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Der MKG-Chirurg

, Volume 12, Issue 1, pp 11–19 | Cite as

Die Frühbehandlung der Pierre-Robin-Sequenz – einer speziellen Form der Gaumenspalte

  • M. KrimmelEmail author
  • M. Bacher
  • B. Koos
  • C. Poets
  • S. Reinert
Leitthema
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Zusammenfassung

Die Pierre-Robin-Sequenz (PRS) ist durch die obere Atemwegsobstruktion ein potenziell lebensbedrohlicher Zustand. Zumindest führt sie unbehandelt bei den betroffenen Säuglingen durch die rezidivierenden Hypoxien und die Fütterungsprobleme zu einer Entwicklungs- und Gedeihstörung. Die Frühbehandlung muss deshalb auf eine Aufhebung der Obstruktion und eine normale Gewichtszunahme gerichtet sein. Goldstandard in der Diagnostik der Atemproblematik sind die Polysomnographie und die Endoskopie. Bei der Therapiemethode der Wahl besteht international noch kein Konsens. Zu unterscheiden ist zwischen nichtoperativen und operativen Methoden. Die Datenlage im Sinne von qualitativ hochwertigen Studien hinsichtlich ihrer Wirksamkeit ist spärlich. Die einzige prospektive kontrollierte randomisierte Studie zur Frühbehandlung der PRS liegt für die Tübinger Spornplatte vor. Die gewählte Therapieform sollte neben dem bestmöglichen Therapieerfolg möglichst wenige Nebenwirkungen bzw. Komplikationen aufweisen.

Schlüsselwörter

Atemwegsobstruktion Entwicklungsstörungen Polysomnographie Unterkiefer Spornplatte 

Early treatment of Pierre Robin sequence – a special kind of cleft palate

Abstract

Pierre Robin sequence (PRS) is a life-threatening condition due its associated upper airway obstruction. In all infants, this at least leads to developmental delay and failure to thrive due to recurrent hypoxemia and feeding problems. Early treatment should therefore aim to relieve airway obstruction and feeding problems and achieve normal weight gain. Gold standard for the assessment of airway patency are polysomnography and endoscopy. There is a lack of international consensus regarding the treatment of choice for airway obstruction. It can be distinguished between non-surgical and surgical methods. High-level evidence on treatment outcome is scarce. The only randomized clinical trial on early treatment of PRS is available for the pre-epiglottic baton plate. The selected treatment should have the best possible outcome, high safety, and few side effects or complications.

Keywords

Airway obstruction Developmental disabilities Polysomnography Mandible Pre-epiglottic baton plate 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Krimmel, M. Bacher, B. Koos, C. Poets und S. Reinert geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Für Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, über die Patienten zu identifizieren sind, liegt von ihnen und/oder ihren gesetzlichen Vertretern eine schriftliche Einwilligung vor.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  • M. Krimmel
    • 1
    Email author
  • M. Bacher
    • 2
  • B. Koos
    • 3
  • C. Poets
    • 4
  • S. Reinert
    • 1
  1. 1.Klinik und Poliklinik für Mund‑, Kiefer- und GesichtschirurgieUniversitätsklinikum TübingenTübingenDeutschland
  2. 2.BIPTübingenDeutschland
  3. 3.Poliklinik für KieferorthopädieUniversitätsklinikum TübingenTübingenDeutschland
  4. 4.Kinderheilkunde IV – Neonatologie, neonatologische IntensivmedizinTübingenDeutschland

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