be stressful. When they see their child change from a scary situation of not being able to breathe or feed, to a normal situation of feeding and breathing in a few weeks, they are elated.

Learn more at www.plasticsurgery.ucla.edu

Category:

Science & Technology

Tags:

• blocked airway
• jaw distraction technique
• Pierre Robin Sequence
• Dr. James Bradley
• UCLA Pediatric Plastic Surgery
• tracheostomy alternative
• distractors

[villagelinca]

My 2nd son had this surgery at UCLA when he was 5 days old. I was so glad my son could have this surgery and did not have to get a trach. He does have some stiffness on one side of his face and a speech delay (he is in speech therapy now). The dad is a bit confusing in this video talking about a "cleft chin". Babies with Pierre Robin Sequence have a cleft palate (which requires a different surgery). The jaw distraction surgery moves the lower jaw forward to open the airway.

[rachm1991]

Ahh...I remember deciding to have this done two years ago, and now, I'm unsure if I want another one (since one side snapped and went back a bit) next summer...bless this little boy though! :)

[elvisnky]

I had this done in Cincinnati Ohio Childrens medical center now my daughter cant open her fricking mouth. Jaw distraction gone bad.

[MyGonzalitro]

Can anybody tell me if they do this operation in irland? please!!!!

[Mariely1782]

Mi hijo tiene 11 años y le hicieron esa cirugia y la verdad q su rostro es totalmente diferente.Dios bendiga al creador de esa maravilla q le dio una nueva y mejor vida a mi hijo!

[Cacheous]

Awesome video.  My son was born with this condition in Jan. of 2011 and thanks to the wonderful team at Primary Children's Hospital in Salt Lake City and this procedure he is doing great. His devices will be removed in the middle of May 2011.

[domajnkos]

My son had a jaw distractor at 3 weeks old! I am so blessed with this new surgery. He is now 5 yrs old and is doing well. I would encourage anyone who needs this for their child to do it!

[nendy21]

This is really helpful for me at this precise moment. My daughter who's 3 yrs. Old needs a jaw distraction. Watching this video helps me come to a decision! Thank you for sharing!

[ANZOAMS2010]

This is an excellent video. I really applaud what you guys are doing

Dr Paul Coceancig. MaxFax Surgeon, Newcastle, AUSTRALIA

[keveystew]

That is wonderfull . I am an adult with a slight case of hemifacial microsomnia. It is just amazing what you can do for a child to grow up normal!