The Journal of craniofacial surgery
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Case Reports
Transmandibular K-wire in the management of airway obstruction in Pierre Robin sequence.
The Pierre Robin sequence was first described by Pierre Robin in 1923 as a triad of micrognathia, U-shaped cleft palate, and glossoptosis. Although the problems associated with Pierre Robin sequence may be numerous, the most acute problem in affected newborns is upper airway obstruction. The causes of upper airway obstruction are heterogeneous, and treatment is controversial and may include a long stay in an intensive care setting. ⋯ The author was not the surgeon who placed the K-wire, and in one of the patients, the K-wire was retained for 4 years before being removed by the author. Both patients had surgical intervention to manage the airway problem in the form of lip-tongue adhesion in addition to the transmandibular K-wire. In conclusion, the value of using a transmandibular K-wire in the two cases presented here could not be determined and was questionable.
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Positional plagiocephaly deformities have increased dramatically in all craniofacial clinics in the United States. There are multiple methods for evaluating the degree of deformity, all of which are expensive, time consuming, and have poor reproducibility. ⋯ The classification allows us to quantitate the degree of deformity in these children at any given time, to reliably determine quantitative changes from evaluation to evaluation. The technique is highly reproducible, cost effective and readily understandable to the family, as well as referring physicians.