Summary

Retrognathia is seen in many different patient populations. The mandible's position has a range of effects on the upper airway in terms of its role in airway compromise as well as in the resulting severity of obstruction. As such, one should have a high degree of suspicion for apparent or subtle airway obstruction when evaluating a patient with retrognathia. Varying degrees of airway compromise may result from retrognathia itself, or from the effects of the posteriorly positioned mandible in combination with other factors. In the presence of any degree of airway compromise and concomitant retrognathia, the etiology of the airway compromise must be determined, and the precise role of the mandible defined. In some patients, the retrognathia may be found to be incidental; in this patient population, addressing the mandible as the source of the airway obstruction will prove futile. However, retrognathia will represent a significant component of upper airway compromise for many other patients. These patients may benefit greatly by various interventions directed at treating the retrognathic mandible.

REFERENCES

Bluestein—CHAPTER 75

1. Peterson LJ, Indresano AT, Marciani RD, Roser SM. Principles of Oral and Maxillofacial Surgery. Philadelphia: JB Lippincott; I992:I228

2. Bacon WH, Turlot JC, Krieger J, et al. Cephalometric evaluation of pharyngeal obstructive factors in patients with sleep apnea syndrome. Angle Orthod I989;60:II5-I2I

3. Sher AE. Mechanisms of airway obstruction in Robin Sequence: implications for treatment. Cleft Palate Craniofac J I992;29: 224-23I

4. Guyette RF, Waite PD. Oral and Maxillofacial Surgery Clinics. Vol 7. Philadelphia: WB Saunders; I995:30I-3I0

5. Waite PD, Shettar SM. Oral and Maxillofacial Surgery Clinics. Vol 7. Philadelphia: WB Saunders; I995:327-336

6. Augarten A, Sagy M, Yahav J, Barzilay Z. Management of upper airway obstruction in the Pierre Robin syndrome. Br J OralMaxillofac Surg I990;28:I05-I08

7. Tomaski SM, Zalzal GH, Saal HM. Airway obstruction in the Pierre Robin sequence. Laryngoscope I995;I05:III-II4

8. Neville BW, Damm DD, Allen CM, Bouquot JE. Developmental defects of the oral and maxillofacial region. In: Neville BW

et al. Oral Maxillofacial Pathology. Philadelphia: WB Saunders; I995:34-40

9. Gorlin RJ, Cohen MM, Levin LS. Syndromes of the head and neck. 3rd Ed. New York: Oxford University Press; I990

10. Myer CM III, Reed JM, Cotton RT, et al. Airway management in Pierre Robin sequence. Otolaryngol Head Neck Surg I998;II8:630-635

11. Frohberg U, Lange R. Surgical treatment of Robin sequence and sleep apnea syndrome: case report and review of the literature. J Oral Maxillofac Surg I993;5I:I274-I277

12. Peterson LJ, Indresano AT, Marciani RD, Roser SM. Principles of Oral and Maxillofacial Surgery. Philadelphia: JB Lippincott; I992:I539-I546

13. Easter B, Wood C, Eppley BL, Sadove AM. Mandibular traction system for adjunctive management of airway insufficiency in infants with Pierre Robin malformation sequence. Am J Occup Ther I99I;45:94I-943

0 0

Post a comment