{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:45:15Z","timestamp":1780469115223,"version":"3.54.1"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n            <jats:title>Introduction:<\/jats:title>\n            <jats:p>Neonates with severe Pierre Robin sequence (PRS) can be treated by mandibular distraction osteogenesis (MDO), tongue-lip adhesion, or tracheostomy; however, there is an active debate regarding the indications of MDO in this patient population. Published algorithms identify tracheomalacia, bronchomalacia, laryngomalacia, hypotonic syndromes, and central sleep apnea as contraindications for MDO and indications for tracheostomy, but these comorbidities may exist along a spectrum of severity. The authors propose that appropriately selected neonates with PRS who concurrently express 1 or more of these traditional contraindications may be successfully treated with MDO.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>The authors performed a 5-year retrospective chart review of all neonates who underwent MDO for treatment of severe PRS. All patients expressed a comorbidity previously identified as an indication for tracheostomy. Pre- and postoperative characteristics were recorded. Apnea\/hypopnea index (AHI) before and after MDO were compared using 2-tailed repeated measures <jats:italic toggle=\"yes\">t<\/jats:italic>-test.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>The authors identified 12 patients with severe PRS and conditions associated with contraindications to MDO: 9 (75.0%) patients had laryngomalacia, 6 (50.0%) patients had tracheomalacia, 2 (16.6%) patients had bronchomalacia, 1 (8.3%) patient had central sleep apnea, and 3 (25.0%) patients had hypotonia. Five (41.7%) patients underwent concurrent gastrostomy tube placement due to feeding insufficiency. Average birthweight was 3.0\u200akg. Average pre-op AHI was 34.8. Average post-op AHI was 7.3. All patients successfully underwent MDO with avoidance of tracheostomy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>By employing an interdisciplinary evaluation of patient candidacy, MDO can safely and effectively treat upper airway obstruction and avoid tracheostomy in higher-risk neonatal patients with traditional indications for tracheostomy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/scs.0000000000007670","type":"journal-article","created":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T21:54:13Z","timestamp":1618610053000},"page":"2326-2329","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["The Surgical Treatment of Robin Sequence: Neonatal Mandibular Distraction Osteogenesis in the Unfavorable Patient"],"prefix":"10.1097","volume":"32","author":[{"given":"Chen","family":"Shen","sequence":"first","affiliation":[{"name":"Hansj\u00f6rg Wyss Department of Plastic Surgery, NYU Langone Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxime M.","family":"Wang","sequence":"additional","affiliation":[{"name":"Hansj\u00f6rg Wyss Department of Plastic Surgery, NYU Langone Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley T.","family":"Eisemann","sequence":"additional","affiliation":[{"name":"Hansj\u00f6rg Wyss Department of Plastic Surgery, NYU Langone Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alcibiades J.","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"NYU Comprehensive Epilepsy Center \u2013 Sleep Center, NYU Langone Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott M.","family":"Rickert","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, NYU Langone Health, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto L.","family":"Flores","sequence":"additional","affiliation":[{"name":"Hansj\u00f6rg Wyss Department of Plastic Surgery, NYU Langone Health"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,4,12]]},"reference":[{"key":"R1-20250803","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1016\/j.ijom.2016.01.009","article-title":"Mandibular distraction osteogenesis for the management of upper airway obstruction in children with micrognathia: a systematic review","volume":"45","author":"Breik","year":"2016","journal-title":"Int J Oral Maxillofac Surg"},{"key":"R2-20250803","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1001\/jamapediatrics.2016.0796","article-title":"Best practices for the diagnosis and evaluation of infants with Robin sequence: a clinical consensus report","volume":"170","author":"Breugem","year":"2016","journal-title":"JAMA Pediatr"},{"key":"R3-20250803","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1097\/00006534-197305000-00003","article-title":"Mandibular lengthening by gradual distraction. 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