A Simple Mandibular Distraction Protocol to Avoid Tracheostomy in XXXX With Pierre Robin Sequence.

@entity3572 @entity5599 @entity1 @entity1224
OBJECTIVE:     Recent treatment goals for @entity5599 ( @entity5599 ) focus on avoiding tracheostomy through modalities such as @entity3572 ( @entity3572 ). We primarily evaluated the efficacy of our straightforward @entity3572 treatment protocol for resolution of @entity5599 -associated @entity1224 while secondarily analyzing @entity1 characteristics associated with success or failure of @entity3572 . DESIGN:     A retrospective chart review before and after treatment. SETTING:     Tertiary institutional center and private practice setting. @entity1 :     All @entity1 were diagnosed with @entity5599 and treated with @entity3572 , according to the @entity3572 treatment protocol, by a single surgeon with the same operative technique from 1999 to 2013. A sample size of n = 38 met the inclusion criteria. Data assessed included tracheostomy status (pre- @entity3572 , post- @entity3572 , or none), microlaryngoscopy and bronchoscopy (MLB) findings, multipositional airway study results, clinical resolution of @entity1224 following @entity3572 , and @entity1 characteristics. MAIN OUTCOME MEASURE:     Resolution of @entity1224 with avoidance of a tracheostomy. RESULTS:     Prior to referral for @entity3572 , five @entity1 required urgent tracheostomy. Of @entity1 without a pre- @entity3572 tracheostomy (n = 33), two @entity1 required tracheostomy post- @entity3572 , while 94% avoided tracheostomy with clinical resolution of @entity1224 (n = 31). On secondary analysis, anatomic abnormalities diagnosed by MLB were associated with a higher rate of tracheostomy (P = .037), confirming the utility of preoperative evaluation with MLB; otherwise, no @entity1 characteristics demonstrated significance in @entity1 selection. Follow-up ranged from 6 months to 10 years (mean = 6.45 years, median = 7.61 years). CONCLUSIONS:     Our treatment protocol demonstrates @entity3572 is highly effective for resolving severe @entity1224 related to @entity5599 . Based on secondary analysis, our simplified protocol does not require amendment.
